A Stuttering Modification ProcessIt is an intensive interval therapy program for people who stutter. First conducted in 1987 Germany, this therapy program was named after Van Riper from whom it took several of its basic underlying principles of treatment. It is called the Van Riper Program as Intensive Interval Therapy. It is called interval because of its block schedule system?a five-day duration of segments with six to eight weeks between the segments. It is called intensive because of its long period of session during segments?about eight hours a day. The basic principles of this program involve the preference and utilization of stuttering modification approach over a fluency shaping approach. It also considers motivation and relapse as major difficulties in many adult stuttering therapies. In addition, it believes that therapist plays a lesser role in most adult stuttering therapies. The Van Riper Program is done in a group?about 12 patients with two therapists. This is often conducted in a church-run boarding house. In Germany, the therapists include Andreas Starke, together with Angelika Engert and Bernd Koppenhagen. There are five weeks overall in the process. The first week focuses on identification. The two major goals in this initial week are improving the understanding of each patient?s stuttering and making patients understand the basic concepts of speech production. This segment involves a video recording of each patient and recorded ten-minute conversational speech and five-minute reading. This is followed by lectures on speech production and analysis of the video recordings. The second week focuses on desensitization. The major goal of this segment is to desensitize patients to the expectation and experience of stuttering. This phase include exercises in maintaining eye contact, analyzing reactions to stuttering, and regaining control in stuttering event. In this phase, patients are expected to make modifications in their reactions to stuttering such as avoiding, interjections, and postponing. The next week uses the cancellation procedure from Van Riper?s technique with introduction and practice processes. This stage teaches patients with slow motion speech with attention given to precise prolongation of natural speed production and the use of pauses. Records have shown that frequency of stuttering have substantial reduction in most patients. Aside from introduction and practice, the fourth week now employs the pull-outs devised by Van Riper. This is simpler than the process in the previous stage. Patients are trained to gain control of the stuttering event, thus completing the word through slow movement. Most patients rarely have difficulty achieving this process. Often than not, they find such process pleasurable. In addition, the fourth week involves less outdoor activities and telephone sessions. However, for ensuring their fluency, a 15 to 20 minute public speech is done as an exercise. Lastly, the final week involves no exercise anymore. It is more of reviewing the sequence of therapy and instructs the patients to work their way backwards. In addition, the therapists further explain the sources of relapse and discuss specific characteristics of a life of a person who stutter. In a recent survey, this stuttering modification process has been successful so far in many patients.
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