IS THIS STUTTERING? Disfluency and Co-existing Learning, Intellectual & Medical Challenges Vivian Sisskin, M.S., CCC-SLP, BRS-FD Lecturer and Clinical Supervisor University of Maryland, College Park vsisskin@umd.edu Annual Convention National Stuttering Association 2009 Scottsdale, AZ

Stuttering-Like Disfluency Disfluency Types Stuttering-Like Disfluency Part-Word Repetition Whole Word Repetition Prolongation Silent Block Other Disfluency Interjection (filler) Revision Phrase Repetition Multisyllabic Word Repetition

Disfluency/Stuttering in Early Childhood Persistent Developmental Stuttering Language- Based Disfluency Atypical Disfluency

Persistence & Recovery in Early Stuttering Time since onset Family history Gender SLD’s over 1 year post-onset Age of onset

Concomitance vs. Co-existence Related to the disorder Concomitant Disfluency In addition to the disorder Co-Existing Stuttering

Concomitant Disfluency or Coexisting Stuttering? Language Disorder Disorder of comprehension and production Vocabulary Grammar Word finding Sentence formulation More disfluency (including SLD) than peers. Cluttering Fluency disorder defined by a collection of symptoms Rate Disfluency Pauses Articulation Other disfluencies (not SLD) Developmental Apraxia Of Speech Motor speech planning disorder Inconsistent errors Groping for postures Initiation of sounds Poor sequencing Oral-motor difficulties Symptoms include SLD’s (repetitions and prolongations) Autism Spectrum Disorders Developmental Disorder Social Interaction Communication Restricted, repetitive behavior, interests, activities Case studies: Other disfluencies, SLD’s, atypical disfluencies

Considerations for Treatment Priorities for Improved Communication What Matters to the Individual Adjusting Session Design Developing Individualized Teaching Strategies

For a list of readings and resources: A special “thank you” to the children, adults, and families who agreed to have their video clip shown for educational purposes. For a list of readings and resources: www.sisskin.com/handouts/NSA2009