Assessment of Fluency Disorders Flashcards
Detail the 5 steps of the assessment process (for the clinician)
- Gathering data from the client
- Getting to know the client as an individual
- Showing an understanding of the client’s point of view
- Demonstrating an understanding of stuttering
- Getting to know, or a sense of, key family members
What are some cultural considerations in stuttering assessments?
- develop a multi-cultural perspective on assessment and treatment
- be aware of and sensitive to differences in communicative style in other cultures
- how do other cultures view speech and language disorders?
- use of eye contact may be inappropriate
- praise - develop special signal between parents and child to reinforces fluent speech
- slowing speaking rate in some cultures is unnatural and difficult to sustain -> operant conditioning approach may be more appropriate
- bilingualism - need to identify stuttering vs. limited proficiency in 2nd language
What is known about stuttering and bilingualism?
- increased risk of stuttering in bilingual individuals
- need to observe if secondary behaviours, cognitive and emotional responses to stuttering etc. are present
- stuttering is more likely to occur in both languages for a bilingual PWS
- may be more severe in one language but need to analyse stuttering in both languages (for treatment plan)
- interpreter, family members, PWS - provide you with information regarding the stuttering in their native language
What must be identified in the assessment of stuttering behaviours?
- frequency
- type
- duration
- secondary behaviours
- severity
- fluency technique/speech naturalness
- speech rate
How do you assess frequency of stuttering behaviours?
- %SS (number of disfluent syllables/total number of syllables x 100)
- highly correlated with severity -> BUT does not reflect duration or physical tension associated with the stutter
How do you assess duration of stuttering behaviours?
- measure duration of longest block
- use as part of a complete assessment of severity in the SSI-4
How do you assess secondary behaviours in stuttering?
- escape behaviours may be used to break out of the stutter once it has started
- may also be avoidance behaviours to prevent the stutter
- eye blinking, extra sounds, pitch rise
- indicates stutter has progressed into a more advanced stage
What information does a severity rating provide?
- most clinically relevant assessment
- reflects overall impression that listeners may have of a PWS
- important measure of assessing treatment outcomes
- measure of progress during therapy
What is the Stuttering Severity Instrument 4th Edition (SSI-4)? Also provide some information about this assessment.
- most commonly used and reliable measure of stuttering severity
- analyse within and beyond clinic samples
- quantifies stuttering an evaluates effectiveness of therapy
- ages 2;10 - adults
- testing time: 15-20 minutes
- has normative data
What is involved in the SSI-4?
Speaking samples are evaluated according to specific criteria:
- frequency: %SS in normal speech
- duration: average length of three longest stuttering events within clinic and beyond clinic samples
- physical concomitants: distracting sounds, facial grimaces, head movements, arm and leg movements
- naturalness of speech
Why use a severity rating scale?
- common language between SP and client
- simple to use
- no equipment
- portable
- non-intrusive
- clients can self-report
What are the a) evidence and b) limitations of severity rating scales?
a)
- perceptive measure vs. objective
- valid
- reliable
- limited training
- correlates well with %SS
b)
- does not account for: stutter type, word avoidance, situation avoidance, anxiety
List 4 questions to ask (as a client) when doing daily Camperdown severity rating scales.
- Was there any stuttering?
- Would it have been heard by a casual observer?
- How does it interfere with communication?
- Was it mild, moderate or severe?
The Camperdown Program also uses a Fluency Technique Scale in conjunction with the SR scale: define what each number on this scale represents.
0 = natural sounding speech with no fluency technique used
1 = natural sounding speech with minimal fluency techniques used to control stuttering, probably not obvious to any listener
2 = natural sounding speech with some fluency technique being used to control stuttering, probably obvious to a familiar listener
3 = fluency techniques will be obvious enough to be noticed by an unfamiliar listener, such as a shop assistant
4-5 = useful level for clients to practise the fluency technique in the clinic environment
6-8 = exaggerated fluency technique, similar to the training model. Typically eliminates all stuttering, and is useful for practising fluency technique. It is unlikely that the client would be comfortable using this in everyday situations.
What is the Australian adult speaking rate?
180-240 SPM
