راهکارهای درمانی خاص در درمان لکنت زبان کلینیک تخصصی لکنت کرج جهانشهر-ضلع غربی بلوار جمهوری
many ways is consistent with cluttering (a point which Van Riper accepts), but as the disorder persists, such children develop awareness of their difficulties as well as linguistic and situ¬ational fears and avoidance strategies; all features strongly associated with stuttering and supposedly incompatible with cluttering. Tracks III and IV represent very small subsets amongst the population that stutters (6 percent and 3 percent respectively), and are characterized by distinctive onset pat¬terns and development profiles. (Table 7.1 summarizes how the four tracks can be compared and contrasted at onset of stuttering. Figure 7.1 shows similar information on stuttering development.)
Van Riper makes it clear that these so-called tracks require further data from large-scale longitudinal studies to substantiate the claims he makes. He also admits that there are a number of methodological problems with the study. For example, subjects were not always seen at regular specified inter¬vals and findings may have been influenced by the effects of therapy (although the data collected on the 44 subjects relate exclusively to those who did not do well in therapy). In fact, there is limited evidence from one small longitudinal study which shows findings consistent with those of Van Riper’s Track I and Track II (Ohashi, 1973), but to date further data are still lacking. Conture (2001) admits surprise at the lack of research on subgrouping stuttering (although he was not specifically referring to the subgrouping of stuttering development, as we are here), having predicted in an earlier edition of his book that there would be a growth of interest in this area.
Table 7.1 Tracks of development at onset (adapted from Van Riper, 1982)
Criteria Track I Track II Track III Track IV
1 Onset 2 V to 4 years Often late, at time of first sentences Any age after child has consecutive speech Late, usually after 4 years
2 Fluency Previously