By: E. Charles Healey, Lisa Scott Trautman, and James Panico [Source:]

 A basic component of most stuttering therapy programs is manipulation of the length and grammatical complexity of client utterances (Healey, Norris, Scott Trautman, & Susca, 1999). For example, Ryan and Ryan (1995) reported that a fluency-shaping treatment program based on a gradual increase in utterance length and grammatical complexity was effective in establishing fluency in school-age children who stutter. Thus, manipulating the length and complexity of client utterances produced in therapy assists him/her in achieving fluent productions.

In a traditional length/complexity hierarchy, utterance length relates to the number of words or syllables produced per speaking turn. Utterance complexity, on the other hand, is associated with the syntactic difficulty of what’s said. Both length and complexity can be independently manipulated to facilitate a more fluent response. In this paper we will describe a modified approach clinicians can use when manipulating linguistic complexity in stuttering therapy. The approach we recommend is substantially different from the typical method focusing only on length and complexity through use of isolated word lists, phrases, or sentences. Instead, our approach extends these methods by changing the cognitive-linguistic and discourse demands placed on the child as well as other features of linguistic complexity that have not been addressed in previous treatment paradigms. Using Norris and Hoffman’s (1993) Situational-Discourse-Semantic (SDS) model of communication, linguistic complexity is manipulated within the context of topic-centered, thematic activities. The SDS model provides a framework for structuring and systematically manipulating cognitive-linguistic, discourse, and individual utterance length/complexity demands. The use of a consistent topic or theme provides the framework for creating meaningful communicative interactions rather than relying on arbitrary linguistic tasks such as word or sentence lists.