|About the presenter: Kristin A. Chmela, M.A. CCC-SLP is a board recognized specialist and mentor in fluency and fluency disorders. She is founder and director of the Chmela Fluency Center at the Central Speech and Language Clinic in Long Grove, Illinois, and serves as an adjunct faculty member at Northwestern University.|
Oral reading may be challenging for some school-age children who stutter. Reading fluency, for the purposes of sharing this clinical activity, is defined as the ability to read with an Easier Relaxed Approach - Smooth Movement at the initiation and throughout production of phrases. This fluency shaping approach, defined by Gregory (2003), utilizes an easier relaxed approach on the first two sounds of a word or phrase, with the remainder of the utterance characterized by smooth movement and continuous phonation, coupled by normal rate, pitch, loudness, and expression. Pausing is incorporated most usually every three to six words, and is followed by another easier relaxed approach.
Developing a reading hierarchy progressing from shorter to longer units of speech coupled by more to less support allows the child to experience continuous success (Campbell, 2003; Ryan, 2001). Accurate responses at each step allow movement to the next step, until the child is able to read aloud independently. Increased support, such as using visual prompts, may assist the child's progress. In order to accomplish this, the first two sounds of the first word of the phrase are highlighted, and a slash mark is placed where each pause occurs. It also may be helpful to create visual spaces between phrases. See example below.
When utilizing Easier Relaxed Approach-Smooth Movement, the child moves in to the first two sounds easily with a slightly slower movement on the vowel, and then the remainder of the phrase is "let go". The transitions within sounds and between words are produced smoothly. After the pause, the next phrase is started in the same manner. These behaviors are modeled consistently by the clinician as well as others practicing with the child.
Utilizing material the child reads in school is suggested. Poetry may be a helpful way for the child to experience speaking in natural phrases. A modified version (such as a smaller number of responses per step) of this hierarchy is utilized for ongoing reading practice. A conversational partner, selected by the child, is guided by the clinician and child on how to execute each step of the bucket. During a short daily practice, the child receives feedback from his/her conversational partner for initiating easy, moving smoothly, keeping sound on, and pausing.
Although the child may be successful at reading independently with increased confidence and fluency, continuous practice of the Reading Bucket is recommended. The clinician and child may also instruct the classroom teacher on how to practice reading in this way, and practice may occur with the teacher throughout the week as well. Children may feel more confident using visual prompts and spaces when reading in class or giving a presentation. Collaboration with teachers is important.
As you look at the sample Reading Bucket, note the definitions of each step below starting from the bottom and progressing towards the top of the bucket.
Campbell, J.H. (2003). Therapy for elementary school-age children who stutter. In H.H. Gregory (Ed.), Stuttering therapy: rationale & procedures, (pp. 217-262). Boston: Allyn & Bacon.
Gregory, H.H. (2003). Stuttering therapy: rationale and procedures, (pp.217-262). Boston: Allyn & Bacon.
Ryan, B. (2001). Programmed stuttering therapy for children and adults (2ND Ed). Springfield, IL: Charles C. Thomas.
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