I received this clinical question, and am hoping that other have insight to share:
I am working with an 8 year-old boy with one of the most difficult presentations. He was initially diagnosed with ADHD and a tic disorder. He was put on stimulant medication around age 6, and subsequently developed a severe stutter. He has become terribly dysfluent, and is barely able to verbally communicate. His stimulant has been changed several times. When he’s off his medication, his school function plummets, but his fluency improves. His tics and OCD are becoming worse and worse, and are impacting every aspect of his life. He’s recently been diagnosed with Autism, and has just started attending a speech clinic outside of school. His vocal tics and stutter, as well as dysfluency continue to grow worse. His attention, while better on the medication, is still poor. While working with his PT, she noticed that if he jumps from one foot to another (like jogging in place with a little more lateral movement), his fluency improves. It takes him about 1/3 of the time to say a sentence while “wiggling” as it does while standing still. His tics diminish as well. Walking does not seem to have this effect. Tapping his hand while speaking helps, but not as much as this. Does anyone have any input or strategies to try? Any idea as to WHY this might be helping?
This seems like a pretty complex situation. Any ideas? Thanks in advance!
~Kathryn Biel, PT, DPT]]>