راهکارهای درمانی خاص در درمان لکنت زبان کلینیک تخصصی لکنت کرج بلوار سرداران- مقابل خدمات شهری منطقه ۹
These children have essentially normal speech and language abilities, but experience an environment which is more conducive to disfluency than flu¬ency. These may include traumatic situations such as frequent house changes, friction within the family, little one-to-one time with parents, hurried and disorganized home environment. Starkweather contends that some parents in this track overtly punish the children for their stuttering whilst others do so unwittingly in their verbal and nonverbal responses to the stuttering. This then can lead to tension and anxiety in the child, and later feelings of shame, embarrassment and avoidance.
Other children included in this track do not appear to encounter unduly stressful environments, but do appear particularly susceptible to stress, and situations which others may deal with easily can become significant problems to such children. According to Starkweather, the resulting severity of stutter¬ing can be highly dependent on a small change in circumstance. The prog¬nosis for these children is usually favourable and stuttering can often be resolved by counselling, and through the instantiation of calming routines at home, for example, improving consistency in bedtime routines. It would be expected that parent-child interaction therapy as described in chapter 10 would be very effective with this type of child.
Children with low self-esteem
Starkweather also identifies a separate track of children who have reduced self-esteem, although he admits that it is often difficult to determine between cause and effect with many in this group. (It is also theoretically possible that low self-esteem may exist alongside but independently of the stuttering.) Stuttering in this group of children may be noticeable when the child is required to initiate (rather than respond to) speech, particularly when a new topic is being introduced, and where the child may perceive that his novel thought as well as increased potential for stuttering will be negatively evalu¬ated. Starkweather suggests there may also be an association with attention deficit hyperactivity disorder (ADHD) children amongst this group.