Speech Remediation of a Long-Term Stutter: A Case Study

Abstract

Background: This research article describes the remediation of stuttering in an adult participant with a long-term history of drug abuse. The unique participant in this case underwent this successful treatment at an urban residential rehabilitation mission where he was living in lieu of incarceration. Methods: The therapeutic intervention in this case consisted of two programs. The primary intervention involved the Ryan Fluency Program, Gradual Increase in Length and Complexity of Utterance (GILCU), which is a stepbased program that requires the participant to progress from the production of a single, fluent word to 10 minutes of conversation in the absence of overt disfluencies. Based on the particular needs of this participant, the primary investigator incorporated the use of delayed auditory feedback in an effort to demonstrate to the participant that fluent speech was possible. Results: As seen in tables and as discussed in the article, the participant initially produced 16 stuttered words per minute in the Fluency Interview and this number was reduced to .06 stuttered words per minute five months later. Additionally, the participant spoke at an average of 130.0 WS/M, which falls into the average rate based on norms established by Ryan (150.9, with range of 119-182.6). At nine months post-assessment, the participant was demonstrating smooth, forward-flowing, speech, free of overt disfluencies, with appropriate rate. Conclusion: This case study adds credence to the growing body of evidence supporting fluency shaping, behaviorally based programs to remediate overt stuttering. Further, this study, which used delayed auditory feedback in conjunction with GILCU, demonstrates the appropriateness of designing therapeutic interventions based on the specific needs of each participant. Finally, this case study validates the in depth knowledge of experienced clinicians as a significant factor in the decision making process for selecting and implementing interventions.