Treating Stuttering in Children With Autism Spectrum Disorder

Treating Stuttering in Children With Autism Spectrum Disorder

Shoko Miyamoto (University of Tsukuba, Japan) and Masayoshi Tsuge (University of Tsukuba, Japan)
DOI: 10.4018/978-1-7998-7053-1.ch011
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The number of case reports of children with autism spectrum disorder (ASD) who stutter is increasing. The duration of intervention for stuttering in children with attention-deficit hyperactivity disorder (ADHD) is often greater than for children who only stutter. Whether there is a similar pattern in children with ASD who stutter should also be examined. In this study, the factors influencing the prognoses of two children with stuttering and ASD were investigated. One child's stuttering had improved and had almost been eliminated, and the other's stuttering continued. The results of the investigation showed that a significant increase in language ability and the absence of physiological problems assisted in eliminating stuttering. The child who continued to stutter originally showed a higher than average language level and high anxiety. Preventing and eliminating anxiety that accompanies ASD, in addition to intervention for stuttering, may be indispensable to reduce stuttering and improve fluency.
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First, there are some things we know from genetic research. In studies on highly consanguineous families from Pakistan, the loci on chromosomes 3, 12, and 16 were identified as more definitive evidence for linkage in stuttering (Riaz, Steinberg, Ahmad, Pluzhnikov, Riazuddin, Cox, Drayna, 2005; Raza, Riazuddin, Drayna, 2010). Loci on Chromosomes 2, 3, 14, and 15 were identified in a large polygamous family from Cameroon, West Africa, and gave evidence of playing a causative role in stuttering (Raza, Gertz, Mundorff, Lukong, Kuster, Schaffer, & Drayna, 2013). In a genetic study of families in which many individuals who stutter were born, several chromosomes were found to be associated with stuttering, including chromosome 2 (Suresh, Ambrose, Roe, Pluzhnikov, Wittke-Thompson, Ng, … Cox, 2006). Chromosome 2 has already been associated with the development of ASD (Buxbaum, Silverman, Smith, Kilifarski, Reichert, Hollander, … Davis, 2001). When analyses were performed on chromosome 2 from subjects with a narrow diagnosis of autism with phrase speech delay, the results suggested an increasing likelihood of linkage. This relationship between autism and stuttering through linkage gene study had been appeared interesting (Buxbaum et al., 2001).

A study of high-functioning individuals with autism and Asperger’s Syndrome reported that their speech contained more repetitions of sounds, syllables, and words and more “revisions” of words than those of the typical developmental group (Shriberg, Paul, McSweeny, Klin, Cohen, & Volkmar, 2001). This “revision” symptom is distinguished from stuttering-like disfluencies in the assessment of stuttering speech symptoms and is classified as “Other Disfluency (ODs),” which is a very important feature when expressing the disfluency of ASD.

Key Terms in this Chapter

Modification Therapy: A therapy technique for changing a stuttering speech to a more comfortable way of speaking, in contrast to “Fluency Shaping.” It's also known as learning how to stutter effortlessly.

Secondary Behaviors: The main symptom of stuttering is the speech aspect when the child is young, but as the child ages, psychological symptoms may be added. Examples of secondary behaviors are escape or avoidance behaviors.

Environmental Adjustment: A method that changes the demands from the environment according to the capacities of the child's side, so that the child's speech and psychological aspects are not burdened. It is one of two currently known evidence-based methods of treatment of stuttering in young children.

Lidcombe Program: It is one of two currently known evidence-based methods of treatment of stuttering in young children. It is a kind of behavior therapy. A speech-language pathologist (SLP) or the parents provide verbal contingency to children's speech to reinforce fluent speech or reduce disfluent speech. For the intervention, parents do the Lidcombe Program at home for about 10 minutes each day and proceed with the SLP’s advice.

Other Disfluencies (ODs): ODs include interjections, multiple-syllable word and phrase repetitions, and revisions or incomplete that usually occur in the speech of people do not have a stutter.

Atypical Disfluencies (ADs): Disfluencies are usually categorized as SLDs or ODs, however disfluencies that cannot be divided into either category are called ADs. Final part-word or final word disfluencies are often categorized as ADs.

Fluency Shaping: A method of acquiring new fluent speech as an appropriate behavior in the speech of people who stutter. Examples of therapy techniques include “gentle onset,” “light contact,” “rate reduced,” and “prolonged vowel.”

Stuttering-Like Disfluencies (SLDs): SLDs are core symptoms of stuttering and include part-word repetitions, single-syllable word repetitions, prolongation, and blocking, which often occur with tense.

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