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Stuttering Modification Therapy. The Van Riper Approach. Rachael Musielewicz & Jenna Stewart. Stuttering Modification . The main goal of stuttering modification is not to speak more fluently but to stutter easily. Two key elements: Modification of stuttering moments to reduce severity.

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stuttering modification therapy

Stuttering Modification Therapy

The Van Riper Approach

Rachael Musielewicz & Jenna Stewart

stuttering modification
Stuttering Modification
  • The main goal of stuttering modification is not to speak more fluently but to stutter easily.
  • Two key elements:
    • Modification of stuttering moments to reduce severity.
    • Elimination of avoidance and covert behaviors to reduce the fear of stuttering.
stuttering modification3
Stuttering Modification

“Uses a progression of having the client:

  • Learn to correct a stutter immediately after it occurs by saying it again in an easier fashion
  • Learn to change a stutter into an easier production of the sound while it’s still going on
  • Learn to start a word the client expects to stutter on in an easy, slow, relaxed fashion that makes the stutter very mild”

(Van Riper, 1973)

style of presentation
Style of Presentation
  • Intensive Program
  • Individual therapy: 1 hr a week, 3 times a week
  • Group therapy: 1 hr a week, 3 times a week
  • Daily self therapy
four phases
Four Phases
  • Identification Phase
  • Desensitization Phase
  • Modification Phase
  • Stabilization Phase
identification phase
Identification Phase
  • To improve the understanding of each individual’s stuttering and to have client understand the basic concepts of speech production.
  • Therapy strategies used to identify behaviors are oral reading, discussion, modeling stuttered behaviors, and self observation.
desensitization phase
Desensitization Phase
  • To desensitize the patients to the expectation and experience of stuttering
  • Therapy strategies are to confront the disorder and desensitize the individual to stutter behaviors and listener reactions such as direct confrontation and pseudo stuttering.
modification phase
Modification Phase
  • Client learns to use Van Riper’s modification techniques:

Cancellations-after stuttering, there is a pause and the word is said a second time using an “easy” stutter.

Pull-outs- when a person begins to stutter, they are to say the rest of the word with ease.

Preparatory set techniques- when the person anticipates a word to be difficult, they are encouraged to work through all sounds of the word slowly and calmly.

stabilization phase
Stabilization Phase
  • Individual becomes a confident communicator and possesses the skills to act as their own clinician.
  • Generalization and maintenance are addressed during the stabilization phase.
success
Success
  • Motivation determines eventual success of therapy
  • Success occurs when the person who stutters changes into a person who is in control and speaks fluently with occasional moments of mild stuttering. It must be discovered and nurtured and cannot be assumed.
generalization maintenance
Generalization & Maintenance
  • Generalization
    • The client is able to use strategies learned in therapy in more natural contexts.
    • The client is encouraged to face situations that were feared and avoided prior therapy.
    • Dismissal occurs when the client becomes more confident and feels that stuttering moments in every day situations are manageable.
  • Maintenance
    • The strategies learned during therapy are maintained by the client during the stabilization phase and after dismissal.
    • If stuttering behaviors reoccur and become problematic, it is encouraged to go over the phases of therapy with a pseudo stutter.
strengths vs weaknesses
Strengths vs. Weaknesses
  • Strengths
    • Focuses on the person as an individual
    • Encourages an internal locus of control
    • Gained awareness that disfluencies are common
  • Weaknesses
    • Strong commitment is essential for success
    • Willingness to discuss stuttering experiences
    • Inappropriate for individuals in the beginning stages of stuttering
references
References

Dodge, D. (n.d.). Study guide for Charles Van Riper's:The treatment of stuttering. Retrieved December 3, 2007 from http://members.aol.com/dmdodge/dw/vriper.htm

Guitar, B. (2006). Stuttering: An integrated approach to its nature and treatment (3rd ed.). Baltimore, MD. Williams & Wilkins.

Jorgenson, M. (2001). Therapy and its importance. Retrieved December 3, 2007 from http://www.d.umn.edu/~cspiller/stutteringpage/therapy.htm

Van Riper, C. (1973). The treatment of stuttering. Englewood Cliffs, NJ: Prentice-Hall