راهکارهای درمانی خاص در درمان لکنت زبان کلینیک تخصصی لکنت کرج خط چهارم حصار
subsequent fluency count with clarification of the criteria used.
Primary vs secondary stuttering
This is another potentially difficult area and there are different perspectives as to how moments of secondary stuttering that present as abnormal or superfluous motor behaviour should be dealt with in the fluency count (or even if such secondary stuttering should be included at all). On the one hand, it would seem wrong not to include secondary activity. After all, for a signifi¬cant number of those with established speakers, these features may represent the most significant problems. On the other hand, the purpose of the fluency count is, after all, to obtain a measure of speech fluency. As is the case with nonstuttering disfluencies, there are methodological inconsistencies in pro¬cedures. Some clinicians count only primary stuttering behaviours. Arguably, the majority at least count verbal secondary responses, including the “ums, ers” and “OKs” we mentioned earlier if they are seen to be postponing devices. Video evidence here can uncover nonverbal secondary behaviours and may also help more clearly identify primary ones, too: for example, a fleeting silent block is more easily identified if video evidence also shows concomitant lip protrusion. When nonverbal secondary features appear alongside a motoric disruption to speech, for example, a head jerk coinciding with the termination of a block, there is no problem in identifying this as stuttering. However, categorizing a moment of eye avoidance when there is no disruption to speech fluency or scoring a moment of obvious circumlocu¬tion presents a greater difficulty. In this example, most likely, the eye avoid¬ance would be noted but not scored as a moment of stuttering. Similarly, the word avoidance would be noted separately but would not constitute a moment of stuttering.
Speaking rate can be as revealing of a person’s communication problem as the percentage of syllables which are stuttered, and it is important that these data are recorded accurately. Andrews and Ingham (1971) calculated a mean figure of 196 SPM and a standard deviation of 34 (therefore