Word-Final Disfluency: Clinical Data From a Single Therapy Protocol

Abstract

Purpose: Word-final disfluency (WFD), also referred to as end-word repetition and echo dysphemia , takes the form of a final rhyme repetition involving a whole or partial syllable (e.g., “lock-ock” and “ca-ake”). Although WFD has been documented in case studies, therapeutic programs have not yet been reported. Our purpose was to report therapy data for 20 cases of WFD using a single therapy protocol called Structured Awareness Therapy for Word-Final Disfluency. The authors report the effects of therapy in routine clinical practice and describe the therapy program to contribute practice-based evidence that may narrow the research–practice gap and improve service delivery for those with WFD. Method: The participants included 20 children (13 boys and seven girls; age range: 5–11 years). Parents reported a diagnosis of autism in five of the 20 participants. The children and their families participated in weekly and biweekly therapy sessions. Pre- and posttherapy spontaneous speech samples were analyzed and compared. Parents' responses to follow-up surveys were reported. Results: All 20 children had successfully reduced (to less than 1.5% WFD) or eliminated WFD in their spontaneous speech with short-term therapy (average, 9 weeks). Parental follow-up surveys confirmed the long-term durability of the therapy. Conclusions: Therapy data support the functional and long-term outcomes of the reduction or elimination of WFD in routine clinical practice. The authors described the therapy program and offered perspectives on the causes or functions of WFD. Suggestions for future directions include research needs and a call for treatment efficacy studies to broaden trusted therapy options for WFD.