راهکارهای درمانی خاص در درمان لکنت زبان کلینیک تخصصی لکنت کرج کوی کارمندان شمالی- ابوریحان پنجم
behaviour is dominated by syllable and word repetition; a finding which is consistent with current observations of early onset of stuttering (for example, Howell & Au-Yeung, 2002; Yairi & Ambrose, 1992b; Yairi et al., 1996). But can the progression of stuttering be characterized by distinct stages of development, as opposed to a process of gradual change? There have been a number of attempts to characterize the development of stuttering in this way.
Bloodstein (1960, 1995) looked at behaviour change in stuttering in a group of over 400 children between ages 2 and 16, suggesting that four sequential stages of development could be identified in the disorder. Many of Bloodstein’s findings are consistent with more general theories of develop¬ment of the disorder; for example, the progression from slow easy repetitions, frequent fluent periods and absence of secondary symptoms such as avoid¬ance, anticipation and word substitution as might be expected in 2- to 3-year- old children to a marked increase in avoidance, specific sound fears and word substitution in the 15 to 16 year olds. (Note that the development of stuttering behaviours is also discussed in chapter 9.) However, there are methodological problems with Bloodstein’s study, which was cross-sectional and not based on longitudinal data.
Van Riper’s four-track model of stuttering development
The track theory of development (Van Riper, 1973) represents a rather differ¬ent attempt to account for change in stuttering over time. Based on 300 of Van Riper’s case histories, 44 of which contained longitudinal information on their progress, Van Riper noted that while there was the heterogeneity of expression that he and others argued confounded attempts to discern a single-stage pattern of development, almost all of his cases could be explained as one of four different initial presentations of the disorder. These four different onsets led to different patterns of development, which Van Riper preferred to call “tracks”.
Although old, I believe this model of stuttering development is important because, as Conture (2001) has pointed out, it remains consistent with more recent conceptualizations such as Smith and Kelly’s