Fluency Evaluation, Pediatrics

Click here for an intake form for assessing fluency in preschool and school-age children.



When assessing fluency in young children, the big question is often whether to begin treatment or give them a few months to see if they grow out of it on their own. Here are some factors to consider when attempting to determine if a child's stuttering is developmental or has potential to be a long-term issue:

1. male

2. onset of stuttering on or after 3.5 years of age

3. family history of stuttering

4. persistence of stuttering for more than 14-18 months

5. production of more than two units per part word repetition

6. silent period between each unit of repetition is of shorter duration

7. dysrhythmic quality to stuttering

8. difficulties in areas of language, phonology and nonverbal skills

Another aspect of stuttering to consider is whether a child's stuttering is ambiguous or unambiguous:

Ambiguous stuttering includes:
- hesitations
- interjections
- revisions
- word repetitions
- phrase repetitions
- no more than 3 repetitions

Unambiguous stuttering includes:
- sound or syllable repetitions
- prolongations
- blocks
- any ambiguous stuttering with tension or multiple repetitions
- any behavior signaling avoidance of the stuttered syllable


Ambiguous stuttering can generally be considered to be normal, UNLESS:
1) there is any tension accompanying the ambiguous stutter,
2) ambiguous stuttering is happening at an usually high rate.

Adapted from a speechpathology.com course by Kathleen Fahey, PhD.

Goal Hierarchy for CAS

Goal hierarchy for CAS (Childhood Apraxia of Speech), from ***

1. Establish eye contact.

2. Establish motor imitation skills.

3. Establish vocalizing and sound effects.

4. Establish speech sounds in isolation.

5. Establish syllable shapes.

6. Establish CVCV reduplication.

7. Establish functional core vocabulary.

Cycles Approach

What is it?

The cycles approach is an articulation intervention developed by Hodson & Paden, 1983.

"The Cycles Approach provides focused intervention on phonological processes through the use of phonemes within a phonological pattern."

The goal of the Cycles Approach is to target the underlying phonological patterns, rather than individual phonemes. Because you are targeting patterns, you should see improvement and generalization more quickly than traditional articulation therapy.

When is this approach appropriate to use?
ages

Assessment


Sample treatment goals


Treatment activities





Click here for my overview of the Cycles Approach.

Click here for Dawn Moore's description of the Cycles Approach.

Click here for a helpful developmental guide of the elimination of phonological processes by Caroline Bowen.