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New approach focuses on behavior

Luis Fábregas
| Wednesday, Nov. 28, 2001

The jumbled words coming out of Adam Myers' mouth didn't make sense to his parents.

Adam, 4, and his family were riding in the car, coming back from a trip to Myrtle Beach, S.C.

"He was all excited about the trip and he would repeat a sentence three or four times, but we just couldn't understand him," said Pamela Myers, 47, of Port Vue.

The Myerses, who had long suspected Adam had a stuttering problem, decided the boy needed help. They soon found out that Adam's stuttering, troubling as it was, is common among preschoolers.

Speech experts believe about 25 percent of children often have trouble putting words and sentences together.

"We just didn't know what was causing it," Pamela Myers said.

Doctors don't know, either. Yet stuttering, although not entirely curable, is now the subject of increased scrutiny.

At the Stuttering Center of Western Pennsylvania, researchers are focusing on a new treatment for children they hope will be used as a national model. The center is a partnership between the University of Pittsburgh and Children's Hospital of Pittsburgh.

Scott Yaruss, the center's director, said stuttering often surfaces as part of a child's normal development. Among some possible causes are genetics, neurological deficiencies and emotional problems.

"It's like when they're learning to walk," said Yaruss, who recently received a five-year, $775,000 grant from the National Institutes of Health to study stuttering. "Some children learn to walk quicker than others and some children fall down more. In the same way, some children make mistakes in their speech, but they have trouble letting those mistakes go."

He said the new technique favored by specialists at the center can dramatically reduce episodes of stuttering. The technique, successfully used to treat Adam Myers last month, is different because instead of focusing on the child, it places the burden of fixing the problem on the parents.

In the first part of the program, speech experts ask parents to keep a diary for 10 days to chart instances when their child stutters.

"We want to know who was the child talking to and how those people are reacting to the child," said Craig Coleman, a speech language pathologist at Children's Hospital.

Such information is invaluable when the therapist comes face to face with the parents. That's when therapists hone in on everything from a parent's speed to the choice of words when talking to a child.

Their goal• To make sure parents slow down when they're talking to their kids and, most importantly, so they can rephrase questions that can be confusing to the child.

"It's important that parents ask less direct questions," Coleman said. "Instead of asking 'what did have for lunch at school?' you can say 'I wonder what you did at school today?'"

To test the newly learned techniques, therapists monitor parents and children from an observation room with a two-way mirror.

As parents talk, therapists give them immediate feedback through a small earphone. Yaruss said this is a novel technique not typically used by other therapists.

"It's one thing to tell children to slow down, it's another thing for parents to do it and do it successfully," he said.

Coleman said it is important to work through the parents.

"If you work directly with the child, it just puts more pressure on them. We don't even tell them they're stuttering."

Coleman emphasized that the focus on the parents doesn't mean they are to blame for their children's speech troubles.

The Myerses said the technique worked with Adam, whose speech has markedly improved.

"We learned how to speak slowly and make him reiterate a sentence," Pamela Myers said. "If he stuttered, we would just slowly say the sentence back and he would repeat it back. It was incredible. Somehow this little guy caught on to the whole concept."

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