First Blog about N

My client, N, is 6 years old and has been in therapy for a year. His diagnosis is fluency. Last semester, N, used the Shine approach to treat his stuttering but since he got bored with it, my supervisor wanted to try something different with N this semester. We are using a contingent management and fluency shaping approach. All we do is play the whole session. There's a 5 minute non-treamtent probe where I talk normally, then we have 20 minutes of treatment. During those 20 minutes, I’m using slow and easy speech. N is supposed to imitate me and every time I hear him use his easy voice, I drop a bean in a container. N earns something at the end of the session according to the amount of beans he earns. We then have another 5 minute non-treatment probe and then while I talk to his dad, he plays with my assistant and his sisters for a maintenance phase.
There are many operant stuttering treatment programs and operant conditioning has been proven to work for children who stutter. In the article, Contingency Management and Stuttering in Children by Ryan, the author states that stuttering is an operant behavior controlled by its consequences. The frequency of stuttering, when followed by aversive events, decreased and when followed by positive events, increased. All of these contingent programs have an acquisition, generalization, and maintenance phase. All of these programs have been proven to also reduce stuttering.
Our program sometimes works for N. He has his days where he won’t use his easy voice at all. Some days you have to bribe him and he’ll only say a certain number of things with his easy voice because he knows he only has to earn that many beans. Or he won't even earn all of this beans and just say a few things in his easy voice. Other days he sees that he’s earning them and he’ll think of things to say just to earn beans. He has had some decrease in his stuttering but it hasn’t always correlated with days he has used his easy voice. His dad even says his stuttering is decreasing at home. It's almost like some days we are pushing his easy voice on him when he's not even stuttering. He just has his good days and bad days. Some days he will have a lot to say and other days he won’t really feel like talking much. At least he’s participating so far and he likes this approach much better than the Shine.

Ryan, B.P. (2004). Contingency management and stuttering in children. The Behavioral Analyst Today, 5(2), 144-150.

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