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From: Melissa Nadel, Graduate Student
Date: 17 Oct 2008
Time: 13:53:12 -0500
Remote Name: 76.15.66.8
I am a student in NYU's Graduate Program in Speech Language Pathology. I am currently taking a Fluency Disorders course and I found your article very interesting. I never realized that children with Down Syndrome are aware of their stuttering to the extent where they become ashamed of speaking to certain people and in certain situations and develop avoidance behaviors. Are the cognitive deficits in some children with DS so impaired that that they aren't aware of their disfluencies and listener reactions? If so, is treatment more difficult if they aren't aware or is it beneficial since they don't develop shame and avoidance? Also, you mention that children with Down Syndrome usually present with stuttering behaviors as young as 7 years old because that's when they are beginning to combine 2-3 words. You recommend we treat these individuals as we would normally developing children who begin to stutter between the ages of 2-5. You mention using traditional fluency enhancement strategies, but also state that teaching easy onsets and stuttering modification should not be the focus. I can definitely understand why they would be too difficult for their cognitive and motor systems and could result in frustration and shame. What type of fluency enhancing strategies do you recommend and how should they be presented to a child with cognitive deficit? How do they differ from the strategies we use with children without concomitant disorders? Your article was really beneficial and informative. Thanks!