Introduction

The purpose of this presentation was to provide the clinician with a clinically comprehensive, yet functional source of therapy principles, goals, and activities for use with the dysfluent school-age child. This information is drawn from a wide source of research studies and treatment programs, which reflects our overall eclectic treatment philosophy.

Our treatment philosophy represents two separate philosophical schools of thought, traditional and operant, and is heavily based upon the developmental continuum of stuttering in children. Fluency shaping therapy, based upon operant conditioning principles, first establishes fluency in a controlled stimulus situation. This fluency is reinforced and gradually modified to approximate normal conversational speech. Traditional theorists take a more holistic approach looking at the individual child and characteristics of the problem when planning treatment. More recently, traditionalists are looking at possible contributing factors to the child's dysfluency, such as physiological, cognitive, and social/emotional processes which may underlie the symptom: by strengthening these "processes," fluency is thought to be facilitated.

IN OUR EFFORT TO PROVIDE YOU WITH A COMPLETE AND COMPREHENSIVE APPROACH, KEEP IN MIND THAT THESE GOALS AND ACTIVITIES SHOULD BE USED DISCRIMINATELY - ASSESSING EACH CHILD'S INDIVIDUAL NEEDS AND CHARACTERISTICS - AS WELL AS SEVERITY, AGE AND MATURITY LEVEL. SOME GOALS AND ACTIVITIES MAY NOT BE APPROPRIATE, YET OTHERS MAY ONLY REQUIRE SMALL MODIFICATIONS FOR USE WITH SPECIFIC CHILDREN. YOU MAY FIND SOME OF THESE ACTIVITIES TO BE THE FOUNDATION FOR MANY NEW IDEAS.

A major concern with the treatment of fluency in children is *maintaining the fluency*. We feel the following approach is especially successful in this regard because we teach the children how to cope with and modify their stuttering, as well as teaching them fluency.