Implementing Avoidance Reduction in Stuttering

Theoretischer Wissenserwerb:

1) Participants will demonstrate understanding and describe the theoretical rationale between stuttering, anxiety and avoidance and identify those avoidance behaviors such as word switching, avoiding situations, and eye gaze aversion.
2)Participants will differentiate between overt stuttering, (core behviors) and secondary avoidance responses within a multidimensional model of stuttering.
3) Participants will be able to differentiate fluency-focused therapy from approach-based therapy and how that leads to greater client engagement rather than chasing fluency.
4) Participats will explain how avoidance behaviors contribute to the maintenance of the stuttering cycle (such as the shame of stuttering while ordering food).
5)Reduced participation, eye gaze shifts, humor deflection, Internal avoidance patterns (e.g., cognitive rehearsal, thought suppression)

Praktischer Wissenserwerb:

1) Participants will identify and document at least five observable and covert avoidance behaviors during a therapy session (e.g., increase in volume, use of interjections)
2) Participants will construct an individualized avoidance hierarchy for a child, adolescent, or adult who stutters. (e.g., low-risk vs high-risk scenarios).
3) Participants will implement at least three in-session avoidance-reduction strategies (e.g., voluntary stuttering, approach tasks, stuttering disclosure practice) while developing measurable, treatment goals targeting approach behaviors .
4) Participants will design tasks that increase real-world communicative participation based on participation, approach behaviors, and reduction of avoidance patterns.

Avoidance reduction therapy views stuttering as an approach-avoidance conflict, where a person who stutters experiences both a desire to speak and connect with others, as well as the opposing urge to hide their stuttering. This conflict can give rise to maladaptive secondary behaviors (e.g., eye blinking, using filler words), that disrupt communication and reinforce feelings of social and communicative restrictions. Therefore, instead of focusing on antiquated, impractical fluency strategies, speech pathologists can implement a program where decreasing avoidances to easier achieve spontaneous communcation, is the ultimate goal.

In this workshop, participants will learn that helping our clients to reduce their avoidances leads to an increase in effective communication as our clients say what they mean to say to anyone, at any time, while stuttering "easier." Participants will be guided in supporting clients to reduce secondary behaviors and increase communicative apporach behaviors. Lastly, attendees will learn how to help clients overcome learned fears through real-life speaking activities that promote avoidance reduction with school-aged children, adolescents, and adults who stutter.