Evidence-Based Treatment of Stuttering: Empirical Bases and Clinical Applications

By Anne K. Bothe | Go to book overview

Appendix A

Mowrer (1975) administered a treatment program to 20 persons who stutter (mean age = 22.1 years; range = 8–43 years). The establishment portion began with the participant uttering monosyllabic words that he felt he could speak fluently following a tone every 5 seconds, and terminated with 5 minutes of conversation. In general, responses were longer with each step; the tone was used in some steps to signal the participant to respond. The intermediate steps consisted of responses such as two word phrases, three word phrases, four word phrases, and so forth; sentences, answering questions, and telling stories. “Good” was uttered by the clinician following fluent responses and “stop” following a stutter. Criteria for advancement to subsequent steps in the establishment phase were 95% fluency and in most steps 100 or more WS/M. Branch steps were used if the criterion was not met in a certain amount of time. The transfer phase for children included similar tasks, performed at school and with students taking on some of their own clinical responsibility. Children also completed a home transfer program involving the reinforcement of a series of fluent sentences and punishment when disfluency occurred. Adult transfer programs involved various beyond-clinic tasks accompanied by the clinician. The maintenance phase consisted of 2 monthly conversations in the clinic and weekly phone calls to the clients. A test with various speaking conditions was given by a clinician before and upon completion of therapy (seemingly when each participant completed the program); number of disfluent words was counted. Not all participants completed all three phases (establishment, transfer, maintenance) or even all steps in the phases, which is the reason for the unusual arrangement in the present Table 10.2.

Johnson, Coleman, and Rasmussen (1978) completed a 21-session (1 hour each), 3-week treatment structured around the GILCU procedure with a 6-year-old male who stuttered. Their program consisted of producing single vowels to eight-word sentences, including tasks such as imitation, labeling pictures, producing a phrase, and answering questions. The criterion to pass each step was 90% fluency on 20 consecutive responses. Branch steps were included if the child had difficulty on a certain step. Activities allowed for spontaneous speech acts that were verbally rewarded when the preceding program was finished. In addition, the child had to repeat, after the clinician, disfluent words followed by the phrase containing the word during the spontaneous speech acts. Physical reinforcers were also used in the program for the completion of activities but not individual

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