Stuttering: A Case Study

The complexity of stuttering has been acknowledged numerous times and in copious amount research throughout the years. It is not surprise that treatment would be just as complicated. Speech Language Pathologists facilitate effective speech and language skills via four basic steps; evaluation, education/counseling, therapeutic treatment, and generalization. Because of the complexity of deficits, Speech language pathologists are presented with challenges in every step of therapy. However, generalization is the step that Speech Language Pathologists struggle with more than any. In this the generalization and maintenance step, effectiveness of treatment is truly assessed. Unfortunately it is not only difficult to achieve generalization, but to
To truly assess a person’s generalization of a skill, he must be assessed in various contexts. Not only is this difficult for a clinician to assess due to limited time with the person with a stutter, but also because a true representation will take into varying context difficulty (Packman et.al , 2004). For example some people find they stutter more when on the phone, while other present with more dysfluencies when talking in front of a crowd. Because of the individualization necessary for assessment of generalization, it is important that the person with a stutter is involved in this assessment as well, via both self-reports in everyday contexts, but in choosing contexts that are more difficult to maintain fluency in (Packman et.al , 2004). As imagined many people will automatically avoid more difficult situations on a daily basis, but to truly assess generalization, theses contexts are necessary. After it is determined that a person with a stutter is generalizing his skills, it is important to determine if these skills are being maintained over time. To determine this a person with a stutter must be assessed in theses various contexts periodically for a minimum of a year but preferably over numerous years (Packman et.al , 2004). This can be extremely difficult as
One of the two primary components that need to be assessed is the individual’s attitudes and beliefs regarding his dysfluencies. This component makes generalization and maintenance extremely difficult for a client, even with sufficient support, strategies, and therapeutic techniques. Attitudes of an individual with a stutter regarding his disfluencies can change from week to week or even day to day (Guitar &Bass, 1978). As negative attitudes decrease, self esteem decreases, leading to a decrease in generalization and maintenance. For this reason counseling and education is an imperative part of the therapy