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From: Sandra Merlo
Date: 18 Oct 2008
Time: 09:41:38 -0500
Remote Name: 200.158.237.43
Dear Kristen, thank you for your questions. About your first question, I don’t know if I understood what your point is. The so-called “speech techniques” always work with components of fluency, but not always work with disfluencies. Sometimes disfluencies are indirectly affected (for example, through decreasing speech rate). About the second question, I use both fluency shaping and stuttering modification methods. Fluency shaping strategies usually work to prevent stuttered disruptions, while stuttering modification strategies usually try to teach the patient how to manage with stuttered disruptions when they occur. So both approaches are useful. About your third question, I usually combine both kinds of methods, regardless of severity. About your fourth question, decreasing speech rate is an effective approach to decrease disfluencies. But the patient will not do this automatically. He/she must practice speaking with a slower speech rate (but it cannot be too much slower, it must sound natural). The patient can start reading aloud, then answering short questions, telling stories (from comic strips without text, for example), and finally speaking spontaneously. The patient should take care to articulate words clearly and to make pauses at each 4-5 words (since this is the temporal window in speech). Best regards, Sandra