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From: Ken St. Louis
Date: 22 Oct 2009
Time: 09:13:32 -0500
Remote Name: 157.182.15.121
Good question. The issue of coexistence of various communication disorders has been the subject of considerable research over the years, although it seems to have waned in recent years with respect to stuttering. Ed Conture, when he was at Syracuse University, along with several of his doctoral students, e.g., Linda Louko, investigated the coexistence of stuttering and phonological disorders. I don't claim to know all that they found, but one recommendation that came from their NIH-funded research was that maybe it was best to teach phonological processes (i.e., not specific phoneme [speech sound] training) when dealing with articulation errors in children who also stuttered. Focus on the sounds themselves can result in children beginning to see these sounds as "more difficult" and thereby beginning to fear them, as Wendell Johnson observed. Language problems can also coexist with stuttering, although I am not aware of research that has specifically tried to compare clinical strategies that are most/least effective when dealing with them simultaneously. In my own clinical experience--not research based--I have found that it is often best to give a child with a mild-moderate articulation disorder a "vacation" from articulation training while dealing with his/her stuttering. If the problem is severe and intelligibility is limited, then I have tried to follow Conture et al.'s advice in focusing on phonological processes. When dealing with language issues, I have found it is possible to work them into whatever material is used for the stuttering therapy.......I'll add another point. coexisting disorders are very common in the related fluency disorder of cluttering. It is possible that many young "stutterers" with coexisting articulation or language problems may have cluttering instead or--or along with--stuttering. In cluttering, almost all therapy deals with a wide range of problems. I hope this is helpful. Ken