Direct Management of the Beginning Stutterer

Historical literature concerning the management of the preschool and young school age stutterer reveals that the diagnosogenic theory (Johnson, et al., 1959) has been a predominant force within the profession (Adams, 1977; Shames and Egolf, 1976), even though the basic premise of the theory has been consistently contradicted in research literature (Wingate, 1976) and was shown to be inaccurate by McDearmon (1968) as well as by Johnson and colleagues (1959). Acceptance of the diagnosogenic theory and the perpetuation of other traditional concepts (Wingage, 1971) has resulted in the young stutterer being worked with indirectly, in order to keep the child from developing an awareness or fear of speaking, and has led to the speech clinician being afraid to treat the stutterer for fear of causing the stuttering to become worse or of causing psychologic harm to the child. The major approach with the b e g i n n i n g s t u t t e r e r has involved modification of parental attitudes and behaviors and manipulation of fluency disruptors in the environment. The significant recommendation has been that the child should not be made aware of stuttering disfluencies (Shales and Egolf, 1976; Yonovitz, et al., 1977; Panelli, et al., 1978). Some individuals (Adam, 1977; Bar, 1973; Van Riper, 1973) have stressed indirect fluency training procedures (making speaking fun), but have still persisted in avoiding making the child aware of either stuttering or nonstuttering disfluencies. They have emphasized the need to reduce communicative stress or eliminate environmental fluency disruptors. Such procedures assume (without documented research literature) that stuttering results from environmental forces. Even though Van Riper (1973) indicates that a hands-off policy should not be followed with the beginning stutterer, he states that it is important to "interact with a young stutterer without calling attention to his stuttering or punishing it," implying a relationship between calling attention to stuttering and punishment.