About the presenter: Kenneth Logan, Ph.D., CCC/SLP is a member of the Department of Communication Sciences and Disorders at the University of Florida, where he teaches, conducts research, and supervises clinical activities related to fluency disorders. He has presented many papers and authored a number of articles that deal with the nature and treatment of stuttering.
Helping Clients Who Clutter Regulate Speaking Rate
by Kenneth Logan
from Florida, USA
Cluttering is a communication disorder that is characterized by disorganized language output, imprecise or inaccurate articulation (particularly on multi-syllabic words), excessive interjections and revisions, and bursts of rapid or irregular speech. One common treatment strategy for cluttering is to improve the client's ability to regulate speaking rate. Clients who clutter often realize significant improvements in fluency, language organization, and speech intelligibility by reducing and/or attending to their speaking rate. At first glance, "slow speech" may seem like a simple, easy solution to a complex problem; however, most clients who clutter report that it is very challenging to regulate their speaking rate on a moment-by-moment basis for long periods of time. Therefore, it is usually necessary to have clients practice rate regulation skills extensively during structured clinical tasks prior to asking them to change the way they talk in real-life settings.
Here are two techniques that clinicians can use to help clients who clutter regulate speaking rate:
- Controlling articulation rate. One way for clients to regulate speaking rate is to alter the speed of articulatory movements. The term articulation rate refers to how quickly the articulators are moving during speech. Articulation rate is affected by the duration of individual sound segments (i.e., consonants, vowels) within an utterance and the extent to which they overlap or coarticulate with one another while talking. Speakers can reduce articulation rate by increasing the duration of individual speech sounds. This results in speech that sounds as if it is being produced in slow motion. Listed below is a sequence of activities that we've found to be effective in helping clients who clutter alter articulation rate.
- Master the basics. The first step is to learn how to produce slow, prolonged speech yourself, so that you can model it effectively for your client. Aim to develop three different articulation rates: very slow, moderately slow, and slightly slow. To develop the very slow rate, locate a watch that has a second hand and a reading passage that is at least 60 syllables long. Read the passage so that it takes about 1 second to say each of the syllables. This translates into a rate of 60 syllables per minute. As you are reading, be sure to stretch out both the vowel and the consonant sounds. Blend each word together smoothly (beginners tend to stop after every word!) and use normal intonation and intensity. Vowels, nasal consonants, and continuant consonants are easy to stretch (e.g.,"No" = nnnnooo; "Yes" = yyyeeesss). Stop consonants ([p, b, t, d, k, g]) are more challenging, however. For these sounds, simply release the consonant at its place of articulation and then extend the aspiration that follows the release. For example, the word "pet" would sound something like "phhheeet." After you master the very slow rate, move up to the moderately slow rate, which is about 2 syllables per second. With the moderately slow rate, you would need 30 seconds to read a 60-syllable passage. For the slightly slow rate, aim for a speech pattern that sounds natural, but is just a bit slower than your customary rate. An appropriate target would be about 3 syllables per second (20 seconds to read 60-syllable passage), which translates to a rate of 180 syllables per minute. The general goal is to speak with a reasonably normal, but carefully monitored speech rate.
- Choral Reading. After you've learned to control your articulation rate, you are ready to help your clients do the same. Use the procedures described in section 1a above to help your client improve his or her control over articulation rate. When setting a target for the "slightly slow" condition, have the client adjust his or her rate as necessary, based on your observations about his or her intelligibility and fluency. A good starting point for practice is to read chorally with the client. Select a passage of suitable reading difficulty. Put slashes on the paper to indicate approximately where in the text you should be after 15 seconds, 30 seconds, 45 seconds, 1 minute, etc., of reading. (Location of the slashes will vary with the rate you are using.) Model the desired articulation rate for the client, and then have the client read the passage chorally with you. Encourage the client to match your model as closely as possible.
- Intermittent Choral Reading. Select a suitable reading passage and record yourself as you read it aloud for about two minutes at each of the three target rates. Beginning with the slowest rate, play the recording aloud and ask the client to read along with it. After several sentences, turn the volume off for several seconds so that the client is now reading solo. Then, turn the volume on the recording up again, so that the client is once again reading chorally with the recording. Evaluate how accurately the client's solo rate matches his or her rate during the choral reading condition. Repeat this process at the moderately slow and slightly slow rates until the client is able to reliably produce the target rates.
- Using Recordings as "Rate References." Select a suitable reading passage and record yourself as you read it aloud for about two minutes at each of the three target rates. Then, ask the client to produce a narrative about a familiar topic (e.g., favorite movie). When the client begins to speak, turn on the recording of yourself at the very slow rate and ask the client to listen to and attempt to match your rate model as it plays in the background. (In other words, the client will talk about a topic that is unrelated to the topic that you are reading about on the recording. The client will attend to the rate, but not the content, of what you are saying on the recording.) After the client has been speaking for several sentences, turn the volume off for several seconds so that the client is now speaking solo. Then, turn the volume on the recording up again, so that client is once again hearing the rate reference as it plays in the background. Evaluate how accurately the client's solo rate matches the rate on the reference recording.
- When the client is consistently able to maintain the very slow rate for several minutes at a time, proceed to the moderately slow and slightly slow rates. Along the way, begin to fade out the rate reference, until the client is able to produce the desired rates while speaking solo. At this point, the client should have sufficient skill to begin using controlled articulation rate in real-life situations.
- A variation of the above is to develop the client's ability to manipulate articulation rate (very slow, moderately slow, and slightly slow) while saying multi-syllable words. In most cases, regulated articulation rate will result in improved articulatory accuracy and intelligibility for such words.
- The ultimate goals are (1) for the client to speak in a natural sounding way at a reasonably normal rate, while monitoring fluency, articulation rate and intelligibility, and (2) to reduce articulation rate as necessary to maintain fluent, intelligible, well-organized speech.
- Increase the frequency and duration of pauses during speech. Another way to regulate speaking rate is to alter pausing patterns. Speakers tend to pause in predictable places during conversation, narration, and oral reading. Often, these pauses coincide with speech breathing and they occur at major grammatical boundaries such as the end of a sentence or clause. A typical speaker is able to produce many syllables on one breath. (Try reading the following sentence at a typical rate, and note how far into the sentence you get before you need to breath: Cluttering is a communication disorder that is characterized by disorganized language output, imprecise or inaccurate articulation, excessive interjections and revisions, and bursts of rapid or irregular speech.) Usually, the duration of these pauses is fairly brief (i.e., < 1/3 of second). During therapy, the aim is to encourage clients who clutter to reduce their speech rate by producing longer, more frequent pauses. Oral reading is a good context for practicing this skill. Listed below is a sequence of activities that we've found to be successful in altering pause patterns with clients who clutter.
- Find a reading passage of suitable difficulty for your client. Record the client as he or she reads the passage aloud. Replay the recording, and have the client mark the places within the passage where he or she pauses. Discuss with the client how the current pausing patterns compare with those of typical speakers and how the pausing patterns might affect the client's intelligibility.
- Mark a second copy of the passage with asterisks to signify places where you would like the client to pause. Place the asterisks at phrase boundaries, so that the client will be pausing after every 3 to 5 words. Example (double asterisks indicate pause locations): "Surfing ** is a sport ** that takes ** lots of practice ** to master. ** Beginners ** should find a beach ** with warm water ** gentle waves ** and plenty of open space.
- As the client becomes proficient with reading such passages, the number of pauses can be reduced and the duration of pauses can be shortened so that the client's speech sounds natural. Research has shown that when speakers pause frequently, they also automatically reduce their rate of articulation. Thus, use of the pausing technique may negate the need for detailed instruction in how to reduce articulation rate.
- The ultimate goals are (1) for the client to speak in a natural sounding way, while monitoring speaking rate, fluency, and intelligibility, and (2) to insert pauses as necessary to regulate rate and maintain fluent, intelligible, well-organized speech.
SUBMITTED: March 6, 2010
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