راهکارهای درمانی خاص در درمان لکنت زبان کلینیک تخصصی لکنت کرج میدان جمهوری- جمهوری شمالی- پایین تر از کانون مهندسین
feared. However, the majority of Track II speakers find themselves with speech which Van Riper describes as mildly stuttered but mainly clut¬tered. Van Riper was very aware of the similarities between Track II stuttering and cluttering (also see chapters 8 and 17), but not all traits are consistent between the two groups. For example, Track II children become aware of their difficulties and may show withdrawal, and use avoidance strategies. Cluttering, on the other hand is associated with a lack of awareness and concern.
This track was seen in 5 of Van Riper’s 44 children who were studied longi-tudinally, and a total of 18 of the overall total of 300. This track is typically seen in older children who until this point experienced perfectly normal flu¬ency. The Track III children in Van Riper’s study were aged 5 to 9, but the pattern has also been observed in children as young as 2, and also in adults. Track III pattern is characterized by an abrupt onset, with the child usually simply being unable to speak. Commonly, attempts are made at vocalization, such as conscious inhalation and appropriate articulatory pre-positioning, which simply result in an inability to produce sound. The child may continue to make repeated attempts to do so, but usually with the same fixed, blocked and silent outcome. If the child is able push through the block and initiate the first phoneme, the remainder of the ensuing sentence is usually fluent. In some cases, there may appear to be some psychological/environmental con¬comitant to this dramatic change; possibly a frightening experience, shock, physical trauma, sudden change in family dynamics. However, Van Riper argues that when these possibilities are pursued they often appear to have little relevance to the onset of stuttering.
Track III develops quickly with struggle, tension and frustration following rapidly. The blocking, seen initially only in sentence initial position, soon appears in other parts of the utterance and also in other articulatory struc¬tures. Lip, tongue and jaw fixations are now also produced with excessive tension and sometimes tremor becoming established. Abnormal breathing patterns, used earlier in