COMPONENT 8. REDUCTION OF (WORD) AVOIDANCE BEHAVIORS

Rationale: Avoidance behaviors must be eliminated as they facilitate 
the progressive growth of the fear of stuttering.

Research: 

Bloodstein (1993) - suggests that the client who thinks of himself 
as a "stutterer" expects to stutter.  This anticipation to stutter 
is, at times, enough to produce stuttering.  "Almost every stutterer 
has his or her own private list of difficult words" (pg. 5).

Perkins (1973) - stated that awareness of the specific stuttering 
behaviors that must be managed is crucial to the maintenance of 
fluent, "normal sounding" speech. 

Peters and Guitar (1991) - emphasize the importance of reducing the
child's negative feelings about his speech and toward eliminating any
avoidance behaviors.

Van Riper (1973)  - suggests that the clinician model an easier type 
of stuttering, and incorporate "easy" stuttering games into the speech
play.  Showing the child a different way of stuttering, without 
struggle and tension, helps to reduce expectancy, negative
emotionality, and struggle and tension behavior.  Van Riper
cautions, however, not to make the dysfluent child sound or word 
conscious because each child demonstrates marked variation in the 
words and sounds he will have difficulty on at any given point in time.

Williams (1971) - encourages the attitude that stuttering (getting 
stuck) is only a simple mistake and compares it to simple mistakes in
everyday things. 
 
Activities/Techniques:

 1. The clinician and older client (ages 15-17) can discuss the
    characteristics of word and sound avoidance behaviors, as well
    as why the client feels it is necessary to avoid.

 2. Have the older client (ages 15-17) keep a log book of specific
    words and sounds he/she avoids and in what situations these
    avoidances occurred.

 3. To eliminate "uhÕs" and "um's" used as avoidance behaviors, the
    clinician may use an abacus or counter to identify and count these
    behaviors.  The client is then encouraged that he/she has the 
    ability to say the work without the interjection and is requested
    to do so.

 4. Playing games in which the client/clinician insert "uh" and "uhm"
    as often as possible while the other person "catches them" may 
    assist the child in identifying this avoidance behavior.  Once 
    the child has identified this feature in their own speech, they 
    are reading to practice elimination the use of interjections.  
    The client must become comfortable and "feel safe" with his 
    stuttering through the use of voluntary stuttering, "triad" 
    drills, and easy bounces and slides.  As he confronts the 
    moment of stuttering openly and without fear, the use of this 
    type of avoidance behavior will gradually decline. 
 
5. Discussing the consequences for using "avoidance behaviors" may
   also help the client to understand the importance of elimination 
   them.  Problem solving with the client by noting all the possible
   outcomes of avoidance behaviors, regarding of their positive or
   negative affect.  The clinician then lists these consequences, 
   and together with the client, assigns a value to their impact on
   communication. 
 
6. The clinician should observe any secondary of avoidance behavior
    specific to the child's pattern.  All such behaviors should be
    eliminated through increasing the childÕs awareness of the
    behavior, discussing itÕs occurrence, and demonstrating how the
    child doesnÕt need them to talk.

7. Any specific avoidance, such as the client's name, which the 
   client reports, must be dealt with directly.