The Normalization of Speech Patterns in People Who StutterMichael Susca, a speech language pathologist, has presented a treatment process for stuttering. He called it the normalization of speech patterns. He believed that people whom stutter comes from a very heterogeneous group. As such, he designed a program specific only to a certain group of people who stutter, but is applicable to a wide range of age. Though it is still a working progress, the eligibility of a patient to undergo such program includes many factors such as normal intelligence, recognition of the stuttering problem, current motivation to eliminate the stutter, the absence of a deep or broad "genetic tree" of stuttering, report of a history of fluent communication experiences before stuttering problem to name a few. Patients are expected to meet as many criteria as possible to be appropriate in the program. His program focuses on fixing underlying problems causing the symptoms and changing physiological processes with emphasis on normal speech and perpetual processes. The program aims to teach patients to become their own therapists. In addition, it aims to improve their communicative skill through self-perception, volition, effectiveness, and naturalness. Patients are thought to change their self-image into a positive belief system. It teaches patients to learn the willingness and confidences to begin communication with other people at varied time and place. It further teaches people who stutter to learn to respond, make changes in the environment verbally, and adjust to a new way of effortlessly sounding normal. Unlike other stuttering programs, Susca?s treatment process does not have particular duration. It changes according to particular patients? problems, needs, and logistics. However, the treatment sessions usually last for one hour and with a minimum of three times a week. Depending on the progress of patients, treatment sessions are normally reduced to once a week and then to once every other week, to once a month until the termination of treatment. The first concern of the treatment program is patients? use of cognitive secondary mannerisms. This process focuses on elimination of the use of avoidances, substitutions, and circumlocutions. The next step concerns with the increase of patients? awareness of sensory inputs. Usually, patients are asked to go through an exercise that provokes the use or sensory inputs such as proprioception, kinaesthesia, and tactility. This is briefly repeated to develop awareness of sensory parameters in body movements. Personal assessments are asked from the patients for them to lay out their progress and difficulties. Through continuous recognition of used techniques, patients learn the normal speech patterns and need less exaggerated techniques. There are major techniques taught in this treatment process. One example is the developing of belly-breathing. This teaches patients about the general dynamics of breathing. In this technique, they are encouraged to use easy belly-breathing while laying their back on the floor. The other technique is to develop and open throat posture that can be achieved in any one of four methods. This posture emphasizes an open, relaxed, pharyngeal structure through which airstream flows. It causes resonance change; teaches proper speaking posture to aid in reducing stuttering.
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