راهکارهای درمانی خاص در درمان لکنت زبان کلینیک تخصصی لکنت کرج شهرک اوج- کوی جهاد – سینا ۲

راهکارهای درمانی خاص در درمان لکنت زبان کلینیک تخصصی لکنت کرج شهرک اوج- کوی جهاد – سینا ۲

 

reinforced, and thereby increase in number (Shames & Sherrick, 1963). But the model does not explain why this occurs, and two issues in particular need clarification. First, why would disfluencies consistent with stuttering such as prolongations and part-word repetitions become reinforced, while others do not? Second, why would such verbal behaviour be rewarded at all? One answer to these questions is that parents unwittingly reward normal disfluency behaviours by giving greater attention to the child’s speech; allowing uninterrupted speech (Shames & Sherrick, 1963). This then reinforces the disfluent speech, resulting in more stuttering. It could follow that the more atypical the type of disfluency, the more likely it is to receive parental attention, and also that as stuttering becomes more established, so this can lead to feelings of frustration and rejection. This could then result in the establishment of secondary behaviours such as avoidance and physical escape behaviours such as eye closing, or eye avoidance, stalling behaviour through use of fillers (“um. . .er.. .”) all of which serve tempora¬rily to terminate negative listener reactions. Van Riper accepts the possibility that disfluency could at first be positively reinforced and later negatively reinforced:

On the one hand listener reactions (attention, concern) are so positively reinforcing that they create the stuttering problem by increasing normal disfluencies. On the other hand, listener reactions are so punishing that successful efforts to escape them are negatively reinforced. This could be true if the child’s listeners changed their behavior from attending to rejecting, or from beyond a certain cut-off. This may indeed take place, although we have no evidence that it does.

(Van Riper, 1982, p. 286)

Unfortunately, more than 20 years later, we still lack any consistent and reliable evidence that listeners do respond in this manner. But setting this aside for a moment, the theory can quite elegantly explain how a stutter changes and develops as it becomes more established over a period of many years. But as persistent stuttering becomes more severe over time, so too a wide range of secondary behaviours may increasingly become sig¬nificant features of the stutter. With the

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