The aim of the study was to determine how Gestalt play therapy may be used in the therapeutic treatment of children in middle childhood who stutter. Stuttering is a problem that touches the lives of many people and is associated with great interpersonal distress. Stuttering is especially difficult for children in middle childhood, a time dominated by the school experience. Gestalt play therapy creates a child-friendly environment, in which the child can share information in a safe manner through the use of play therapeutic techniques. Literature was reviewed according to relevant topics, semi-structured interviews were conducted with three respondents, the data obtained was qualitatively analysed and research findings were discussed. The researcher concludes that Gestalt play therapy can be used to good effect with children who stutter, as it allows them to work through their emotions, and therefore, encourages them to communicate more freely within the therapeutic environment. / Social Work / M. Diac. (Play Therapy)

The thesis deals with stuttering in adulthood. The first part provides a theoretical basis for using professional literature. It contains theme of communication, communication disorders, stuttering (terminology, incidence, etiology and symptomatology, classification, diagnosis and therapy of selected techniques for adult age), and the International Stuttering Awareness Day. Another theme of the work is the employment of people with stuttering. Thesis also includes advice on how to talk to stutterers and guide phoning for stutterers. The practical part contains its own investigation, processing and results. KEY WORDS Communication, Stuttering, Poeple who stutter, Stuttering in adult age, International Stuttering Awareness Day, Stutterer and career choice

Thesis (MPhil (Centre for Health Sciences Education)--University of Stellenbosch, 2010. / AFRIKAANSE OPSOMMING: Doel: Te min spraak-taalterapeute (STT’e) wêreldwyd spreek vlotheidsversteurings aan. Dit mag aan hul gevoelens van onbevoegdheid in die hantering van persone wat hakkel toegeskryf word. Nuut-gegradueerde STT’e, in die Suid-Afrikaanse konteks, het dikwels nie toegang tot ondersteuning en leiding van ervare klinici om hul vaardighede en bevoegdheid in die hantering van persone wat hakkel, te ontwikkel nie. Die doel van hierdie studie was om voorgraadse STTstudente se persepsies van hul eie bevoegdheid om persone wat hakkel te hanteer, te ondersoek en beskryf 1) direk na die voltooiing van hul teoretiese module en voor kliniese plasing, en 2) na blootstelling aan ‘n bykomende opleidingskomponent waar hulle waargeneem het hoe intervensieprosedures op ‘n gesimuleerde pasiënt toegepas word. Metodes: ‘n Beskrywende opnameontwerp, met pre- en post-intervensie-vraelyste is gebruik om die andragogiese benadering se impak op studente, voor en nadat hulle die bykomende opleidingsgeleentheid ontvang het, te evalueer. Resultate: Voor die intervensie het die meeste studente hulself nie as bevoegd geag om persone wat hakkel te evalueer of behandel nie. Na die intervensie is statisties beduidende veranderinge in die studente se self-ervare bevoegdheid vir die meeste aspekte verwant aan die evaluering en behandeling van mense wat hakkel, gerapporteer. Opsomming: Daar is tot die gevolgtrekking gekom dat die studente hierdie tipe innoverende opleidingsmetodologie hoog op prys stel en dat dit ‘n nodige aanvulling tot studente se bestaande kliniese plasings is.

Thesis (MEdPsych (Educational Psychology))--University of Stellenbosch, 2010. / Bibliography / AFRIKAANSE OPSOMMING: Die verskynsel van hakkel word omgewe deur persoonlike belewenisse wat bydra tot die vorming van die selfkonsep van iemand wat hakkel. Die toenemende soeke na die oorsake, "behandeling" en "genesing" van hakkel lei waarskynlik tot die onderbeklemtoning van die wyse waarop die persoon sin maak van sy of haar hakkel. Holistiese ondersteuning fokus egter nie slegs op die hantering van hakkel nie, maar ook op die positiewe integrasie van hakkel in iemand se selfkonsep – ongeag die pyn of hartseer wat daarmee geassosieer word. Om dit te kan doen, word kennis benodig van die wyse waarop die verskillende dimensies van die persoon se selfkonsep tot uitdrukking kom. Die doel van hierdie studie was tweeledig van aard. Eerstens het dit gepoog om die selfkonsep van studente wat hakkel te verken en te beskryf deur middel van hulle belewing daarvan ten opsigte van die verskillende dimensies van die selfkonsep. Dit het aanleiding gegee tot 'n ruimer begrip van die wyse waarop die selfkonsep van die betrokke studente manifesteer in verskillende verhoudings. Tweedens het die studie ten doel gehad om meer holistiese wyses van ondersteuning te identifiseer en wat gevolglik gelei het tot die identifisering van sodanige ondersteuning binne die terapeutiese sowel as die onderrig- en leeromgewings. Ten einde hakkel as 'n menslike hoedanigheid te verstaan en te verduidelik, word van 'n kwalitatiewe benadering tot navorsing gebruik gemaak. Dit word ondersteun deur gefundeerde teorie as gekose navorsingsontwerp wat die induktiewe wyse van datagenerering en -analise beklemtoon. Die metodes van navorsing ten opsigte van datagenerering sluit in individuele onderhoude en 'n fokusgroep. Data is geanaliseer deur gebruik te maak van die konstante vergelykende metode. Die verkenning van die studente se selfkonsep op hierdie wyse het uiteindelik tot die identifisering van enkele determinante ten opsigte van intra- en interpersoonlike funksionering aanleiding gegee. Die twee prosesse van heling en verwonding betrokke in die vorming van die studente se selfkonsep illustreer hoe verhoudings tot die ondersteuning of selfs stigmatisering en gevolglike uitsluiting van hierdie studente bydra. iv Die verkenning van die verskillende dimensies van die selfkonsep van studente wat hakkel het die volgende aan die lig gebring: Dat die selfkonsep dien as uitdrukking van die studente se verband met hakkel op die drie verskillende vlakke van sielkundige funksionering, naamlik die: - Kognitiewe vlak: vervreemding van die outentieke self, persoonlike waarhede, transendensie en kongruensie - Affektiewe vlak: psigiese verwonding - Konatiewe vlak: kompensasie, isolasie en projeksie Spesifieke terapeutiese benaderinge kan moontlik heling bevorder by die student wie se selfkonsep broos blyk te wees weens die verwonding wat soms met hakkel gepaard gaan. Dit kan waarskynlik as 'n voorafgaande raamwerk dien vir die ontwikkeling van 'n enkele, meer omvattende behandelingsplan ter bevordering van 'n positiewe selfkonsep. Toeganklikheid ten opsigte van akademiese deelname vir studente wat hakkel behoort bevorder te word in 'n veilige en nie-bedreigende onderrig- en leeromgewing. Spesifieke wyses van ondersteuning in die konteks van die Universiteit Stellenbosch is voorgestel. Die uitsluiting van studente wat hakkel weens stigmatisering bring psigiese verwonding mee, wat gevolglik bydra tot die wyse waarop die student se selfkonsep tot uitdrukking kom. As navorser vertrou ek dat hierdie studie sal bydra tot 'n ruimer begrip van die selfkonsep van studente wat hakkel. Op so 'n wyse kan Opvoedkundige Sielkunde as vakgebied 'n agent van verandering wees, deurdat dit krities-reflekterende denke ten opsigte van die holistiese ondersteuning van studente wat hakkel, aanmoedig. Die teoreties gefundeerde gevolgtrekkings en aanbevelings in hierdie tesis kan dien as kennisraamwerk vir toekomstige navorsing op hierdie gebied. / ENGLISH ABSTRACT: The phenomenon of stuttering encompasses personal experiences that contribute to the forming of the self-concept of somebody who stutters. The increased search for the causes, "treatment" and "curing" of stuttering probably leads to underemphasising the manner in which the person makes sense of his or her stuttering. However, holistic support focuses not only on dealing with stuttering, but also on the positive integration of stuttering in someone's self-concept – regardless of the pain or distress associated with it. To be able to do this, knowledge about the manner in which the various dimensions of the person's self-concept are expressed, is required. The aim of this study was of dual purpose. Firstly it attempted to explore and describe the self-concepts of students who stutter by means of their experiences of stuttering with regard to the different dimensions thereof. This has lead to a better understanding of the way in which the self-concept of the students concerned becomes manifested in different relationships. Secondly this study aimed to identify more holistic ways of support which has lead to the identification of such ways in both the therapeutic and teaching and learning environments. To understand and explain stuttering as a human quality, a qualitative approach to research is used. It is supported by grounded theory as selected research design, which emphasises the inductive method of data generation and analysis. The methods of research with regard to data generation include individual interviews and a focus group. Data is analysed by using the constant comparative method. Exploring the students' self-concepts in this way eventually led to the identification of a few determinants with regard to intra- and interpersonal functioning. The two processes of healing and suffering involved in students' self-concepts illustrate how relationships contribute to the support or even stigmatisation and consequential exclusion of these students. The exploration of the different dimensions of the self-concept of students who stutter brought the following to light: That the self-concept serves as a manifestation of the students’ relationship with stuttering on the three different levels of psychological functioning, namely the: vi - Cognitive level: alienation of authentic self, personal truths, transendence and congruency - Affective level: psychological distress (suffering) - Conative level: compensation, isloation, projection Specific therapeutic approaches can possibly enhance healing in the student whose self-concept seems to be brittle due to the psychological distress or suffering that sometimes goes with stuttering. It can probably serve as a preliminary framework for developing a single, more comprehensive treatment plan to enhance a positive self-concept. Accessibility with regard to academic participation for students who stutter should be enhanced in a safe and non-threatening teaching and learning environment. Specific ways of support in the context of the Stellenbosch University are suggested. The exclusion of students who stutter due to stigmatisation causes psychological suffering, which consequently contributes to the manner in which the student's self-concept is expressed. As a researcher, I trust that this study will contribute to a broader understanding of the self-concept of students who stutter. In such a way, Educational Psychology as a subject field could be an agent for change by supporting critical-reflective thinking with regard to the holistic support of students who stutter. The theoretically grounded conclusions and recommendations in this thesis could serve as a framework of knowledge for future research in this field.

This report was developed to: a) enhance the clinician’s understanding of transfer and maintenance as it relates to stuttering, b) explore the unique challenges that face the school-aged population, c) examine research outside of the field that may be of benefit for school-aged stuttering clients, and d) provide the clinician with examples and activities that will facilitate the transfer and maintenance of stuttering treatment. The report will include a brief discussion of transfer and maintenance. The remainder of the report will focus on facilitating transfer and maintenance by increasing motivation, self-efficacy, realistic goal setting, and self-regulation. / text

The present study compared lateralization of cortical activation patterns in the prefrontal cortex (PFC) of adults who stutter (AWS) and typical speakers (TS) as measured with functional near infrared spectroscopy (fNIRS) in habitual and fluency-enhanced speaking conditions. Participants were AWS (n = 11) and gender- and age-matched TS (n = 11) who completed speaking tasks in three condition blocks: (1) habitual speech using no speaking strategy (2) prolonged speech after receiving short-term training in fluency-shaping strategy-use (3) syllable-timed speech after being trained to speak in rhythm with a metronome at 92 beats per minute. The three primary dependent variables were mean change in HbO (oxygenation) relative to resting baseline in the right and left PFC hemispheres and a Laterality Index (L-R)/(L+R) calculated from these values. Two primary hypotheses were tested: (1) AWS will present with greater right-hemisphere PFC oxygenation relative to TS in a habitual or everyday speaking task (2) AWS will present with reduced right-hemisphere PFC activation (leftward shift in laterality more similar to TS) during fluency-enhanced speech strategy tasks relative to a habitual speech task. Real-time stuttered speech measures using fNIRS indicated greater effortfulness of speech production in AWS when speaking fluently and disfluently as measured by greater bilateral change in PFC HbO relative to TS. AWS laterality did not differ from TS during everyday conversation and did not significantly change when using fluency-enhancing strategies, which was counter to the hypotheses. The TS group presented with significantly greater leftward PFC HbO in the metronome condition compared to AWS. Prolonged speech and metronome-timed speech seem to be associated with different activation patterns in the PFC for AWS and for TS. Results suggest an alternative explanation for compensatory activation in AWS during speech production, such that AWS present with greater overall activation in both PFC hemispheres relative to TS which results in greater right-sided laterality than TS. Future long-term studies on adults receiving prolonged speech treatment and examination of similar measures in young children who stutter may reveal more about the compensatory versus causal nature of stuttering.

A dissertation submitted to the Faculty of Arts, University of the Witwatersrand, Johannesburg. in fulfilment of the requirements for the degree of Master of Arts in Social Work. / The study sought to investigate the relationship of maternal and paternal attitudes and child-rearing practices towards children of different birth order positions. The research also investigated possible differences in the childrearing practices and attitudes toward" their children, of parents who had a child that stuttered, and of parents ill which there was no child wuo stuttered in the family. The research was conducted among a selected sample of forty three families who were matched on certain variables. Group A comprised thirty families in which there was no child who stuttered, and Group B comprised thirteen families each of whom had a child who had been identified as suffering from the disorder of stuttering. The data were collected by means of a postal questionnaire, and then analysed quantitavely and qualitatively using various statistical analyses. Selected variables were studied in an attempt to assess the possible effects on children as a result of birth order, parenting and stuttering. Findings revealed that parental attitudes towards the children of different birth order positions were not significantly different, However, the parents' expectations of and perceptions of their firstborn child's intelligence differed from their expectations and perceptions of their other children, No differences in child-rearing were identified between the parents of children who stuttered. and the parents of children who did not stutter. However, the parents in Group B reflected more confidence in their parenting skills. Religious centres were identified as being a popular venue for parenting programmes especially for the parents in Group A. Practice guidelines for social workers rendering services to the family in which there was a child who had the disorder of programmes were enumerated. Social workers need to be aware of the individual in interaction with an levels of the ecosystem. Social workers must also take cognizance of alternate family structures, the importance of the father in the development of the child and for Inclusi..a in therapy and benefits and methods of parenting programmes as a preventative tool to alleviate the possibility of future pathology. / Andrew Chakane 2018

STUDENT NO: 9902414P MA HUMANITIES SCHOOL OF HUMAN AND COMMUNITY DEVELOPMENT / ABSTRACT Rationale: In the early 1990s, the Lidcombe Programme, which is a direct, parentconducted, operant intervention programme for early childhood stuttering, was introduced to therapists. Available data in Australia suggest that the Lidcombe Programme is an effective early communication intervention as it eliminates stuttered speech in the medium and long term and is able to maintain these effects for up to seven years post-treatment (Onslow, Costa & Rue, 1990; Onslow, Andrews & Lincoln, 1994; Lincoln & Onslow, 1997; Jones, Onslow, Harris & Packman, 2000). However, despite the plethora of research in Australia, no South African research appears to have previously been conducted to establish long-term results and maintenance of fluency following the administration of this programme with young children. Purpose: The present study endeavoured to establish long-term results and maintenance of fluency using the Lidcombe Programme with children who stutter. Participants: Nine children were recruited, ranging in age from six to eleven years who had undergone therapy using the Lidcombe Programme during the previous two to six years. The parents of these children also participated in the study. Method: As part of the Lidcombe Programme, the percentage syllables stuttered (%SS) and the severity rating score (SR) were recorded at the time of the assessment and termination of therapy. The researcher evaluated each participant’s speech in two different situations using the measurements of %SS and SR and then compared these scores to the %SS and SR score recorded at the initial assessment and termination of therapy to ascertain whether each participant’s speech had improved, deteriorated or remained consistent. An interview with the child’s parents was also conducted to obtain a qualitative assessment of the parent’s views of their child’s speech since the termination of therapy. Results: The Wilcoxon signed rank test revealed a significant decrease in %SS and SR between pre-treatment scores and scores recorded at the time of the study (p = 0.00195 & p = 0.00195 respectively). Four participants’ %SS obtained at the time of the study compared to immediately after termination of therapy had increased slightly although this difference was not statistically significant (p = 0.4375). All parents reported that they had noted improvement in their child’s speech since the termination of therapy except for one mother who reported that her child’s speech had remained the same. Conclusions: It would seem that the Lidcombe Programme was successful with this particular group of participants as all of the children demonstrated a definite decrease in stuttering following therapy compared to pre-treatment and had maintained the levels of fluency obtained post-treatment to the time of the study. These findings have implications for early communication intervention, training of speech-language pathologists, theory and future research. KEY WORDS: stuttering, Lidcombe Programme, children, severity rating (SR) percentage syllables stuttered (%SS)

A fluência refere-se ao fluxo contínuo e suave de produção de fala, porém, quando ocorre a ruptura deste fluxo de fala têm-se o que chamamos de disfluências (alterações da fluência), que variam em maior ou menor grau, dependendo do dia, da emoção envolvida e do domínio sobre o tema da conversação. O que diferencia uma disfluência comum de todos os falantes de uma disfluência gaga é a quantidade de rupturas da fala e a capacidade individual para a pronta recuperação do equilíbrio entre os dois processamentos. Geralmente, percebe-se que um indivíduo apresenta a gagueira (disfluência) já na infância, sendo assim é imprescindível que esta criança realize tratamento fonoaudiológico, de modo que há diversas abordagens terapêuticas e programas fonoadiológicos para este tratamento, porém, independentemente de qual programa ou abordagem terapêutica o fonoaudiólogo optar, se os pais não forem bem orientados e engajados pelo terapeuta para participarem ativamente do processo de intervenção, o progresso deste provavelmente será mais lentificado e desmotivador. O objetivo deste trabalho foi elaborar, implementar e analisar dois programas voltados para crianças disfluentes, sendo um programa de intervenção para as crianças e outro programa de intervenção para o fonoaudiólogo aplicar com os pais. Os participantes da pesquisa foram seis pais de seis crianças disfluentes, com faixa etária de 2 anos e 11 meses a 6 anos e 11 meses, com disponibilidade de participar tanto os pais (grupo de pais) quanto às crianças (terapia fonoaudiológica) do programa completo que foi realizado durante 10 sessões com frequência semanal e duração de 50 minutos cada sessão. Ressalta-se que o programa de pais e crianças foram correlacionados. Foram aplicados protocolos e avaliações pré e pós-intervenção do programa supracitado, de modo que estes dados foram analisados por meio de uma análise estatística comparativa, utilizando-se os testes de Wilcoxon, Mcnemar e NVivo. Nos resultados foi possível observar que, quando comparadas as avaliações pré e pós-intervenção do grupo de pais, houve melhora estatisticamente significante nas características do temperamento que os pais percebiam em seus filhos. Em relação às crianças foi observado que houve uma melhora no grau de severidade da gagueira; em relação ao perfil da fluência ocorreu uma diminuição significativa das disfluências gagas e, quando comparados os sentimentos das crianças em relação à sua fala na pós-intervenção, os sentimentos negativos que na pré-intervenção foram elencados numa maior frequência apareceram numa frequência menor de palavras na pós-intervenção. Portanto, o estudo propôs o uso de um programa que permitisse uma intervenção concomitante na área de fluência de pais e filhos, além de propor o uso de protocolos e questionários que podem ser utilizados como instrumentos para a avaliação e intervenção na área da fluência. Além disso, mostrou a importância da participação dos pais durante o processo interventivo de seus filhos, permitindo que participem ativamente da intervenção fonoaudiológica, compreendam a gagueira e se instrumentalizem sobre quais atividades podem realizar no ambiente doméstico de forma a promover a melhora da fluência de seus filhos. / Fluency refers to the continuous and smooth flow of speech production, but when the speech flow ruptures we have what we call disfluencies (changes in fluency), which vary to a greater or lesser degree depending on the day , The emotion involved and the mastery over the subject of the conversation. What differentiates a common disfluency from all speakers of a gaga dysfluency is the amount of speech disruption and the individual capacity for the prompt recovery of balance between the two processes. It is generally perceived that an individual presents with stuttering (dysfluency) already in childhood, so it is imperative that this child perform speech-language therapy, so that there are several therapeutic approaches and phonoadiological programs for this treatment, however, regardless of which program or Therapeutic approach the speech-language pathologist will choose, if the parents are not well oriented and engaged by the therapist to participate actively in the intervention process, the progress of the intervention will probably be slower and demotivating. The objective of this work was to elaborate, implement and analyze two programs aimed at children with disfluentes, being an intervention program for the children and another intervention program for the phonoaudiologist to apply with the parents. The participants of the study were six parents of six disfluentes children, ranging in age from 2 years and 11 months to 6 years and 11 months, with the participation of both the parents (parents group) and the children (speech therapy) of the complete program Which was performed during 10 sessions with weekly frequency and duration of 50 minutes each session. It is noteworthy that the program of parents and children were correlated. Pre- and post-intervention protocols and evaluations of the aforementioned program were applied, so that these data were analyzed through a comparative statistical analysis, using the Wilcoxon, Mcnemar and NVivo tests. In the results it was possible to observe that, when comparing the pre- and post-intervention evaluations of the parents group, there was a statistically significant improvement in the temperament characteristics that the parents perceived in their children. Regarding the children, it was observed that there was an improvement in the severity degree of stuttering; In relation to the fluency profile, there was a significant decrease in gut disfluencies, and when the children\'s feelings were compared with their speech in the postintervention, the negative feelings that in the preintervention were listed at a higher frequency appeared at a lower frequency of words In post-intervention. Therefore, the study proposed the use of a program that allows a concomitant intervention in the area of fluency of parents and children, besides proposing the use of protocols and questionnaires that can be used as instruments for evaluation and intervention in the area of fluency. In addition, he showed the importance of parental participation during the intervention process of their children, allowing them to participate actively in speech therapy intervention, understand stuttering and to instrumentalize what activities they can perform in the home environment in order to promote the improvement of their children\'s fluency.

The topics of this master thesis are mainly findings on speech-therapy and the treatment of stuttering - stammering in the Czech and foreing reference literature. The work is divided into four chapters; three theoretical and one practical. The first theoretical chapter deals with stuttering-stammering, defines the basic concepts, deals with its etiology, symptoms and expresions, classification and division. The second chapter summarizes findings of balbuties in the Czech literature. The third chapter summarizes findings of balbuties on diagnosis and therapy in the English written literature. The fourth chapter is empirical and it is a quantitative empirical survey. The main method of data gathering was an online survey. The main purpose of the survey was to ascertain which methods and techniques are used when treating stuttering-stammering in the Czech Republic and in the Great Britain. The sub-chapters of the empirical part represent the scientific goals and chosen hypotheses, used methods, an actual processing of the quantitative survey and outcomes of the survey. KEYWORDS stuttering-stammering, balbuties, diagnosis, therapy, speech-therapy, reference literature