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Efficacy of the Arabic Modified Fluency Shaping Program in the treatment of stuttering

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Abstract

Background

The goal of fluency-shaping approaches is not to modify stuttering but rather to completely replace it with fluent speech. This is achieved by applying a range of fluency-controlling techniques, usually implemented within a slow-speech framework, which fundamentally changes the way that respiration, phonation, and articulation are coordinated for speech.

Aim

The present study aimed at evaluating the efficacy of the Arabic Modified Fluency Shaping Program as a valuable treatment approach for Egyptian stutterers.

Patients and methods

The study design was a prospective longitudinal experimental controlled one.

The present work was carried out on 100 stutterers of both sexes in the age range of 8–20 years. The participants were divided into two groups: the study group and the control group.

A multidimensional assessment protocol was used for all participants. It included elementary diagnostic procedures (personal interview, visual perceptual assessment, and auditory perceptual assessment), clinical diagnostic aids (Stuttering Severity Instrument for Children and Adults-Arabic version, speech rate, psychometric evaluation, and assessment of feelings and attitudes using speech performance self-reported questionnaire), and additional instrumental measures (spectrographic assessment and Visi Pitch).

Therapy program: Participants in the study group were trained using the Arabic Modified Fluency Shaping Program.

Results

The study group achieved better outcome with the therapeutic program regardless of the age of the patient at the time of therapy. There was marked reduction in mean total score of Stuttering Severity Instrument for Children and Adults-Arabic version in the study group and was 1.48, 1.66, and 2.12, respectively, during post-therapy, first follow-up, and second follow-up evaluations compared with 25.36 during the pretherapy evaluation. As regards spectral analysis, there were higher post-therapeutic values for voice onset time, vowel duration, syllable duration, and shorter sentence duration. As regards Visi Pitch, there were lower post-therapeutic values for percent voiced and percent pause and a higher value for the percent unvoiced, which denotes improvement. The results of speech performance self-reported questionnaire showed an increase in patient’s satisfaction with speech and trust in their abilities as a speaker; there was also a decrease in avoidance of speaking situations and speaking on the phone after therapy.

Conclusion

The results of this study indicated the efficacy of the Arabic Modified Fluency Shaping Program in rehabilitation of stuttering. The presented program provides participants with strategies that significantly improve their speech behavior and their attitudes toward speech.

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Correspondence to Sally T. Kheir El-Din MD.

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Rifaie, N.A.A., Saber, A.S., Kheir El-Din, S.T. et al. Efficacy of the Arabic Modified Fluency Shaping Program in the treatment of stuttering. Egypt J Otolaryngol 32, 306–321 (2016). https://doi.org/10.4103/1012-5574.192546

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Keywords

  • cognitive therapy
  • fluency shaping
  • spectrographic assessment
  • stuttering; treatment of stuttering