راهکارهای درمانی خاص در درمان لکنت زبان کلینیک تخصصی لکنت کرج شهرک ۱۷شهریور- پارک ۱۷ شهریور- جنب مسجد
4 Lack of speech rhythm. Whether accompanied by tachylalia or not, most experts would agree that this is a good diagnostic indicator of cluttering (Daly, 1996; St Louis, 1992; St Louis et al., 2003). Speech may be charac-terized by jerky bursts of fast speech, interspersed with inappropriate short pauses. These pauses, and subsequent abrupt onset of speech, may give a staccato impression to speech delivery. Because of this, some people who clutter may also have great difficulty in replicating simple phrases (such as children’s poems which carry easily maintained rhythmic patterns) even under a slower and controlled rate. When severe, the poor phrasing can greatly reduce intelligibility, and can be difficult to treat.
5 Monotonous speech. Difficulties with phrasing may lead to speech that is lacking in pitch range. When there are breaks to the natural flow of speech (as above) this can further reduce intelligibility.
6 Festinant speech. Speech may start at a normal pace but become increas-ingly quick. Coincident with this, speech may become mumbled or over-coarticulated (see above) and may tail off into inaudibility. Wohl (1970) went as far as to suggest that festinant speech was the outstanding fea¬ture of cluttering. Although festinant speech may be seen in some who clutter, this view is not commonly shared nowadays.
7 Fluency disruptions. With the exception of (3), which directly affects flu-ency, many of the motoric features tend to affect intelligibility, rather than fluency. Clutterers typically neither block nor prolong, but part-word repetitions are quite common. Word and phrase repetitions are also com-mon, but it may be that these are more related language-based difficulties (see below). Quick phoneme repetitions, free from any struggle behaviour and usually comprising no more than 2-3 per instance, may also be associated with cluttering, but all of these fluency errors will be produced in the absence of any apparent concern, and secondary behaviours.
The box illustrates examples of motoric and linguistic cluttering.