SPED 5240 Stuttering Seminar

Dr. Sheree Reese Office Hours: Mondays (4-6PM)

Spring, 2001 Tuesdays (10-12AM)

Office Telephone: 629-7190

Email: sh-reese@home.com

FAX: (732) 636-1076

Purpose of Course:

The purpose of this professional course is to prepare you to effectively diagnose and treat fluency disorders in a variety of patients. The course will include significant theories, recent research, counseling techniques and current issues relating to providing therapy services for children and adults. In addition, we'll learn about preventative principles to apply to young children. The ultimate goal of the course is to help you develop into effective and efficient clinicians who will be comfortable and competent working with people with fluency disorders.

Course Objectives:

At the conclusion of this course, students will:

  1. Demonstrate an understanding of how to differentiate various patterns of dysfluency and determine which are normal and which require intervention.
  2. Develop an understanding of various theories of the onset of stuttering.
  3. Assess, diagnose and interpret diagnostic results and apply those results to the development of treatment programs.
  4. Assess the outcome and effectiveness of treatment.


Shapiro, David Allen (1999). Stuttering Intervention. Pro-Ed, Austin:Tx

Stuttering Intervention : A Collaborative Journey to Fluency Freedom
In Stock:Ships within 24 hours .
David Allen Shapiro / Hardcover / PRO-ED, Incorporated /
January 1999
Our Price:

There will be supplemental assigned readings posted on the website. They

will be in the form of links taking you directly to the text.

There will be additional supplemental assigned readings which will be

accessible through a ‘virtual’ library site. You will be able to access the

articles from your home computers.

Highly Recommended:

Complete set of Stuttering Foundation of America publications

The order form will be distributed in class.


Myers, F.L. and St. Louis, K. O. (1986). Cluttering: A Clinical Perspective.

Singular Publishing Group, 4284 41st Street, San Diego, California 92105-

1197, ISBN#1-56593-543-8


Course Requirements:

All students will be required to complete the following course requirements:

Two pre-course (ungraded) assignments are designed to familiarize you with the website support for this class. They include:

    1. posting a brief biographical sketch
    2. completing a brief quiz/survey

The graded components of the course include the following:

1. Listserv assignment 5%

2. Transcription Project 15%

3. Midterm 20%

4. Simulated Stuttering Project 20%

5. Treatment Program Analysis/Web page 20%

6. Final Examination 20%

7. In addition, students can earn up to 5 points of extra credit during the semester by

viewing videotapes on reserve at IRC. Details to be discussed in class.

Grades may be adjusted at the discretion of the professor based on a combination of class attendance, participation (that enhances the class experience in a positive manner), and preparedness (specifically having completed assigned readings prior to class and turned in assignments in a timely manner)


    1. = A 77-79 = C+
    1. = A- 73-76 = C
    1. = B+ 70-72 = C-
    1. = B 65-69 = D+

80-82 = B- 60-64 = D

Below 60 = F


A Note on Attendance

Regular attendance is expected. Class absences can affect your competency level and your grade. If there is a serious reason that you cannot be in class, please discuss it with me personally. Please be attentive in class; it is unfair to the professor and the other students to talk out of turn.

No make-up examinations or late work will be permitted, except in the case of documented illness, emergency, or by prior arrangement with the professor.

The following is a general outline of the classes and assignments…changes may occur as guest speakers, videotapes and 'experiences' are added.


Class # Date Topics Assignment

1&2 1/22 Guest Speaker

& Overview of course

1/29 Definitions

Prevalence and Incidence

Theories of onset & development


Shapiro: Chapters 1,3

Desensitizing SLP's : http://www.mnsu.edu/comdis/isad2/papers/shields.html

Language & Fluency: Nan Ratner


Neurophysiological theory: http://www.mnsu.edu/comdis/isad/papers/denil.html

3 2/05 Impact of Stuttering

On stutterer

On family

On clinician


Shapiro: Ch. 2, 5, 6, 7

Case histories:




Article from a wife: http://www.mnsu.edu/comdis/isad/papers/weiner.html


4 02/12 The Person Who Stutters: Characteristics

Measurement issues

Multicultural considerations


Shapiro, pages 163-175


5 02/19 Preschool Children: Assessment

& Treatment


Shapiro: Ch 9

*Guidelines for Practice in Stuttering Treatment, SID4

*Treatment Efficacy: Stuttering, Edward Conture

*Treating the Child Who Stutters With Concomitant Language or

Phonological Impairment, Nan Bernstein Ratner

*Fluency Intervention for Preschoolers & Their Families in the

Public Schools, Gottwald & Starkweather

  1. 02/26 Guest Speaker

School-Age Children: Assessment

& Treatment

Read: Shapiro: Ch. 10

*Strategies for Treating Elementary

School-Age Children Who Stutter: An

Integrative Approach, Healey & Scott

*Working with 7-12 Year Old Children Who Stutter: Ideas for

Intervention in the Public Schools, Peter Ramig, Ellen Bennett

Pseudostuttering: http://www.mnsu.edu/comdis/isad2/papers/starke.html

Summer camps: http://www.mnsu.edu/comdis/isad/papers/bennett.html

Internet Assignment due

03/5 Class Canceled: Spring Break

7 03/12 Midterm Exam

8 03/19 Adolescents: Assessment & Treatment


*Helping Adolescents Who Stutter Focus on Fluency

David A. Daly

*Adolescents Who Stutter, Howard D. Schwartz

Waggott: http://www.mnsu.edu/comdis/isad2/papers/waggott.html

Caggiano: http://www.mnsu.edu/comdis/isad/papers/caggiano.html

Transcription Project Due

9 03/26 Counseling:Class held on-line only

Read: *Counseling Parents of Children Who Stutter,

Patricia Zebrowski

*Parental Involvement in the Treatment of Stuttering

Lena Rustin, Frances Cook

Neiders: http://www.mnsu.edu/comdis/isad2/papers/neiders.html


10 04/2 Adults: Assessment & Treatment


ADA: http://www.mnsu.edu/comdis/isad2/papers/parry.html


11 4/9 Simulated Stuttering Project Due

Class Discussion

12 4/16 Guest Speakers: Support Group

13 4/23 Cluttering and Other Fluency Disorders

Read: Shapiro, Chapter 4

*The Clutterer, David Daly

Read: *Clinical Management of Cluttering,

Ken St. Louis, Florence Myers

Treatment Program Analysis Due

Atypical Stutterer- http://www.mnsu.edu/comdis/isad2/papers/molt2.html

Cluttering: http://www.mnsu.edu/comdis/isad/papers/stlouis.html


14 4/30 Final Exam


In order to ensure full class participation, any student with a disabling condition requiring special accommodations (e.g. tape recorders, special adaptive equipment, special notetaking or test-taking procedures) is strongly encouraged to contact the professor at the beginning of the course.

SPED 5240



1. Each of you should get an e-mail address so you will have computer access to researchers all over the world who are involved in stuttering research. Attached are applications; if you’d like, I will accompany you to the computer center to help facilitate the process.

Also attached is a list of resources related to stuttering. On page 2, you will see addresses for three listservs. Listservs are online discussion groups. Each of the listservs on your resource form is different, yet similar in some ways. Controversial issues are frequently discussed... you will be reading on the "cutting edge" of the newest and keenest thoughts of important authorities in the field of stuttering.

  1. Sign onto at least one listserv that is relevant to stuttering.

b. Read all the postings for one week during the semester and briefly summarize the discussion for that week.

c. "Lurk" the discussion that is going on and "post" at least once to a

discussion that you find interesting. Print out and attach a copy of your posting to your summary.



Two sensitive measures for describing the behaviors of stutterers are speech rate and stuttering frequency. The goal of this project is to help you develop expertise in assessing both of these areas. A videotape (containing 48 speech samples) and accompanying instruction manual will be on reserve in the IRC. In addition, I will "sign-out" videotapes with an accompanying disk (scheduled to be arranged individually). You will be able to print out forms and transcripts using these disks.

Necessary Equipment:

A VCR with a counter

A stop watch

Copies of forms

The manual talks about performing these measurements using a computer program. While I hope to have the actual program to show you during the semester, you do not have to use it for this project.

Part I: Counting Syllables

Speed of speech, also referred to as 'speech rate', is an important dimension of a speaker's speech pattern and one that changes as a function of treatment. A measure of speech rate is one important descriptor of a person's speech pattern. Pretreatment measures of speech rate will contribute to decisions regarding the kind of treatment that may be appropriate for a client. In order to accurately measure speech rate, you must first learn to count syllables. The first sample in your assignment is from the speech of a nonstuttering person. Before you begin counting syllables, listen to the first 30 seconds or so of the sample to 'calibrate' your ear. When you begin counting syllables, count every syllable that the speaker produces, including 'um's' and 'well's' and other insertions, as long as they are spellable. Be sure to count what the talker actually says, without being influenced by how you might say the word or by how it is spelled.

Sample One: _________________Number of syllables

Part II: Counting Stutters

The frequency of a person's stuttering is obviously an important measure for assessment, treatment and posttreatment phases of the clinical process. Many clinicians and most stutterers view as a major clinical goal the substantial reduction or complete elimination of moments of stuttering. Therefore a valid and convenient measure of stuttering frequency is required. Defining a moment of stuttering is difficult because they take so many different forms within and across speakers and because the same behavior (e.g., a phrase repetition) might be a moment of stuttering on one occasion and not on another, or for one person but not for another.

Use the criteria that we discussed in class and listen to the next three samples. (It is a good idea to just listen to the sample to be judged for 30 seconds or so, until you are familiar with the speaker's stuttering "style" and the kinds of stuttering behaviors you are likely to see and hear.) Then determine the frequency of stuttering for that sample.

Sample two:___________

Sample three:___________

Sample four:__________

Part III: Counting Syllables and Stutters

For Sample #5, compute the following:

# of Syllables:_____________

# Stutters:________________

Percentage of stutters per minute (SPM)

Hierarchy of types of stutters (including percentages):


Part IV: Real-Time Analysis

Read the article by J. Scott Yaruss, "Real-Time Analysis of Speech Fluency Procedures and Reliability Training".

Using Sample #6 attempt to perform this type of analysis. You may use the formats recommended in the article, or develop your own.




'Modeling Stuttering Behaviors' exercise: What would it be like to be a person who stutters?

In order to successfully and effectively deal with the disorder of stuttering in the clinical process, it is necessary to fully understand the disorder. The following are a series of assignments that are designed to help clinicians develop a better understanding of the covert and overt aspects of stuttering.

Part I

Practice 'fake' stuttering (also called pseudostuttering) in class (time will be provided) and with a friend from the class to make sure your fake stuttering behaviors are representative of stuttering. Next, stutter openly in public on 5 different occasions. Examples of situations in which you can stutter include the following:

a. ordering coffee at a coffee bar

b. calling information for a phone number

C. buying a book at the bookstore

d. asking for directions to a building on campus

e. ordering lunch in a restaurant

f buying clothing at a department store

g. ordering pizza over the phone

h. calling a radio talk show

Only one "experience" can be on the telephone…. the other 4 must be in person. On at least one of the stuttering "experiences", accompany or be accompanied by another class member. Each of you will then have the opportunity to observe the reactions of bystanders that may not be apparent to the "stutterer".

Please try to make this assignment as real as possible. In other words, don't just stutter once during the conversation and then stop - become the person who stutters during each of the 5 occasions. Try to understand what it would be like to be a person who stutters.

AT NO TIME MAY YOU REVEAL THAT YOU ARE A NORMAL SPEAKER. Please do this exercise respectfully - make sure there is nobody who stutters already present who may think you were mocking him. We will devote class time to an open discussion of your


Part II Fluency Shaping Exercise

On two additional instances (one may be with friends or family, one must be in public) speak using "fluency shaping techniques". (Don’t attempt this exercise until we have discussed and practiced them in class.) Examples of fluency techniques include using prolonged speech, light articulatory contacts, easy onset, etc. The purpose is also to see through the eyes of your future clients.

Part III

Write a reaction paper (no more than 3 pages):

  1. Describe stuttering setting (for each of the 5 trials)
  2. Describe the reaction of the person you were talking to.
  3. Describe your own reactions - be sure to comment about your

feelings both before and after you completed this assignment.

4. How did the stuttering affect your ability to communicate?

5. Were some situations easier or harder than others?

6. Did stuttering in public get easier or harder as you progressed

through the assignment?

7. What bystander responses did you "observe" when you went

out in pairs?

Criteria for grading:

Grades will be based on completion of all parts of the assignment, a sincere attempt to make this assignment a learning experience, insights gained from the experience, creativity in selecting sites and developing educational materials.



Select a treatment program from the list provided below. A sign- up list will be distributed in class so that there are no duplicates. If you have familiarity with or access to a program you would like to analyze that is not on the list, be sure and clear it with me.

Include the information suggested on the Treatment Program Analysis format provided below to design your analysis. You will submit your assignment in the form of a web-page. See samples of web pages done by students of Dr. Celia Hooper, of the University of North Carolina, Chapel Hill at http://www.unc.edu/~chooper/classes/voice/webtherapy/index.html Each of you will prepare a ONE PAGE treatment analysis document suitable for placement on the stuttering class web pages. You may prepare the document using a web editor (such as Microsoft Composer), the WebCT tool called Student Homepages, OR , if this terrifies you you may use the Microsoft Word word processing program. If you DO use Word, you will save your document as an html file and turn it in that way (on disk). A GREAT place to go to teach yourself is http://www.unc.edu/cit/resources/simple/ You must be very careful to reference material and you must understand web copyright infringement. We can talk more about this in class. If you have difficulty, I will be available to help you. In addition, you should print out your page as a handout for the class. (Your handout may be in outline form if desired.)

You will be judged/graded on: 1. Accuracy and completeness of the content of information. 2. Quality of web handout. 3. Creativity....try to make this a little more interesting than watching grass grow. Image files and great web links would be nice. Regular WORD file is fine, SO RELAX.


Name of program:


Packaged for purchase? By whom? Cost?

Suggested age range

Theoretical basis for the program

Is there an assessment component?

Are the fluency techniques clearly described? What are they?

Are rate and vocal inflection addressed?

What is the client's role in the program? Parent's role?

Does the program deal with attitudes? Self-esteem?

Are social skills training/role playing included in the program?

Are suggestions/techniques for stress reduction included in the program?

Is maintenance and/or relapse talked about? Provided for?

Can the program be easily adapted for different settings/populations?

Can the program be used with a special population?

If not, can you modify it for such use? How?

What is the best feature of this program?

Is there anything you would add, or delete, to make it more effective?

What does the literature say about this program?

(Include appropriate journal references, web links etc. in this section.)



  1. Behavioral Treatment for Children and Adolescents Who Stutter Janis Costello
  2. Component Model for Treating Stuttering, Riley & Riley
  3. Delayed Auditory Feedback
  4. Easy Does It-2, Heinze & Johnson (1987)
  5. Fluency Development System for Young Children
  6. Meyers & Woodford (1992)

  7. Freedom From Fluency, David Daly
  8. Facilitator, Kay Elemetrics
  9. Generating Fluent Speech, Barbara Dahm
  10. The Fluency Rules Program, Charles M. Runyan and Sarah Elizabeth Runyan
  11. The Lidcombe Program, Michelle Lincoln and Elisabeth Harrison
  12. The Monterey Fluency Program, (GILCU) Bruce P. Ryan and
  13. Barbara van Kirk Ryan

  14. NCS Treatment Program (formerly Airflow), Martin Schwartz
  15. Personalized Fluency Control Therapy (PFC), Cooper & Cooper (1985)
  16. The POWERR Game: Dealing with Stuttering, Gordon W. Blood
  17. Precision Fluency Shaping Program Webster (Hollins Communication Research Institute)
  18. The Retz Approach
  19. REBT
  20. Second Opinion
  21. Stutter-Free Speech, Drs. George Shames & Cheri Florance
  22. Speech Motor Training, Jeanna Riley and Glynden Riley
  23. The Stuttering Intervention Program (SIP), Rebekah H. Pindzola, 1987
  24. Stuttering Therapy Step by Step, Harvey J. Gardner
  25. Systematic Fluency Training for Young Children, Dr. Richard Shine (1980)
  26. Successful Stuttering Management Program (SSMP)
  27. Starbuck Fluency Clinic
  28. The Adolescent/Adult Program

    The Family Program

    Computer Programs:

  29. Dr. Fluency, Arye Friedman
  30. Computer Aided Fluency Establishment Trainer (CAFET), Annandale Fluency Clinic
  31. ID Rate
  32. speak:gentle


Extra Credit Assignment

Classic Videotapes…from the '70s

Here's your opportunity to see a master clinician at work. Nine videotapes of Charles Van Riper are on reserve at the Instructional Resource Center on the second floor in Hutchinson (J). All of the therapy was done in seven sessions - one week apart - a total of seven hours of therapy. The eighth tape covers a follow-up session one year later. The ninth tape is a 20-year follow-up and discussion of the long-term effectiveness of this therapy.

Be sure and log in and out in the accompanying sign-in book so that there is a record of your loan. If there is no record in the log book, you will not receive the extra credit. There are video rooms at the IRC where you can sit down and view the tapes. They may not be taken home.



This will be a group experience.

Dr. Sheree Reese

Answer both of the following questions in addition to the case history question. I suggest that you allow no more than 30 minutes for each of the first two questions (15-20 minutes for discussion and the remaining time to actually compose your answer to everyone’s satisfaction). You will turn in only one set of answers per group…thus the grade will be a group grade. The grade will be based on the quality, creativity and thoughtfulness of your answers.

  1. We’ve discussed (and you’ve read about) many issues surrounding the onset, development and nature of stuttering. How would you address each of these questions? How have your assumptions about stuttering and people who stutter changed as a result of what you’ve read/heard in this course.
  2. We’ve discussed (and you’ve read about) the importance of working with families, rather than just with individuals who stutter. What challenges do you feel are within the boundaries of your training? How will you recognize those challenges and what will you do should you find yourself expected to perform outside the limits. What other challenges do you feel you will encounter from a family systems perspective.
  3. Following are two case histories of children who stutter. The first child is a

preschooler and the second child is in third grade with a confirmed stuttering

problem. Select one of the case histories and address the following issues:

  1. What specific information will you attempt to obtain from the parents?
  2. Describe an evaluation that is specific to this child. What information will you attempt to obtain from the child and how will you obtain this information. Focus your attention on both the characteristics of the child’s problem as well as the characteristics of the child. Provide a rationale for your selections.


Bruce’s mother phones and reports to you that her son has been stuttering for three months. Mrs. Wayne indicated to you that she just knows that her son is stuttering because both her brother and father are stutterers. "Bruce repeats words and phrases and occasionally gets stuck on a word." Mrs. Wayne reported that her husband is in sales and is one of the top producers in his company. In addition, Mrs. Wayne indicated that she was a theater major in school and often participates in community theater productions. Upon questioning, Bruce’s mom indicated that her son doesn’t appear to be aware of his stuttering, "he just continues talking even when he’s repeating a lot." The mother stated that Bruce has an older brother (John, age 8) who is "always talking". The mother stated "At dinner, it’s hard to get a word in when the boys get going". Mrs. Wayne noted that Bruce will sometimes blink his eyes when he gets stuck on a word but "I don’t think he knows that he’s doing this." Bruce presently attends the Tokyo Toddlers play group, five mornings per week where he is learning Japanese. The parents believe that learning Japanese is crucial for Bruce’s future success in business.




Jack and Jill are fraternal twins who are in third grade at the M. Goose elementary school. You are presently working as the speech-language pathologist at M. Goose, although this is your first year (you transferred this year from H. Dumpty Junior High). Mrs. Hill, the twin’s mother indicated to you that Jill has been stuttering since she’s three years old. "I just don’t understand why Jill has a problem and Jack doesn’t" said Mrs. Hill. The mother stated that when she was younger she used to stutter although she grew out of the problem before receiving any kind of help. "I just don’t understand why my kid needs therapy, I outgrew the problem".. Reportedly, Mr. Hill is an accountant and is very quiet. "My husband is very successful but he doesn’t talk an awful lot". Sometimes, we can sit for hours and not say a word" reported Mrs. Hill. Our kids play together and don’t need to include us in their games. Finally, Mrs. Hill stated "I think it will be a good idea for Jill to wait and see if she grows out of her problem.




After watching the videotape of E.J., you may ask me any questions you like. You will have the opportunity to view the videotape once more and then will answer the following:

  1. What ‘pertinent’ information do you have about this client? What information do you not have that you wish you had?
  2. Which factors do you feel you have minimal control over … which do you feel you can potentially impact.

  4. Establish the long-term goal(s) of treatment. Assume you will have the client in therapy for 6 months. Describe your rationale for selecting each goal? (your philosophical approach to therapy)
  5. Establish at least one realistic short-term goal(s) for each long term goal.

  7. What behaviors will you choose document? Why and how?
  8. What criteria will you use to determine when to terminate treatment?


I suggest that you develop an outline before writing. (actually, outline form is acceptable). Please write neatly so that I can read it.