Article 4

Krista Rice writes:

Speech Disfluency in School-Age Children’s Conversational and Narrative Discourse

This was an insightful article. I know I will consider what the authors found in this study in future assessments and even during current therapy sessions.

To begin, the authors note that previous research illustrates that children who stutter typically do so more during conversational tasks than other communicative tasks (i.e. narration). However, this research has analyzed the fluency of preschool aged children.  The article I read, Speech Disfluency in School-Age Children’s Conversational and Narrative Discourse, makes comparisons among school-aged children. The authors compared speech samples of children who stutter (CWS) and children who do not stutter (CWNS) by comparing structured conversation and narration.  The participants were divided into groups based on age (younger 6:0-7:7 and older 8:0-10:5) and diagnosis of a fluency disorder (CWS and CWNS). All of the participants demonstrated typical development of articulation, language and voice skills. The authors used an experimental version of the TOCS to elicit structured conversational speech samples and narrative speech samples. The structured conversational task was completed first, and participants were given open-ended commands and open-ended questions.  The participants then completed the narrative task, formulating a story using the same picture scenes from the conversational task. The examiners provided explicit directions to tell a story and did not engage in any communicative exchange during the narration.  The authors analyzed the types disfluencies produced by all groups of participants into 2 broad categories: stuttering-like disfluencies (monosyllabic word repetitions, audible sound prolongations, blocks, sound or syllable repetitions) and non-stuttering like disfluencies (typical- phrase repetitions, revisions and interjections). Each word of the samples was analyzed for the disfluency type and frequency. The authors further determined the percentage of disfluencies in the each sample, percentage of stuttering-like disfluencies per word and percentage of non-stuttering like disfluencies per word.

 

The authors determined that significantly more types of stuttering-like disfluencies occurred in the narrative task than the conversational tasks in the CWS groups (age did not matter). As predicted, the CWS groups produced more stuttering-like disfluencies than the CWNS groups in both types of discourse.  There were no significant differences found between the ages of the groups or the frequency of disfluencies between conversation and narration. When comparing non-stuttering like disfluencies, there were no significant differences found in types of disfluencies between conversation and narration or the frequency of non-stuttering like disfluencies. The authors noted that CWS groups and CWNS groups produced similar amounts of non-stuttering like disfluencies in both types of discourse. However, the younger group in this study produced significantly more typical disfluencies during the conversational tasks than the narrative task and there was not a significant difference found in the older group.

 

The authors suggest that the CWS narrative samples contained more types of stuttering-like disfluencies because of the linguistic commands of narration in itself. Also, the speech sample length did not appear to be a determinant factor in the frequency of stuttering-like disfluencies as the conversation samples were approximately three times longer than the narration, but the frequency of disfluencies was higher in the narrative samples. The authors suggest that narration appears to elicit more stuttering-like behaviors vs. conversation in school-aged children. Previous research supports this conclusion, noting that narrative tasks put more communicative responsibility on the narrator as they are responsible for the communicative expectations alone.  The authors noted differences in previous research; preschool aged children are more likely to demonstrate stuttering-like disfluencies during conversational task. This current research illustrates that school-aged children are more likely to demonstrate stuttering-like disfluencies during narrative tasks.  The authors suggest this is the case because children’s narrative skills increase over the elementary years, as children develop higher linguistic skills, higher vocabulary and the use of more complex sentences; plus children continue to develop higher awareness of the listeners expectations during narration task

 

What I take from this article is that: 1) our assessment procedures should include both types of discourse- conversation and narration; 2)  consider the age of the child (preschool or school-aged) when selecting tasks to obtain speech samples, ensuring that we are utilizing types of discourse that will provide an opportunity to observe true stuttering behaviors. I plan on applying this in treatment sessions as well, creating speaking situations that utilize a type of discourse where students are more likely to produce stuttering like disfluencies. This will allow for more opportunities for the students to practice their strategies and modification techniques, while also informally targeting language skills. This can also help in planning and creating activities to address multiple goals in mixed therapy groups; 3) carefully consider the types of disfluencies. While reading the article, I kept thinking about the Fluency professional development taught by Dr. Lonnie Harris. I remember him discussing the types of disfluencies and how certain ones (what the authors call stuttering-like disfluencies- monosyllabic word repetitions, audible sound prolongations, blocks, sound or syllable repetitions) are a red-flag when evaluating the fluency of a younger child to determine if the child actually has a fluency disorder or if the child is demonstrating developmental stuttering. This research article illustrated that types of non-stuttering like disfluencies and frequency of non-stuttering like disfluencies were about the same among the CWS and CWNS groups. This is important to remember as we are evaluating the fluency of a student.

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5 thoughts on “Article 4

  1. Jamie Priddy says:

    I am so glad that you reviewed this article! I am working on multiple initial evaluations for fluency students, and this information will really help me when assessing them and writing goals. The fact that I need to focus more on narration discourse skills changes the therapy activities and assessment tasks that I will use with students who stutter. It is also great to see the correlation between this article and the PD that we had a few summers ago. Great review!

  2. Katie Cohen says:

    Thanks Krista, your review will definitely have an impact on my therapy sessions. This year I have a therapy group with only students who stutter ranging from 1st to 5th grade. This has been especially beneficial for the younger students in the group as they have found the learning environment comfortable enough to volunteer to speak and found role models in older students. However, your review makes me realize the importance of also facilitating more natural conversations in same grade mixed impairment therapy groups because it will be more authentic.

  3. Jane Stosberg says:

    Thank you for this review, Krista. I may need to go and read the whole article, as I am interested in more detail about the differences between the narrative tasks and the conversational tasks. I agree with you that this provides a great reminder to take time to focus on the types of dysfluencies a student produces, noting that some dysfluencies are typical for all speakers. Ultimately this article seems to give some great guiding principles for evaluation and therapy.

  4. Kelly Miklosh says:

    Thanks for the review! This article made me reconsider how I have the students implement their fluency enhancing strategies. I have a few adolescents that are currently targeting using their strategies in conversational speech and occasionally narratives. This article made me aware that it is just as important to target using those strategies in narrative discourse.

  5. allison forrester says:

    I enjoyed reading this review and I agree with Jane, I may have to go back an read the entire article at some point.This article provides a lot of great information that can be applied to the evaluation and treatment of CWS. I do not currently have any CWS on my caseload, but I will definitely keep this information for future evaluations and treatment sessions. In the past, I have put so much focus on conversational discourse. Thank you!

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