流暢性形成法の導入により改善した幼児吃音の1例

Recovery of a preschool stutterer after intervention with fluency shaping approach

　吃音が1年8か月以上持続した4歳2か月の男児にリッカム・プログラムを実施したところ，吃音症状は持続した．その後，流暢性形成法にアプローチを変更したところ速やかに吃音は改善した．

　本症例の経過から，(1)流暢性形成法が本児の改善に一定の効果があったこと，(2)吃音症状が重度で二次的症状がみられる症例に対しては，流暢性形成法が有効である可能性があること，(3)発話パターンの改変を伴う流暢性形成法を行う際は，リッカム・プログラムの後に導入することが望ましい可能性があること，(4)流暢性形成法を行う際，流暢な発話の般化に時間を要する点について説明する必要があること，が考えられた．

　This paper reports on the treatment of a preschool boy, aged four years and two months, who stuttered. Initially, the subject was treated using the Lidcombe Program, but his stuttering persisted. Thereafter, his treatment was switched to the fluency shaping approach, and he began to speak fluently. The treatment process of this case suggests that (1)the fluency shaping approach was effective with this case, (2)the fluency shaping approach may be effective more generally, for cases with severe stuttering and secondary behaviors, (3)introducing the fluency shaping approach, which changes speech patterns, may be more appropriate after first trying the Lidcombe Program, and (4)when introducing fluency shaping, it is important to explain to patients that it takes time to generalize fluent speech to conversation.