CONCEPT

The stammer is an oral phenomenon for which certain syllables recur and others, on the other hand, cannot be marked.

CAUSES

The causes of the stammer are not known. Hereditary predisposition seems to exist. The stammer has collaborated also with desarreglos affective. In any case, the conducts of avoidance with which the patients try to solve the problem turn partly fundamentally of the disorder.

TARGETS OF THE TREATMENT

Almost all the sputterers can pronounce perfectly the word that in other circumstances they stutter. If the target not to stutter appears, the mistake is almost sure. The target of the current therapies is to help the sputterer to unlearn his old answers desadaptativas, that are those who lead him to stuttering, and to learning in his place more adaptive others.

PHASES

1. Identification phase. In her the sputterer explores, analyzes and classifies the conducts that him are proper in his stammer:

To identify the fluid speech. That the sputterer realizes that we all stutter of some form, but that we do it in a fluid way and that he in some occasions makes it equal. East turns into the target to be reached for his stammer. To try to obtain the perfect speech to 100 % is a utopia.

To identify the avoidance conducts, like replacing a few words with others, changing the order of the words into the phrase and any other one that it uses to avoid the awesome words.

Identification of the conducts of postponement. The sputterer uses repetitions of the previous word, rustles or "mmmms", the gullet clears up, it gives the lips, etc. Someone can be very complex.

Identification of the conducts that finish the postponement. As for example, to shake the head or the jaw, to exhale forcibly the breath, etc.

Identification of the verbal desencadenantes of stammer. It can be the length of the word, the position in the phrase, the past history like unpleasant, the letter by which the word starts, etc.

Identification of the situations in which the sputterer speaks worse. Cases can happen like speaking by phone, asking for favors, speaking to many people, etc.

There are identified also the reactions later to the stammer, the feelings of frustration, shame and hostility.

2. Desensibilización phase. In her the sputterer is desensitized to his anxieties on having spoken and to other negative emotions that are related to the stammer. It is a question of the mistakes in the verbal fluency without taking them to an increase of the anxiety that would worsen his verbal performance. There are used the same skills as for any other anxiety treatment (exhibition, flood, successive approaches, desensibilización in alive, etc.). The results of this phase are usually spectacular: they can eliminate many of the showiest conducts of the patient.

Modification phase. It is a question of modifying the behavioral patterns of the sputterer so that he learns more adaptive ways of behaving before the absence of fluency. It includes several subphases:

Change. There interfere alternative ways of stuttering so that control is gained on the device fonador.

Desaprendizaje of answers of avoidance, struggle, delay, cancellation, etc. The sputterer learns later to realize alternative conducts when it enters a blockade, so that it ends up by going out of fluid form of him. He learns to go out of the fixation, of the quakes, of the closings larynxes, of the conducts of repetition.

4. Stabilization phase. It is a consolidation process. It is a question of the sputterer reaching a suitable valuation of fluid speech. Exercises are realized to learn to speak about syntactically correct form automating the learned conducts. In this phase one teaches him to handle also the relapsing.

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