راهکارهای درمانی خاص در درمان لکنت زبان کلینیک تخصصی لکنت کرج بلوار بهشتی-نبش غربی خیابان کسری
an attempt to overcome laryngeal blocking, now appear as ritualized gasping for breath. Van Riper observes that Track III children move from the blocking type of stutter to prolongations. Quickly after the prolongation becomes established, the laryngeal blocking reduces. Coincident with this, struggle reduces and speech output increases. After the prolongations become established, syllabic repetitions begin to appear. Unlike the repetitions that are characteristic of Track I development, these often occur following phoneme prolongation, and each repeated syllable may also be slightly prolonged, for example:
“c ►, c—> a >, c—► a >, can I have a juice?”
It is interesting to note that in terms of the sequence in which the different types of stuttering develop, Track III presents as almost a mirror of Track I, where syllable initial repetitions later lead to prolongation and blocking. Equally intriguing is that when Track III development reaches the syllable repetition stage, the prognosis for recovery actually increases. For those who do not, however, Van Riper paints a gloomy picture of severe and persistent stuttering accompanied by complex stuttering patterns, high levels of avoid¬ance and anxiety, and increased likelihood of interiorized stuttering. The issue of causation in Track III is an interesting issue, which at first sight might appear to have ramifications for psychogenic stuttering. However, stuttering characteristics do not appear to be consistent with this acquired variant of stuttering. We return to this issue in chapter 16.
This was the least commonly observed pattern in Van Riper’s group with 4 of the original 44 and 9 of the total 300 showing this pattern of development. Like Track III, this pattern usually begins later than Track I, following a period of normal fluency and with a sudden onset. The initial stuttering behaviour is, however, different to both, being characterized by multiple repetitions of (sometimes) syllables, but more commonly words (including multisyllabic words) and/or phrases. The disfluency appears as a considered and highly con¬scious pattern on behalf of the child, almost as if there is