Dennis Tanner's Pragmatic Stuttering Intervention

By Kelly Gavin

Basic Information

- Designed for children between 7 and 12 years old.

- Emphasis placed on helping children to participate actively and effectively in social situations as they learn to speak more fluently.

- Developed for students who have come to see themselves as ‘stutterers’ and who require a direct program for stuttering intervention.

- Can serve as a core approach or as an adjunct to other approaches currently available for the treatment of stuttering.

- Interpersonal communication is the process by which meaning is exchanged; stimulate meanings rather than exchange them. Expressive communication is the art of using words to stimulate in the listener a mutual association of meanings. Stutterers often have problems with combined verbal and nonverbal communication strategies, self disclosure, assertiveness, active listening, and empathy.

The Manual

Divided into four sections

1. Theoretical Framework

a. Intervention programs for children with fluency disorders are likely to be most effective if a multi-dimensional, eclectic approach to therapy is used. The total individual must be treated, such as the disfluencies, coping attitudes and behaviors, personality adjustment, and emotionality that associated with verbal communication for a successful intervention program.

b. Goals of Stuttering Intervention

i. To increase speech fluency by treating the audible and visible characteristics of the speech disorder.

ii. To reduce anxiety and negative emotions that have come to be associated with speech.

iii. To modify behaviors, thoughts, and attitudes that are incompatible with the long term achievement of fluency and positive self-concept.

iv. To improve the child’s social interaction skills and his/her effectiveness in the pragmatic uses of language

Some stutterers fail to acquire the conversational skills necessary for them to effectively make use of language. Many children with fluency disorders are rarely observed to initiate interactions, volunteer information, ask questions, express personal opinions or share feelings

2. Assessment Procedures

a. Specific strategies for assessing the child’s fluency, attitudes, and behaviors that may be contributing to the communication disorders. It also gives suggestions for collecting case history information

b. Assessing pragmatic aspects of communication

i. Assess child’s effectiveness in using language for specific purposes; info from direct observation and from interviews w/ parents, teachers, and others

c. Pragmatic Communication Record Form

i. Greet others; initiates conversations, asks questions, gives complete answers when asked for information, requests assistance when help is needed, offers suggestions to others, volunteers information during discussions, describes events accurately and in sufficient detail, maintains topic over a series of utterances, describes personal experiences, takes turns appropriately during conversation, participates verbally during group activities, expresses needs, shares feelings expressive viewpoints, expresses feelings of disagreement.

3. Disfluency Treatment Procedures

a. Detailed description of strategies that can be used to facilitate the development of fluency and the more effective use of language for communication purposes

i. Establish a relaxed speaking voice

ii. Use of structured speaking activitiesàdesigned to elicit minimal anxiety in the early stages of stuttering intervention. The initial goal is to establish fluency in a structured situation and once fluency has been established, the child will be provided with opportunities to practice the newly acquired speaking behaviors in a variety of speaking contexts

4. Counseling Strategies

a. Strategies for reducing anxiety and the negative emotions associated with the stuttering problem. Counseling techniques are addressed that can be used during all aspects of program implementation. These techniques are particularly useful in helping the stutterer to achieve long term carryover and maintenance of the objectives

A Few More Tips

Systematic desensitization

A technique that can be used to facilitate anxiety reduction when feared stimuli are encountered; based on the assumption that the individual has learned to associate anxiety and negative emotions w/ a particular stimulus and that this association must be unlearned. Because of past learning, particular phonemes, words, situations, and/or people elicit feelings of anxiety and associated negative emotions in the stutterer. Desensitatizing requires learning to associate these phonemes, words, situations, and/or people w/ neutral or positive physical, cognitive, and emotional states

Child’s responsibility for behavior change

Children must make a conscious effort to practice using newly acquired speaking skills in a variety of situations. If the individual is to become fluent, he/she must no longer avoid feared sounds, words, people, and situations. Both the clinician and the child must be aware that the presence of secondary gains reduces the probability of a permanent cure for stuttering. By helping children develop strategies for reducing their anxiety and negative emotions, clinicians can facilitate the development of self-confidence.