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Clinical Methods > 3.01 - Treatment for Fluency Disorders > Flashcards

3.01 - Treatment for Fluency Disorders Flashcards

1
Q

What are the four fluency disorders?

A

Stuttering

Cluttering

Neurogenic Stuttering

Psychogenic Stuttering

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2
Q

What four things does fluent speech contain?

A

Rate

Continuity

Rhythm

Effort

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3
Q

Over ________ Americans stutter.

A

3 Million

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4
Q

The male to female ratio for stuttering is __:__.

A

4:1

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5
Q

What is the cause of stuttering?

2

A

Unknown

Neuro-motor basis seems influenced by genetic & environmental factors

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6
Q

What are the three core behaviors of stuttering?

A

Repetitions

Prolongations

Blocks

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7
Q

What are secondary behaviors to stuttering?

A

Those that develop as a reaction to the core stuttering behavior

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8
Q

What are the two categories of secondary behaviors to stuttering?

A

Escape

Avoidance

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9
Q

What are escape behaviors to stuttering?

3

A

Head nods

Blinks

Jaw tremors

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10
Q

What are avoidance behaviors to stuttering?

3

A

Substitutions

Tension

Pauses

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11
Q

What is another important element to stuttering therapy?

A

The client’s attitudes and emotions towards stuttering

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12
Q

Stuttering is a ______ speech disorder wherein there are _____ or _____ speech/language networks in the brain.

A

Neural Motor

Slow developing

Inefficient

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13
Q

Some children persist in stuttering because of what two things?

A

Factors within the child

Factors within the environment

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14
Q

What factors within the child can contribute to stuttering?

4

A

Family history

Sensitive temperment

Male gender

Presence of other speech/language disorders

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15
Q

What factors within the child’s environment can contribute to stuttering?

(4)

A

Rapid-fire, high-pressure, high-level conversation

Impatience or anxiety about the child’s stuttering

“Traumatic” events in the child’s life

High expectations

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16
Q

What are normal nonfluencies?

A

Effortless disfluencies associated with linguistic developement

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17
Q

What are normal nonfluencies experienced by many children between 2-8 years?

(5)

A

Phrase repetitions

Interjections (um)

Revisions

Normal rhythm and stress is maintained

No tension or tremors

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18
Q

What three things may signal an “abnormal” disfluency in young children?

A

Frequent (More than 10%)

Occurs in several situations

Occurs over longer periods of time

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19
Q

Dysfluencies primarily occur on ______.

A

The first sound/syllable

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20
Q

What types of disfluencies tend to not be normal?

4

A

Repetitions of sounds or syllables

Repetitions of short words

Prolongations

Blocks

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21
Q

When dealing with preschool stuttering, we need to distinguish between ____________.

A

Normal nonfluencies and stuttering

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22
Q

When dealing with preschool stuttering, it is important to address _________.

A

Parental concern

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23
Q

What four things can parents of stuttering preschoolers do?

A

Give the child more time to talk (1 second pause)

Talk more slowly

Use shorter, simpler sentences and ask fewer questions

Don’t correct or tell the child to slow down (adds pressure)

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24
Q

What two things does direct intervention for stuttering preschoolers contain?

A

Exploring speech and stuttering

Helping a child to modify speech

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25
Q

When working with older children and adults who stutter, what is the focus not on? What is it on?

A

Not on whether or not the person is stuttering

On what they can do when they are disfluent to become more fluent

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26
Q

When working with older children and adults who stutter, what two types of assessment do we do?

(2)

A

Measure core stuttering behaviors, secondary behaviors, and attitudes/emotions

Dynamic assessment to identify strategies to help them be more fluent

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27
Q

When working with older children and adults who stutter, what sorts of treatment can we offer?

(4)

A

Using fluency shaping techniques to establish fluent speech

Stuttering modification techniques to help in moments of stuttering

Helping to generalize skills to spontaneous speech

Helping the client carryover skills to environment outside the clinic

28
Q

How do we measure the frequency & type of disfluency?

2

A

Count each disfluency one time (1 pt per word)

Divide the number of disfluencies by the total number of syllables

29
Q

When might we measure the length of a stutter?

A

In severe stuttering moments

30
Q

Are there scales to measure each type of disfluency: repetitions, prolongations, & blocks?

A

Yes

31
Q

Are there scales to measure attitudes and emotions?

A

Yes

32
Q

Should we assess situations & explore techniques that can increase or decrease fluency?

A

Yes

33
Q

What is fluency shaping?

3

A

Goal is to increase fluent speech

You teach the client techniques to produce fluent speech

You gradually shape the techniques to sound as normal as possible

34
Q

What is stuttering modification?

3

A

Goal is to teach the client to stutter more easily

You help the client identify what to do when they stutter

You teach strategies to modify speech during stuttering moments

35
Q

Do you have to chose a fluency shaping or a stuttering modification technique?

A

No. You can combine them

36
Q

What are six Fluency Shaping/Enhancing techniques?

A

Easy onsets

Decrease speaking rate

Light articulatory contact

Continuous phonation

Change the overall speech pattern

Delayed auditory feedback

37
Q

What are the two treatment techniques for stuttering?

A

Modifying stuttering making episodes acceptable

Focusing on the moment of stuttering

38
Q

What are the six ways we can focus on the moment of stuttering?

A

Identification

Desensitization

Relaxation

Pull-Outs/In-Block Corrections

Post-Block Corrections

Preparatory Sets (rehearse fluent speech)

39
Q

Who came up with the Techniques to Treating the Entire Disorder (Stuttering)?

A

J. Scott Yaruss, Ph.D.

40
Q

What are the main points of the Techniques to Treating the Entire Disorder (Stuttering)?

(5)

A

Addressing Impairment: Improving Fluency

Addressing Impairment in Body Function: Techniques to Modify Stuttering Behaviors

Reducing Physical Tension

Easy Stuttering - Voluntary Behaviors

Addressing the Rest of the Disorder

41
Q

How do we address the impairment and improve fluency?

A

Focus on changing timing or tension

Learning guidelines to reduce speaking rate

Changing timing through pausing

Changing timing through pacing

Changing tension through light contact

Changing timing & tension through easy starts

42
Q

How do you focus on changing timing? (stuttering)

3

A

Reducing rate & pace

Pausing & phrasing

Easy starts

43
Q

How do you focus on changing tension? (stuttering)

4

A

Light contact

Easy starts/easing in

Pulling/easing out

Cancelation

44
Q

How do you learn guidelines for reducing speaking rates? (stuttering)

(4)

A

Practice learning the slow rate before you try it for real

Use natural intonation and rhythm

Do not use choppy/robot speech or stretch out all the words

Slower, natural rates can be incorporated into all activities

45
Q

How can you change timing through pausing? (stuttering)

3

A

Increase the length of time between words and phrases

Put pauses in natural locations

Pauses should not be too long (uncomfortable silence)

46
Q

How can you changing timing through pacing? (stuttering)

2

A

Manage the pace

Goal is effective and successful speech

47
Q

How can you change tension through light contact? (stuttering)

(2)

A

Try to reduce physical tension as articulators touch

Practice

48
Q

More tension means more ______.

A

Stuttering

49
Q

How can you change timing & tension through easy starts?

2

A

Reduce the pace and physical tension at the beginning of phrases

Use when the individual knows they are about to stutter

50
Q

How can you address impairment in body function: techniques to modify stuttering behaviors?

(2)

A

Explore stuttering

Learn what they are doing when they stutter

51
Q

How do you explore stuttering?

5

A

Learn about the speech mechanism

Learn how articulators move during stuttered and fluent speech

Stay in the block to learn how to move articulators to change stuttering

Develop self-monitoring skills & desensitize stuttering

Pretend to stutter (pseudostuttering)

52
Q

How can you reduce physical tension? (stuttering)

3

A

Tension & struggle are normal reactions

Physical tension during stuttering is a learned reaction

Reduce tension during pseudostuttering (cancellation, pull outs) and practice with real stutters

53
Q

What is easy stuttering: voluntary behaviors?

2

A

Learning that the way you stutter can change

Reduces the tendency to hide stuttering

54
Q

How can you change the way you stutter?

A

Bouncing

Gliding

Stretching

55
Q

Why is hiding stuttering bad?

A

The more it is hidden, the more likely it is to occur

Comfort with stuttering releases muscular tension and prevents bigger blocks

56
Q

What is addressing the rest of the disorder? (stuttering)

A

Techniques for addressing the individual’s ABC reactions

57
Q

What are the ABC reactions to stuttering?

A

Affective

Behavioral

Cognitive

58
Q

What are the Affective reactions to stuttering?

A

The experience of embarrassment, shame, isolation, fear, and/or anxiety about speaking

59
Q

What are the Behavioral reactions to stuttering?

2

A

Physical tension and struggles when speaking

Avoiding speaking situations

60
Q

What are Cognitive reactions to stuttering?

A

Evaluating oneself negatively as a communicator due to stuttering

61
Q

How do you address stuttering reactions directly?

3

A

Explore stuttering to learn more about stuttering and to reduce anxiety

Easy stuttering teaches that they have control of the speech musculature

Easing out helps to reduce behavioral reactions

62
Q

What do we do when dealing with affective reactions to stuttering?

(5)

A

Talk about the stuttering in a safe environment

Provide a vocabulary & analogies

Be open and honest

Express emotions

Reduce shame

63
Q

What do we do when dealing with behavioral reactions to stuttering?

(2)

A

Use techniques to unlearn physical tension, struggle, & avoidance

Reduce the underlying causes of these reactions (emotions, lack of understanding, etc.)

64
Q

What do we do when dealing with cognitive reactions to stuttering?

(4)

A

Understanding (learn about stuttering)

Perception (disfluencies are a normal part of speech)

Tolerance (it’s ok to stutter)

Support (meet other stutterers)

65
Q

What are the four general treatment guidelines for stuttering?

A

Systematically increase the difficulty of the linguistic task and environment

Work towards increasing the naturalness of the speaking task

Move the client towards self-monitoring

Support groups can help deal with negative attitudes and emotions

Clinical Methods (11 decks)

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