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Fall '13-123 (Exam 2) > 10/7/13-Lecture 8 > Flashcards

10/7/13-Lecture 8 Flashcards

1
Q

Here is some information about the Monster study- chuchas said we don’t need to know this for quiz or exam.

A
  • Stuttering experiment performed on 21 orphaned children in 1939
  • dr. wendell Johnson 1939
  • Mary tudor, graduate assistant, conducted experiment
  • tried to induce stuttering in healthy children and to see whether telling stutterers that their speech was fine would produce a change
  • Told that they would be receiving speech therapy
  • Half the children given positive speech therapy, telling them that their speech was good
  • other half received negative speech therapy saying their speech was bad.
  • some who weren’t stutterers were told that they must stop themselves from stuttering
  • Negative therapy participants suffered psychological effects
  • named the “monster study” by Johnson’s peers
  • 6 of the orphaned students were awarded $925,000 by the state of Iowa in 2007
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2
Q

What are the 6 ASHA (1995) guidelines for Practice in stuttering treatment?

A
  1. Fluency Shaping Approach
  2. Vocal Control Treatment Approach
  3. Contingency Management
  4. Reduction of speech associated anxiety/excitement
  5. Training parents
  6. Prevention
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3
Q

In terms of ASHA guidelines, what do we tell parents when training them?

A

-speak more slowly, with normal intonation, timing, and stress

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4
Q

In terms of ASHA guidelines, what are some things done in the Vocal control treatment approach?

A
  • better vocal tone
  • breath support
  • full resonance
  • timing
  • stress
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5
Q

IN addition to stuttering modification & fluency shaping programs, what are some other stuttering treatment approaches?

A
  • Lidcombe Program (Preschoolers/school age)
  • Family-Centered, Indirect Treatment Approach for Preschoolers
  • Fluency Rules Program (preschool and early grade, grade-school children)
  • Comprehensive Stuttering Program for School Age Children
  • Comprehensive Stuttering Program for Adolescents and Adults
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6
Q

Who came up with the Lidcombe Program and when?

A

-Onslow, Packman, Harrison (2003)

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7
Q

What kind of program is the Lidcombe program and who was it targeted for?

A

-direct treatment Program initially for preschool children

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8
Q

What kind of approach is the Lidcombe program?

A

-direct operant conditioning approach

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9
Q

Where was the Lidcombe program developed?

A

Australia

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10
Q

What are the two components (stages) of the Lidcombe program?

A
  • Stage 1: Eliminate or Reduce Child’s stuttering to a very low level (clinical visits regularly each week)
  • Stage 2: Maintain the stuttering reduction for a long period (systematically increasing period of time between clinic visits)
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11
Q

What are the child actions that will elicit parent responses in the Lidcombe program?

A
  1. Stutter-free speech: parents acknowledge it, praises it
  2. unambiguous stuttering (clearly stuttering) parents acknowledge-ora ask child to self-correct the stuttered word
  3. Non essential parent responses:
    • self evaluation of stutter free speech
    • self correcting of stuttering
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12
Q

What are ways the parent encourages the child using verbal contingencies?

A
  1. Acknowledgement (“Those words were smooth”)
  2. Praise (“wow, good smooth talking”)
  3. Self-Evaluate (Was that smooth? or were there bumps there?”–then after, parents may acknowledge “that was a bump there” or…. –Request child to self-correct: (can you say ‘orange’ again?)

**Verbal contingencies are used intermittently to lessen invasiveness or overwhelm child

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13
Q

What is the therapy focus on in the Lidcombe program?

A

-focus is on child’s speech

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14
Q

What are the speech measures the clinician needs to do in the Lidcombe program?

A
  • prescribe treatment goals
  • assess child’s progress
  • determine effectiveness so treatment can be adjusted
  • determine when stuttering rate and severity are below program criteria @ near zero levels
  • prescribe targets for stage 2
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15
Q

In terms of ASHA guidelines, what are some things done in the Fluency Shaping Approach?

A
  • Slowed rate of Speech Movements
  • Easy onset of voicing; slow inhalation; soft but true voice to full voice before vowel initiation; practice in order to shorten time to take up by onset of voicing period
  • Blending or continuous voicing
  • light articulatory contacts
  • smooth, slow speech movements
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16
Q

What are the speech measures for the parent to do in the Lidcombe Program?

A
  • Severity Ratings
    * 10 point Scale Stuttering “2”, “2” is extremely severe stuttering
    * each day must obtain SR for entire day or 10 min. period of time
  • Stutterers per minute of speaking time (SMST)
    * optional measure
    * to calculate, parents listen to child’s conversation, measures # of unambiguous stutters in that period
    * SMST calculated by dividing # of stutters by duration of child’s speech
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17
Q

In terms of the Lidcombe Program, there are structured and structured treatment conversations the parent needs to do with the child. What happens in stages 1 & 2?

A

STAGE 2

  • Parent taught to engage child in structured treatment-toys that child prefers are used to ensure the child enjoys the experience to promote stutter free responses
  • contingent stimulation used carefully, not excessive
  • as severity ratings decrease, movement to unstructured treatment conversation is accomplished
  • *make it as positive as you can-use toys that are familiar with the child and that he/she enjoys

STAGE 2

  • move to stage 2 when stuttering ratings in clinic and outside clinic decrease to certain levels over 3 consecutive weeks
  • goal of Stage 2 is for parents to gradually withdraw treatment while child maintains same stutter-free speech
  • half hour clinic visits that gradually decrease in frequency dependent upon child meeting certain criteria
18
Q

What must occur with clinician and parent collaboration for the success of the Lidcombe Program?

A
  • treatment in stage 1 needs to occur everyday
  • clinician needs to insure parent is using contingencies for stutter-free speech appropriately as well as praise during structured treatment to create success for stutter-free speech during unstructured treatment
19
Q

What is the evidence-based support for the Lidcombe Program?

A

-clinical trials have been completed-supporting the “treatment is safe-in fact fun-and that the overwhelming majority of parents in such trials will comply with it and that the overwhelming majority of children in those trials will not stutter after they have had it”

20
Q

What evidence displays treatment for school aged children for the Lidcombe Program?

A

-studies have been done indicating that this program may also be viable to school-age children

21
Q

What does the family centered indirect treatment approach for Prechoolers focus on?

A

-focuses on “making changes to a child’s environment through parent training and clinician modeling without directly overtly identifying stuttering to the child and/or overtly attempting to change the child’s speech-language problem”

22
Q

What does the fluency rules program create?

A

creates an environment of fun

23
Q

Who created the fluency rules program and what are the years?

A

Runyan & Runyan

1993 & 1999

24
Q

Who are integral participants in the Lidcombe program and what do they learn to do?

A
  • parents are integral parts

- learn to conduct treatment & measure stuttering severity

25
Q

Who monitors the treatment of stuttering severity measures with the Lidcombe Program and when do they do it, what else may they do?

A

Clinicians

during clinic visits, as well as adjusting parents treatment based on data

26
Q

In terms of ASHA guidelines, what are some things we teach and work on when working on prevention?

A
  • training parents to talk less often, with simpler language
  • interrupt less often
  • ask fewer questions requiring long, complex answers
27
Q

In terms of ASHA guidelines, what are some things done in “contingency management”?

A
  • combined reinforcement of fluent speech
  • successive approximation (shaping) toward fluent speech
  • practice from easiest to more difficult speech situations in a hierarchy
  • use of fluency enhancement in clinic device
  • use of computer assisted devices
  • systematic reinforcement for natural sounding speech
28
Q

Fluency Rules Program:

For the rule “speak slowly (turtle speech)” what hand gesture/nonverbal cue goes with it?

A

move hand up and down; slow down

29
Q

Fluency Rules Program:

For the rule “Say a word only once” what hand gesture/nonverbal cue goes with it?

A

hold one finger up

30
Q

Fluency Rules Program:

For the rule “say it short)” what hand gesture/nonverbal cue goes with it?

A

hold thumb and forefinger together

31
Q

Fluency Rules Program:

For the rule “use speech breathing” what hand gesture/nonverbal cue goes with it?

A

breath curve in air with finger; snapping silently at moment of

32
Q

What ages are targeted for the fluency rules program?

A

-preschool and early grade children

33
Q

Fluency Rules Program:

For the rule “start Mr. Voice Box running smoothly” what hand gesture/nonverbal cue goes with it?

A

pull fingers apart with one hand elevated slightly like going up a gentle slope

34
Q

what does the fluency rules program utilize?

A

response contingent hand gestures when stuttering occurs

35
Q

What are the 3 sections of the fluency rules program?

A
  • universal rules (speak slowly, say a word only once) used with all clients
  • primary rules (use speech breathing, start “mr. voice box” running smoothly) for airflow
  • secondary rules used when concomitant behaviors are present
36
Q

Fluency Rules Program:

For the rule “touch ‘speech helpers’ together lightly” what hand gesture/nonverbal cue goes with it?

A

touch the thumb and forefinger together

37
Q

Fluency Rules Program:

For the rule “only use the speech helpers” what hand gesture/nonverbal cue goes with it?

A

no gesture

38
Q

Who was the Comprehensive Stuttering Program for School Age Children designed for and what did it integrate?

A

-comprehensive approach “designed for kids aged 7-12 years integrated program that addresses both overt and attitudinal emotional consequences of stuttering, delivered in a 4 week format”

39
Q

What are the components of the Comprehensive Stuttering Program for School Age Children?

A
  1. Fluency enhancing skills: tension modification; prolongation; easy breathing; gentle starts; smooth blending; light touches; self- correction; 3 T’s (think, take a break, talk)
  2. Attitude-Emotions: Feelings about stuttering, cause of stuttering, acceptance of stuttering, acceptance of fluency skills, openness, avoidance/coping skills, listeners who interrupt effective communication strategies; self perceptions and self talk; teasing and bullying
  3. Involves parent/family in therapy
40
Q

What are the procedures for the Comprehensive Stuttering Program for ADOLESCENTS AND ADULTS?

A
  • Fluency enhancing techniques to deal with core stuttering and learned struggle behaviors
  • cognitive-behavioral methods to deal with the emotional and attitudinal aspects of stuttering; client family relationships
  • ongoing data collection of behavioral and self report for therapy progress
41
Q

What are the techniques used in the Comprehensive Stuttering Program for ADOLESCENTS AND ADULTS?

A
  • prolongations
  • easy breathing
  • gentle starts
  • smooth blending
  • light touches
  • refining prosody/naturalness
  • slow, medium, light stretches
  • control rate
  • 3 T’s

Fall '13-123 (Exam 2) (7 decks)

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