Stutter Case Study

Background
Accurate assessment of a person with stutter (PWS) is crucial in selecting the most effective relevant therapy and achieving successful outcomes. (Tarkowski, 2010). In particular it is important to assess whether a person has a normal disfluency or a stutter (Curlee & Perkins, 1985; Andrew & Ingham,1971). Diagnosis can be challenging due to the occurrence of disfluent speech at early age which appears and disappears in some situations and can be missed in others (Tarkowski, 2010). Nor should a parent’s input be overlooked as it may provide a clinician with essential information on their children’s speech (Einarsdo & Ingham,2008).

There are variety of symptoms that associated with stuttering, both overt and covert, also recognizable
Since the SLT is not involved the interaction flows naturally and the affect of his parent’s behaviour (such as whether they interrupt; talk fast; use complex sentences etc) can be seen first-hand on the child’s disfluency, self-awareness and level of embarrassment. (Guitar, 1998).

Title
As mentioned above Danny is classed as a moderate stutter and the rate of speech is slower than norm. Danny’s stutter has been getting worse over the last year, therefore he requires an early intervention so that the better outcome is reached. Late intervention can be less successful once children pass the pre-school age (Ingham and Cordes 1998 Through early intervention stuttering can be eliminated (Jones 2007).

The clinical pathway would begin with the clinician deciding on the most appropriate intervention, (ie. Direct vs Indirect; Lidcombe Program vs Palins Parent-Child Interaction?) based on the long term goals of the client. The intervention begins alongside regular monitoring by the clinician. Once Danny reaches a level deemed to be stutter-free speech, the next stage is ensuring that the level of fluency is transferred across different situations and finally maintained over a long period of
Conture & Kelly, (1991) claim that the secondary characteristics of stuttering indicate children’s own awareness of their stutter. It is difficult to judge whether any secondary characteristics are present since he is not facing the camera. However, in the parenting report it is noted that Danny said ‘can’t get the words out’, which possibly indicates his awareness of his own stutter. Danny’s parents should be involved in the chosen intervention since parents’ involvement is crucial in children’s health monitoring (Hall, 1996)

The ultimate goal of therapy will be to eliminate stuttering (Jones, 2007) as with all pre-school CWS. Danny’s clear dissatisfaction and frustration with his speech indicates that an additional goal of therapy would be to also eliminate the negative thoughts, emotions and anxiety that accompany the stutter (Conture, 2001, Guitar, 2006).

In relation to the ICF framework, Danny is due to start school and it is important that his stutter does not result in participation restriction. Consequently it could impede on his learning or affect his self-confidence. It is also important that Danny is not made a victim of bullying due to his