It is not a Panacea but you can try... Overview of approaches used in different countries for treating stuttering as communication difficulty and speech disorder Olena DEMYDENKO Master’s Thesis Master of Philosophy in Special Needs Education Department of Special Needs Education Faculty of Educational Sciences UNIVERSITY OF OSLO Spring 2013 © Forfatter År Tittel Forfatter http://www.duo.uio.no/ Trykk: Reprosentralen, Universitetet i Oslo II Abstract Communication is a key factor in our life. Communication skills are important for development of the professional and personal relationships. Without them, one’s effectiveness in all roles during the life is limited. The main focus of the present research is stuttering that is a speech disorder where the sounds, syllables, or words are repeated or last longer than normal. The main purpose of the study was to find out the best approaches of treating stuttering through identification and classification of stuttering, and in designation of existing approaches for its treatment with a particular focus on Ukraine and Norway. Focusing on these two countries in an international frame was even more interesting, since understanding of this disorder and the approaches used for its treatment have been very much influenced in the past by the Soviet scientists in Ukraine and by the American, British and Australian researchers in Norway. The study was performed according to the qualitative approach based on a case study design using the document analysis as a research method. Data analyses were performed using a reflective type of analysis and by using the concept of interpretive zone according to Wasser & Bresler (1996). The received results indicated broad spectrum of differences in theories about the cause of stuttering, its definition and classification as well as its assessment between Norway and Ukraine. This led to the differences in approaches used for treatment of stuttering. This study also showed that understanding of stuttering as a disability and its treatment should be analyzed in the context of historical, social, economic and political relations in the two mentioned countries as well as taking into account the national cultural features. In addition, this research highlights other factors that influence the ways of stuttering treatment and that should be considered for adaptation and implementation of new approaches in each country (if such decision would be done). Among them, there are models of designation and treatment of disability, the sectors of healthcare, interactions: speech language therapist– person who stutter, teacher – person who stutter, peers – person who stutter; role of the family and the environment. III Acknowledgements I would like to thank everyone who took part in process of writing this manuscript. First of all, I am very thankful to my supervisors – Ivar Morken and Anne-Lise Rygvold - who have been supportive and encouraging along the whole work process. Their advices and various constructive suggestions were very helpful especially in the part of research devoted to Norway. I am also very thankful to everybody at the Department of Special Needs Education, University of Oslo, both teaching staff and students for an opportunity to conduct this study and make it interesting. My sincere thanks are also given to Professors Steinar Theie, Berit Helene Johnsen, Jorun Buli-Holmberg and Siri Wormnæs for their guidance, inspiring and enthusiastic teaching. I would also give many thanks to Denese A. Brittain and Nicolai Mowinckel-Trysnes for their support and administration during my study at the University of Oslo. Last but not least, I express my deep gratitude to my family and to my husband, whose love are the most inspirational ever! In honor and respect, I dedicate this Master thesis to them. Oslo, May 15 th , 2013 Olena Demydenko IV Table of Contents Abstract ................................................................................................................................ III Acknowledgements ............................................................................................................. IV Table of Contents .................................................................................................................. V List of Tables and Figures .................................................................................................. VII Chapter 1: Introduction ...........................................................................................................1 1.1 Background and purpose of the study .......................................................................2 1.2 Short description of the country – Norway................................................................4 1.2.1 Education ..........................................................................................................4 1.2.2 Towards inclusion in Norway. ...........................................................................4 1.2.3 Development of speech language therapy in Norway .........................................5 1.3 Short description of the country – Ukraine................................................................7 1.3.1 Education in Ukraine .........................................................................................8 1.3.2 Towards inclusion in Ukraine ............................................................................8 1.3.3 Development of speech language therapy in Ukraine ....................................... 10 1.4 Statement of the research problem .......................................................................... 11 1.4.1 Research problem ............................................................................................ 11 1.4.2 Research questions .......................................................................................... 11 1.4.3 Expectations of the study ................................................................................. 12 1.5 Structure of the thesis ............................................................................................. 12 Chapter 2: Theoretical Framework ....................................................................................... 14 2.1 Introduction ............................................................................................................ 14 2.2 The socio-cultural theory of L. S. Vygotsky ........................................................... 15 2.3 Models of designation and treatment of disability ................................................... 16 2.4 Sectors of healthcare .............................................................................................. 17 2.5 Interaction of environment and person with stuttering ............................................ 19 2.6 Theories about stuttering ........................................................................................ 22 Chapter 3: Research Design and Methodology ...................................................................... 32 3.1 Case study .............................................................................................................. 32 3.2 Data sampling ........................................................................................................ 34 3.3 Analysis ................................................................................................................. 35 3.4 Validity .................................................................................................................. 36 V 3.5 Ethical issues .......................................................................................................... 38 3.6 Research limitations ............................................................................................... 38 Chapter 4: Data Analyses and Findings ................................................................................ 40 4.1 Stuttering in Norway .............................................................................................. 40 4.1.1 Definition and classification ............................................................................ 41 4.1.2 Assessment of stuttering .................................................................................. 44 4.1.3 Approaches for treatment of stuttering ............................................................. 45 4.2 Stuttering in Ukraine .............................................................................................. 52 4.2.1 Definition and classification ............................................................................ 53 4.2.2 Assessment of stuttering .................................................................................. 59 4.2.3 Approaches for treatment of stuttering ............................................................. 60 Chapter 5: Discussion and Summary .................................................................................... 72 5.1 Common and differences in understanding phenomenon of stuttering and its treatment in Norway and Ukraine ..................................................................................... 72 5.2 Influence of different factors on treatment of stuttering in Norway and Ukraine ..... 74 5.2.1 Models of designation and treatment of disability ............................................ 75 5.2.2 Assessment of stuttering .................................................................................. 76 5.2.3 The sectors of healthcare ................................................................................