The Treatment of Fluency Disorders: Experience in Bulgaria

Clinician's method

Year

Age

Therapy

schedule

and duration

Description of the main stages of the therapy

Speech techniques

Measures of effectiveness and results

Therapy approach

1. Vlassova, N. А., Rаu, Е. Ph.

1959

Preschool age

8 - 9 months

Complex therapy. For first time different degrees of speech independence are applied.

1.Accompanying speech

2.Reflective speech: the child repeats speech therapist’s speech

3. Answers of questions on pictures

4.Independent description of pictures

5.Retelling

6.Spontaneous speech

7.Normal speech

1. Breathing exercises

2. Articulation exercises

3. Voice exercises

There is no data for Bulgaria.

In Russia 70% effectiveness; 30% complementary effects ( Vlassova).

60% effectiveness; 19% considerable improvement; 13% failed; 8% - relapses (Rau).

Complex approach;

Fluency shaping approach

2. Cheveleva, N. А.

1965

Preschool age

8 - 9 months

Complex therapy in the situation of a game activity and manual activity! Transition from situational to complex speech.

1.Limited speech activity

2.Accompanying speech

3.Final speech: the child describes executed, past events and activities

4.Planned speech: the child talk about what he/she intents to do

5. Stabilization speech: the aim is to maintain the new fluency skills.

1. Breathing exercises

2. Articulation exercises

3. Voice exercises

4. Movement exercises

There is no data for Bulgaria.

The most applied method in Bulgaria

Modified for Bulgarian conditions by Stamov, Vurbanova, Stavrakova (1987).

Complex approach;

Fluency shaping approach

3. Mironova, S. А.

1969

Preschool age

8 - 9 m.

1. Plain situational speech: work over the Lexis

2. Repetition of speech habits for the situative speech and gradual transition toward plain context speech work over phrases

3. Independent context      speech work over stories

4.Independent speech with different degrees of complexity

1. Articulation exercises

2. Voice exercises

3. Breathing exercises

4. Prolonged speech

5. Airflow

There is no data for Bulgaria.

Complex approach;

Fluency shaping approach

4. Seliverstov, V. I.

1979

Preschool age

8 - 9 m.

1. Preparatory

2. Training

3. Repeating

The logopedic therapy is accomplished in the conditions of a game activity

Work over:

1.Prosodics

2.Rhythm

3.Voice strength

In different speech situations.

There is no data for Bulgaria.

39.7% without stammering;

47.8% considerable betterment;

12.5% inconsiderable betterment (Seliverstov)

Complex approach;

Fluency shaping approach

5. Volkova, G. А.

1983

Preschool age

2-4 years

4-7 years

8 - 9 m.

1.Diagnostic stage

2. Limited speech activity

3.Accompaning-reflected speech

4. Stage of questions and answers

5. Spontaneous independent speech

Partitions of the program for logopedic work:

1. System of games

2. Logorhythmics

3. Educational work

4. Influence upon the micro-social environment of children

1.Articulation exercises

2. Voice exercises

3. Breathing exercises

There is no data for Bulgaria.

70.2% without stuttering;

26.3% considerable betterment;

3.5% noticeable betterment;

(Volkova)

Complex approach;

Fluency shaping approach

6.Vigodskaya, I. G.,

Pelinger, Е. L.,

Uspenska, L. P.

1984

Preschool age

8 - 9 m.

1.Silence

2.Formation of speech breathing

3.Short phrases

4. Longer phrases

5. Speech in speech situations

6. Spontaneous speech

Relaxation exercises are leading through the games

1.Articulation exercises

2. Voice exercises

3. Breathing exercises

There is no data for Bulgaria.

Complex approach;

Fluency shaping approach

7. Cheveleva, N. А.

1978

Primary school age

9 m.

The logopedic work is carried out on the background of manual activity:

1. Accompanying speech

2. Final speech

3. Planned speech

4. Maintenance of the speech skills

1.Articulation exercises

2. Voice exercises

3. Breathing exercises

4. Prolonged speech

There is no data for Bulgaria.

Complex approach;

Fluency shaping approach

8. Yastrebova, А. V.

1979

Primary school age

8 - 9 m.

Method for stutterers with language impairment

1.Work over speech fluency, Lexis, grammar, development and   stabilization of the skills for word analysis

2. Stabilization of the skills for fluent speech

3. Work on the sound and the speech   intonation

Work over:

1. rate

2. rhythm

3. fluency

4. articulation

5. gentle onset

6. proper direction of airflow

There is no data for Bulgaria.

Complex approach;

Fluency shaping approach

9. Missulovni, L. Y.

1988

Adolescent and adults in the conditions of   psychoneurotic dispensary

3 - 4 m.

2 times per week

1. Diagnostic stage

2. Silence after a sitting of suggestion

3. Automation of speech habits

4. Stabilization of speech skills

The logopedic work is carried out together with the medicine therapy and psychotherapy

Gentle onset

Airflow

Systematic desensitization

There is no data for Bulgaria.

17.8% without stuttering

34.6% considerable betterment;

38.5% betterment;

9.1% without betterment (Missulovin)

Complex approach;

Fluency shaping approach

10. Bujanov, М. I.

1989

Adolescents in the conditions of clinics or dispensary

4 m.

1. Stage of speech technique formation: midriff breathing,   voice exercises, syllable exercises

2. Reading of texts and/or retellings with a different degree of complexity

3. Automation of speech habits in different speech situations and mastering of habits for autogenous training

The logopedic work is carried out parallel with the medical therapy, psychotherapy, physiotherapy ,occupational therapy and music therapy

1.Articulation exercises

2. Voice exercises

3. Breathing exercises

There is no data for Bulgaria.

Complex approach;

Fluency shaping approach

11. Shkolovski, V. М.

1974

Adolescents and adults

2.5 - 3 m.

1. Diagnostic stage

2. Reorganization of the pathologic speech skills

3. Stabilization of the skills for speech fluency

4. Prophylactics

5. Sanatorium and resort treatment

The logopedic work is carried out parallel to hypnotherapy, self suggestion, rational psychotherapy, suggestive psychotherapy, physiotherapy

1. Articulation exercises

2. Voice exercises

3. Breathing exercises

There is no data for Bulgaria.

Complex approach;

Fluency shaping approach

12. Hvatsev, М. Е.

1959

Adolescents and adults

45 days

1. Diagnostic stage

2. Work over breathing

3. Work over voice

4.Work over sound pronunciation

5. Work over the rhythmical speech (accompanying speech , reflected speech, reading, learning by heart of texts, independent speech in different speech situations)

1.Articulation exercises

2. Voice exercises

3. Breathing exercises

There is no data for Bulgaria.

Complex approach;

Fluency shaping approach

13. Daskalov, D.

(Bulgarian method)

1963

Adolescents and adults

45 days treatment program

Balneal-sanatorium treatment of stutterers.

1.Systematic breathing and speech exercises, rhythmic vocal exercises with musical accompaniment, singing

2.Auditory masker – for severe stuttering cases

(10-12 days subcutaneously inject at each of certain points in the Zakharin-Head zones of the speech organs – see Van Riper, 1973, p. 93)

Application of protracted sleep along with drugs; relaxation; healing effects of the naturally favorable climate and the baths; psychotherapy, gymnastic therapy, remedial exercises had air, sun and aqueous baths.

Temporary effectiveness during the pharmacy therapy

This method has been completely abandoned in Russia (Platonov, 1959)

Complex approach;

Fluency shaping approach

14. No specific method for cluttering treatment.

The treatment procedures are the same as in stuttering cases