راهکارهای درمانی خاص در درمان لکنت زبان کلینیک تخصصی لکنت کرج بلوار جمهوری

راهکارهای درمانی خاص در درمان لکنت زبان کلینیک تخصصی لکنت کرج بلوار جمهوری

 

deliberate stuttering on purpose, yet occurring in the apparent absence of anxiety or concern. It is the very large number of repetitions that tend to distinguish early Track IV stuttering from normal disfluency. Track IV children may quickly move from word repetition to a mixture of part-word and word repetitions, whilst main¬taining the large number of repetitions. Thus “It’s-It’s-It’s-It’s-It’s-It’s a nice day” becomes “I-I-I – It’s-It’s-I-I-it’s it’s-it’s a nice day”. This tendency to repeat words that have already been produced fluently is a defining character¬istic of this group and is consistent with the very open stuttering seen from the start. In contrast to the other tracks, Track IV stuttering behaviour changes very little from onset to full establishment. Stuttering continues in the absence of fear and avoidance, and without the development of escape behaviours. Van Riper considers Track IV stutterers to use their disfluency as a device to help gain control over the situation, and/or over the listener. As he puts it: “These stutterers suffer less than their listeners. One can sense the controlling, punishing, wheedling, exploitative urges behind the behaviour” (1982, p. 105).

Rather confusingly, Van Riper also considers that there may be some classed as Track IV stutterers who have a rather different onset, with initial behaviours

being unfilled pauses rather than repetitions. He cites as an example the case of a young boy who presented with repeated inhalations when speaking, to the point where his chest became distended. Van Riper discovered that the child had used this pattern when frustrated, and long before any fluency difficulties had arisen. It was concluded that this was a controlling tactic over his mother and he was referred to a child psychiatrist. The stutter persisted into adulthood and with it Van Riper describes additional reactions, referring to his behaviours as still “infantile, neurotic” and “controlling”.

Summary of track development

Van Riper’s track profiles suggest that the majority of stuttering (as in Track I) begins preschool, most commonly begins with repetition, and later ends with blocking, fear and avoidance. Track II in

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