Voluntary Control of Involuntary Utterances

Voluntary Control of Involuntary Utterances is a treatment approach for severe nonfluent aphasia clients that are having difficulty with their expressive language skills (Helm & Barresi, 1980). These clients tend to produce single word stereotypes and overlearned phrases (Helm & Barresi, 1980). This approach helps clients produce functional speech with voluntary control (Helm & Barresi, 1980). During these sessions, the client determines the lexicon that will be used throughout the session (Helm & Barresi, 1980). This facilitates in helping the client with aphasia gain control over their uncontrolled verbal output which can lead them to more functional communication. Helm & Barresi conducted a study that resulted in clients showing an increase in their ability to complete naming tasks evidencing that Voluntary Control of Involuntary Utterances is a beneficial therapy task to conduct with aphasic clients (Helm & Barresi, 1980). 

Potential Goal: By December 2023, the client will voluntarily produce 4 out of 5 words correctly with their corresponding picture with 80% accuracy and minimal prompting as measured by SLP data collection. 

Materials Needed: 

• Index cards

• Pen/pencil

• Picture cards

How To: 

Step 1: Clinician will identify all real words that the client produces including: 

• Stereotypical utterances

• Words used in natural environments

• Any verbal output that is uttered spontaneously 

Step 2: Clinician will create a list of the words said by the client. 

Step 3: Clinician will write each word on an index card. 

Step 4: Ask the client to read each word out loud. Keep the card in the deck if they produce the word correctly. 

Step 5: Show the client each card with a picture on it and ask them to tell you what it is. If they are having trouble telling you what the picture is then show them the corresponding card with the word on it. 

If at any time the client produces a different real word for the picture then discard the former word and replace it with the word they produce. 

Step 6: Provide the client with target word cards to practice at home. Have them practice them in natural conversation with familiar communication partners. This will help them practice voluntary use of words in daily conversations. 

Data Tracking: Data can be tracked by the clinician keeping the cards that were produced correctly. Data can also be tracked by encouraging the familiar communication partners to keep track of how often the client is using the words voluntarily and can be reported per “family report”. 

Resources: 

Helm, N. & Barresi, B. (1980). Voluntary Control of Involuntary Utterances: A Treatment Approach for Severe Aphasia. Clinical Aphasiology Conference, 10, 308-315.

YouTube. (2020, March 22). Voluntary control of involuntary utterances (VCIU). YouTube. Retrieved December 18, 2022, from   https://www.youtube.com/watch?v=wqeSKUSW62I

Data index card. US Markerboard - Your leading source for Custom Whiteboards, Glass Boards and so much more. (n.d.).
  Retrieved December 18, 2022, from https://www.usmarkerboard.com/p/data-index-card/9805 

Pencil Vectors & Illustrations for free download. Freepik. (2016, April 7). Retrieved December 18, 2022, from https://www.freepik.com/vectors/pencil