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Fluency > Assessment > Flashcards

Assessment Flashcards

1
Q

Factors to Consider when assessing

A
  • client’s needs/ clinician expertise
  • genetic/constitutional
  • developmental
  • speech & language
  • home environment
  • stuttering behaviour
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2
Q

Client Needs

A
  • Genuine interest/empathy from clinician
  • acceptance as a whole person
  • celebrate tx victories
  • recieve understanding in backslides
  • assisted in accepting self
  • **heard w/ respect to assessment and treatment goals
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3
Q

Procedure

A
  • preassessment info
  • parent-child observations
  • clinician-child observation
  • case history/interview
  • counselling
  • speech tasks
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4
Q

Preassessment info

A 
Initial contact
Questionnaires
Case History Forms
Referral Letter
Teacher Information
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5
Q

Parent-Child Observation

A
  • Frequency/types of disfluencies
  • struggle and secondary behaviour
  • situational variability/consistency
  • phonetic variability/consistency
  • parents’ speech (rate, disfluencies)
  • verbal/non-verbal interactions
  • personalities of child and parent (ask about development)
  • other speech-lang variables
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6
Q

Clinician-child observation

A
  • Changes in speech fluency, interaction style, etc?
  • High pressure conditions (time pressure, questions, interruptions)
  • Low pressure conditions
  • Child’s awareness
  • can child talk about stuttering?
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7
Q

Case History

A

Typical one but with:

  • parent description of child’s problem
  • family history of speech/lang/stuttering
  • onset
  • who first notices?
  • changes in speech patterns over time
  • child’s awareness
  • struggle, escape, or avoidance behaviours?
  • situation or sound specific
  • parents reactions
  • **Previous/current therapy
  • previous advice
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8
Q

Other Components

A 
OME
speech/lang tests
artic
language screen
hearing screen
consult w/ other professionals
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9
Q

Ax of Speech Rate

A
  • Count syllables PER MINUTE
  • Only syllables client would have said if no stuttering was present
  • Only meaningful speech units (e.g. not interjections)
  • exclude long pauses (>2 sec) unless silent blocks
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10
Q

Ax Instruments

A

Dx:

  • Stuttering Severity Instrument - 4th Edition (SSI4)
  • Stuttering Prediction Instrument

Attitudes:

  • Children’s Attitude Test (CAT)
  • S-24
  • Locus of Control Behaviour (LOCB)
  • Perceptions of Stuttering Inventory (PSI)
  • Speech Situation Checklist (SSC)
  • Overall Assessment of Speaker’s Experience of Stuttering (OASES)- assesses how stuttering affects person’s daily life
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11
Q

Interview: Behavioural

A
  • How does client describe speech problem?
  • What secondary behaviours used? (Avoidance, Escape)
  • How aware is client of secondary behaviours?
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12
Q

Interview: Developmental

A 
When did it start?
Who noticed?
Changes over time?
Easy vs. hard situations?
How do you cope when difficult?
Easy vs hard sounds/words, why?
How does client cope?
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13
Q

Interview: Psychological-Social

A

Can client anticipate stuttering?
What does client do when anticipating?
What effect on school, friends, work, social etc.
How do others react?

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14
Q

Interview: Neurological

A

Family history of stuttering?
Other speech, language, motor or health concerns?
Drug use (affects dopamine)

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15
Q

Interview: Previous Treatment

A

Received tx?
Type, techniques, why was it terminated, seeking ax now?
Seeing other health professionals?

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16
Q

Speech Tasks

A

Reading Task
-single words, sentences of ^ length, paragraph, adaptation (does it occur?)

Monologue (more fluent) vs. Convo
-300 syllables each

Automatic speech
-Count 1-20, days of week

17
Q

Fluency Enhancing Techniques

A
  • Altered auditory feedback during reading (doesn’t work for psychogenic)
  • Masking
  • *Slowed speech (word level, sentence level)
  • Choral reading
18
Q

Counseling

A
  • 1st impression of ax results
  • stuttering or not
  • need for therapy?
  • format of therapy (parent’s role, practical arrangements, homework)
  • questions/concerns
  • referrals
19
Q

Developmental Levels of Stuttering (Guitar)

A 
Normal disfluency
Borderline stuttering
Beginning stuttering
Intermediate stuttering
Advanced stuttering
20
Q

Normal Disfluency

A

Core Behaviours

  • 10 or FEWER disfluencies/100 words
  • Single unit repetitions
  • Repetitions, interjections, revisions

Secondary Behaviours
-NONE

Feelings/Attitudes
-Child not aware/concerned

Hypothesis
-Stresses of speech, lang and devt

21
Q

Borderline Stuttering

A

Core Behaviours

  • 11 or MORE disfluencies/100 words
  • More than two units in repetitions
  • More repetitions & prolongations than interjections & revisions

Secondary Behaviours
-NONE

Feelings/Attitudes

  • Child generally not aware
  • Sometimes surprised or mildly frustrated

Hypothesis
-Genetic predisposition interacting w/ stresses of speech, lang & devt

22
Q

Beginning Stuttering

A

Core Behaviours
-Rapid, irregular & tense repetitions may have fixed artic posture in blocks

Secondary Behaviours
-Escape behaviours (e.g. eye blinks, increases in pitch/loud)

Feelings/Attitudes

  • Child generally aware
  • frustrated

Hypothesis
-Conditioned emotional reactions cause excess tension & conditioning of escape behaviours

23
Q

Intermediate Stuttering

A

Core Behaviours
-Blocks where sound/airflow cut off

Secondary Behaviours
-Escape and avoidance behaviours

Feelings/Attitudes
-Fear, frustration, anger, shame

Hypothesis
-Those from borderline & beginning stuttering plus AVOIDANCE CONDITIONING

24
Q

Advanced Stuttering

A

Core Behaviours
-Long tense blocks including tremor

Secondary Behaviours
-Escape and avoidance

Feelings/Attitudes
-Fear, frustration, anger, shame, negative self-concept

Hypothesis
-Those from earlier stages plus cognitive learning

25
Q

Assessing Duration

A
  • Average duration of 3 longest stutters

- Use stopwatch then calculate w/ SSI-4

26
Q

Assessing Secondary Behaviours

Escape VS Avoidance

A

Escape - after stuttering has started. Attempt to stop stutter and say word (e.g. head nod, eye blink)

Avoidance - occur before stutter has begun. Attempts to keep from stuttering. (e.g. saying extra sound, changing word)

27
Q

Assessing Severity

A
  • Captures what listeners hear
  • Measures progress in tx
  • SSI-4 (Stuttering Severity Instrument)
28
Q

SSI-4

A

Stuttering Severity Instrument
=Frequency = %SS
Duration = average 3 longest stutters (to 1/10th a second)
Secondary bevrs = ratings of 4 physical concomitants (distracting sounds, facial grimace, head movements, movements of extremities)
*Scores added

29
Q

Scale for Rating Severity of Stuttering

A

More subjective than SSI-4

-used to get overall clinical impression of client

30
Q

Severity Rating Scale for Parents of Preschoolers

A
  • Parents mark ‘X’ in box each day
  • Weekly charts used to assess progress
  • Evidence for reliability

Fluency (10 decks)

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