Indirect Approach is a family focused treatment plan for preschool age children (ages 2-6).
The treatment includes teaching parents specific strategies and providing suggestions to facilitate their child’s fluency and to promote a healthy speaking environment. The speech-language pathologist addresses the young child’s dysfluency symptoms without calling further attention to them. This may include parental style adjustments such as rate, turn-taking latencies, interrupting behaviors and parental language style changes. Parents may also be instructed to directly model fluency enhancing techniques.
Counseling is utilized as part of this treatment approach to help parents reduce their anxiety about stuttering, and employ child-focused strategies to aid the child in modifying his behaviors and communication attitudes as well as the child’s environment.
Direct Approaches target the child’s individual speech behaviors.
Direct therapy is implemented when the child is aware of and/or frustrated by his stuttering, as well as when secondary behaviors are exhibited. At Suburban Speech Center, we use Stuttering Modification, Fluency Shaping and Hierarchical approaches.
Fluency Shaping is based on the assumption that stuttering is a learned behavior. This approach focuses on teaching the child to speak more fluently. The goal of fluency shaping is to work with the child’s motor speech control capabilities and to apply various approaches to facilitate new speech production patterns.
- Easy onset/prevoice exhalation: The speaker is taught to exhale slightly before beginning phonation and reaches conversational loudness gradually.
- Decreased speaking rate: The speaker is trained to stretch out the sounds (primarily vowels) in his speech and produce words at a slower-than-normal speaking rate while maintaining normal stress and intonation.
- Light articulatory contacts: The speaker is taught to move the articulators in a loose and relaxed manner.
- Continuous phonation: The speaker is trained to reduce all breaks between words by maintaining voicing continuously until he naturally needs to take a breath.
The ultimate aim of programs based on a fluency shaping philosophy is to completely change speech behavior by teaching the child to use these techniques at all times, not just during disfluent moments. These techniques are designed to interfere with the stuttering behaviors, thus reducing them. Therapy sessions focus solely on acquisition of these behaviors and generally do not address secondary behaviors or the negative feelings and attitudes that may be associated with the stuttering.