COMPONENT 3: ESTABLISHMENT OF LIGHT ARTICULATORY CONTACTS Rationale: Children and adolescents who stutter frequently produce consonants with hard articulatory contacts. Hard contacts are the source of a great deal of articulatory tension and may result in the impedance of airflow in the oral cavity. Teaching the client to produce soft, loose articulatory movements is helpful in reducing the articulatory tension. Light contacts are also helpful in providing the child with a tool to reduce tension during the stuttering moment. Research: Conture (1990) - recommends making speech "visible" through learning easier onsets. He incorporates the use of the VU meter to demonstrate how one can "make appropriate vocal initiations and transitions" (pg. 196) Gregory (1991) -emphasizes the use of an easier initiation of speech with smooth movements from sound to sound. Irwin (1980) - uses the concept of lengthening or elasticizing the first syllable of a dysfluent word in his treatment approach, asserting that it reduces the muscular tension in the speech organs. Peters and Guitar (1991) - use the fluency enhancing behavior of "soft contacts" for some clients. By this, we mean that the movements of the articulators (tongue, lips, jaw) should be slow, prolonged, and relaxed. These articulatory movements should not be fast and tense: (pg. 231). Wall and Meyers (1984) - find loose contacts a most useful technique This technique requires reduction of muscle activity in the vocal tract, thereby preventing immobilizing tension and allowing smooth movement through a word. Van Riper (1973) - stresses the importance of reduced oral tension during length articulatory contacts, especially within the context of modifying stuttering behaviors. Activities/Techniques: 1. Teach the client the concept of soft, loose sounds. Emphasizing the "feeling" of loose articulatory movements and smooth, continuous airflow. How relaxed does the tongue feel? "Soft sounds" can be taught at the phoneme level and incorporated into activities that follow a hierarchy of increased length and linguistic complexity up through conversation. 2. Use of a delayed auditory feedback unit (DAF) may be used with older children to facilitate light articulatory contacts through abnormally slowed rate at the single word through reading levels. 3. Voluntary stretches, accomplished by lengthening or prolonging the first syllable of a word, involves soft, slow articulation of the consonant and prolonged phonation of the vowel. These stretches may be incorporated in single words through conversational tasks. 4. Contrast drills are a helpful activity to increase the client's awareness of hard vs. articulatory contacts. Be sure to emphasize kinesthetic awareness. Have the child read from a list of words alternating hard and soft productions of each word. Encourage the client to feel the difference while the clinician explains why they are different. Negative practice drills (Gregory, 1989), in which the client produces a hard moment and then reduces the tension by 50%, provide an excellent way to demonstrate this concept of hard versus soft speech production. 5. The clinician may demonstrate several samples of the clients' stuttering behaviors and then demonstrate how he/she can stutter more easily. The clinician may slow down a repetition, stretch out of a block, or do an easy repetition to ease out of laryngeal block. One way of facilitation comprehension of different ways of stuttering is through the use of "triad" drills. Each point of a triangle represents certain ways of stuttering: "hard bounce, easy bounce, and slide" and/or "easy bounce, slide and easy onset (stretch)". Starting with the first triad (HB,EB,S), the client learns how to change his/her stuttering patterns and gradually works toward the second type of triad (EB,S,EO). Multiple repetitions of triad drills will facilitate the development of monitoring and proprioception skills. For the younger child, Westbrook (1989) uses the analogy of "Energy" to facilitate this concept. The child manipulates various levels of tension as a means of "conserving energy"; energy being on a continuum of 100% energy (hard speech) to 25% (easy speech). 6. The following excerpt is from Dell, "Treating The School-Age Stutterer," and describes a method of teaching light, loose articulatory contacts: When you are stuttering hard on it, you will feel your tongue jammed up against the alveolar ridge. You will also feel air pressure building up behind your tongue. The air wants to escape but you are forcing it back with your tongue. Now gradually loosen the pressure on your tongue by reducing the force of the air pressure pushing up against it. Then gradually begin to relax the tension you have purposely placed on your tongue. When you remove some of this lingual pressure, you will probably hear a little burst of air escaping between the tongue and the alveolar ridge. You then need to change these bursts into a small, steady stream of air, it is easy to add the voicing necessary and once again slide into the work but beware of prolonging the vowel. It should be tttable' not taable'. 7. Cancellations may be employed to further facilitate awareness of light articulatory. Immediately after the stuttering moment, the child should repeat the work with a light articulatory contact. "This technique allows the child to reattempt a work in which the coarticulatory gestures have not been smoothly produced." (Wall and Myers).