Fluency Techniques – 7 steps:
1) Picture Selection of Monosyllabic Words
· Child is presented with 69 pre-selected monosyllabic words one at a time and the words are sorted into piles of “fluent and readily identifiable words” and “non-fluent and non-readily identifiable words”.
2) Determining Fluent Speaking Mode
· Child uses whispered speech because it closely resembles normal speech. The child has normal articulatory contacts, is monotone, barely audible, and has an open vocal fold.
· If the child is unable to produce whispered speech, then prolonged speech is used.
3) Establishing the Easy Speaking Voice
· The child is taught to use the easy speaking voice instead of the whisper or prolonged speech. Components of the easy speaking voice include slightly loose articulatory contact, optimal voice quality, variable intonation, slow to rapid rate, quiet to above normal loudness, and easy onsets to begin utterances.
4) Environmental Program
· The parent or guardian is trained in this session to identify and score stuttered words, so child can generalize fluent behaviors outside of therapy.
5) Picture Identification, Story Book, Picture Matching, and Surprise Box
· The child uses pictures and is required to use the words with a carrier phrase.
· The child is read a story and is required to complete 1-6 word phrases. Then, the child tells the story in the new fluent speaking voice.
· The clinician and child each choose a picture and the child needs to uses phrases such as “Who has the ______?” or “I have the ______.”
· Excitement is created as the child selects an item out of a surprise box. The child is taught to use fluent speech while excited.
· The parent or guardian and clinician help the child use the fluent behaviors that were learned in the environmental program in all natural speaking environments.
· Child is re-evaluated periodically for at least one year using the following schedule: once a week for the first month, twice during the 2nd month, once a month for 2 months, at the end of 6 months, and at the end of 1 year.