راهکارهای درمانی خاص در درمان لکنت زبان کلینیک تخصصی لکنت کرج حاشیه شمالی شهرک خاتم الانبیا
increased rate, as do pauses which carry tension or respiratory struggle (Ambrose & Yairi, 1999;
machine recognition of stuttering moments may point the way for the future in this area (for example, see Howell, Sackin, Glenn, & Au-Yeung, 1997).
To make a decision about supralexical disfluency we need to consider a number of factors. One useful indicator is frequency of the repetition or revision: “it’s it’s over there” may be regarded as a normal disfluency, “it’s it’s it’s it’s it’s it’s over there” is less likely. Other important cues include tension and concomitant escape or struggle behaviour. Even a single repetition of a word will clearly be identified as stuttering if it is accompanied with excessive facial tension and head jerk.
Should nonstuttering disfluencies be included?
There may be occasions when a clinician would want to focus more on the client’s overall fluency rather than stuttering alone. Here a case can be made for including nonstuttering disfluencies in the count alongside moments of genuine stuttering. In the majority of cases, though, the fluency count is used to identify stuttering alone. However, some disfluencies are not easily categor¬ized. As we have seen above, interjections such as “um … er … OK” may or may not be examples of stuttering, depending on a number of factors. Even experienced clinicians might not agree as to their categorization by a given speaker. Indeed, it is perfectly feasible for “um” to present as both stuttering and normal disfluency on different occasions within a single speech sample. If the interjection is being used to control or postpone a moment of stutter¬ing there may be a case for counting all interjections as stuttering moments, or all as normal disfluencies. There may also be a case for including only some as stuttering. The reality is that there is no consensus as to how to deal with this issue. Some clinicians automatically include all interjections as stuttering, on the grounds of consistency, and that they are, in either case, impediments to fluent and articulate speech and as such factors which they would want to consider in therapy. In the end, the decision lies with the clinician. Once a decision has been made and justified, it is crucial to qualify findings from any