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SPH512 Fluency > Ax of Stuttering > Flashcards

Ax of Stuttering Flashcards

1
Q

How is %SS measured?

Why measure it?

A

Use SMS program on computer. Helps to support perceptual SRS measures, useful for understanding research.

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2
Q

How is SPM measured?

Why measure it?

A

Use SMS program on computer. Helps to support perceptual SRS measures, useful for understanding research.

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3
Q

How do I measure the severity of a stuttering in a contextual speech sample?
Why do this?

A

Use Severity rating scale to give severity rating (SR)

  • Preschoolers 10 point (0-9)
  • Adult 9 point scale (0-8)

SRS are the most important rating of stuttering. Shared understanding of severity with other clinicians, client/parents. Can perceptually measure severity improvement across treatment.

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4
Q

Lidcombe Behavioural Data Language (Packman + Onslow, 1998)

Repeated Movements:

A
  • Syllable repetition
  • Incomplete Syllable repetition
  • Multisyllable repetition
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5
Q

Lidcombe Behavioural Data Language (Packman + Onslow, 1998)

Fixed Postures:

A
  • with audible airflow

* without audible airflow

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6
Q

Lidcombe Behavioural Data Language (Packman + Onslow, 1998)

Superfluous behaviours

A
  • Verbal

* Non-verbal

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7
Q

Lidcombe Behavioural Data Language (Packman + Onslow, 1998)

Superfluous behaviours

A
  • Verbal

* Non-verbal

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8
Q

Can increase stuttering:

A
  • Audience size/perceived friendliness etc
  • Status of conversational partner
  • Speaking situation
  • Fatigue (time of day..)
  • Anxiety
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9
Q

Can increase stuttering:

[Conditions that increase stuttering can be different for different people]

A
  • Audience size/perceived friendliness etc
  • Status of conversational partner
  • Speaking situation
  • Fatigue (time of day..)
  • Anxiety
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10
Q

Stuttering and its treatment: Eleven lectures.

A

Onslow (2021)

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11
Q

What kind of samples do you need to rate for a preschooler?

IN ADDITION:
–>Video of child at their worst, if parents have one, so we can report most severe stuttering child displays and rate it -> helps parents to calibrate to stuttering scale so they can rate child’s least severe stuttering.

A

2-3 REPRESENTATIVE samples

  • 1 in clinic (not so representative, may be a bit performative)
  • 2 outside of clinic - different contexts/speaking partners (usual for child) –> stuttering severity can be context dependant.
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12
Q

-Preschoolers 10 point (0-9)
-Adult 9 point scale (0-8)
of what?

A

Severity Rating Scale (SRS)

MUST rate all samples. Collect ratings from parents for each day. Then measure again in clinic.

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13
Q

Can %SS be high, but SRS be rated lower?

A

Yes - if a number of short stutters that are overcome quickly and don’t slow delivery of the message too much.
SPM can help show not too severe, as it will be higher on someone who is getting their message across.

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14
Q

2 things to focus on in stuttering assessment:

A
  • Speech (presenting condition, SRS, %SS, SPM)

* Impact of stuttering for the client

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15
Q

During Ax, how do I document the presenting condition?

A

*Connected speech samples [min ~10 min or 500 syllables - young children longer to get 500 syllables]

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16
Q

5-10 minutes or 500 syllables minimum for what?

A

Connected speech samples

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17
Q

Where to take connected speech samples?

ASK: is this representative of typical speech?
ASK: does stuttering get better/worse depending on time of the day?

A

Preschool, home, the car (if the child talks a lot in this context - consider background noise)
–> several situations/conversation partners usual for the child.
–> Different times of day (fatigue)
+
1 in clinic (prob. not representative)

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18
Q

How to get a representative sample in people with previous therapy, or who are used to being recorded (and may switch to performative mode)?

A

Covert recording (GET PERMISSION) need a 3rd person to set up.

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19
Q

How to calibrate SRS score:

A

*with
other professionals
*Self-reliability - rate recorded sample. Leave a gap. do it again. Are you reliable +/-1 with yourself?

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20
Q

Describe stuttering using Lidcombe Behavioural Data Language (Packman + Onslow, 1998)

A

*Overview descriptor (ie mild-moderate)
*Features in sample (ie fixed postures with audible airflows, 3 repetitions in 10 min sample)
Why: people reading file have a ‘picture’ of client’s stuttering.

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21
Q

Describe stuttering using Lidcombe Behavioural Data Language (Packman + Onslow, 1998)

A

*Overview descriptor (ie mild-moderate)
*Features in sample (ie fixed postures with audible airflows, 3 repetitions in 10 min sample, superfluous behaviour of lip pumping, prior to fixed postures [say what the superfluous behaviour is, as they are idiosyncratic.)
Why: people reading file have a ‘picture’ of client’s stuttering.

22
Q

Nearly all Ax for stuttering is non-standardised, with the exception of QoL and social anxiety. True or false?

A

True.

23
Q

median 7 sessions, ~17hrs, then 1 year maintenance…

A

The Lidcombe Program (Onslow, Packman, + Harrison, 2003)

–> prior to 6 yrs old.

24
Q

X syllables, of which Y are stuttered…

A

%SS

25
Q
  • BL = Baseline
  • $ = stutters
  • ◊ = cumulative speaking time of client
  • BC = beyond clinic –> speech sample taken somewhere other than clinic (should be in an environment typical for the client, with a typical conversation partner).
  • WC = within clinic
  • %SS = percent of syllables stuttered. For every 100 syllables, that many were stuttered.
  • SPM = syllables per minute. Syllables spoken/time
A

Some measures taken during initial Ax

26
Q

In one study that rated %SS of preschool children stuttering, the midpoint was?

A

Mid-point was 3.2 %SS

27
Q

What would be a diagnostic statement for a child with 23-24%SS?

A

extremely severe stuttering

28
Q

What would be a diagnostic statement for a child with 23-24%SS?

A

extremely severe stuttering

one of most severe cases Linda has ever seen in a preschooler

29
Q

Must go into a report for parents

needed in our report for Ryan

A
  1. Label (diagnosis of stuttering) level: mild-moderate
  2. Interpretation of data available
  3. Prognosis (with/without treatment)
  4. Justification for recommendation.
30
Q

OMA is not needed for an assessment purely for fluency. (structure and cranial nerves are not thought to have anything to do with fluency). True or false?

A

True

31
Q

Something we must avoid, if a child doesn’t stutter during assessment?

A

AVOID FALSE NEGATIVE - the parents brought their child in because they thought the child was stuttering. Child needs to be put on a monitoring program if no evidence of stuttering can be found (could be in a ‘good cycle’ of variablility BUT check samples are representative and sufficient.

32
Q

In general, how long would a child be put on a monitoring program before being discharged?

A

12 months

33
Q

Psychological impacts of stuttering on a child can begin as early as 3 years old. True or False?

A

True (REF)

34
Q

Case History questions:

–>Excluding the questions about speech samples and current stuttering.

A
  • Onset: (when? Sudden/gradual? Over what time period?)
  • Variability: (More/less severe over time - “Good” periods of no/little stuttering increasing/decreasing? How frequent are the cycles?)
  • Family Hx (stuttering? Natural recovery or not? - could be wrong)
  • Trigger/factors associated with onset?
  • Indications of social anxiety: (avoidance? shyness?)
  • Speech/language Hx: (developmental? Problems?)
  • Child’s Awareness of their stuttering.
35
Q

Case History Questions:

About the stuttering sample and current stuttering.

A
  • Validity (representativeness) of samples: (child’s normal speech, severity of stuttering?)
  • Contextual variability: (worse/better in certain situations/times of day/topics/conversation partners?)
  • Over the samples taken, which is most representative of client’s stuttering severity? (Are they every more/less severe?)
  • What situations does client speak in? Who are their typical conversation partners?
  • ASK: things that will impact upon treatment decisions: (moving house? starting school? Time availability? Goals with treatment?)
  • Interactions at school/sports etc (bullying? Exclusion?)
36
Q

In addition to typical case history questions and questions about sample representativeness and stuttering variability across contexts, what else do you need to do with a client/patient re: the speech samples?

A

Explain the severity rating score (Paediatric 0-9) and get parent consensus.

37
Q

Case Hx questions for older children/adults:

A
  • Impact: On socialisation, career.
  • What are your goals? (councel if they want it gone - they can learn to control it)
  • Contextual factors influencing stuttering: (time of day, conversation partners etc)
  • Impact on ICF activity and participation.
  • Gather lots of information to make recommendation for treatment.
38
Q

When should you ask about medical history or demographic information?

A

Intake form.

Medical Hx only usally relevant in the case of possible neurological causes, or some medications linked to stuttering.

39
Q

What are the 3 main aims of stuttering assessment?

A
  1. Determine whether stuttering is present, and if so, to describe and document it.
  2. Understand and document the impact that stuttering is having on the client’s activity and participation.
  3. Gather other information that will influence recommendations about treatment options, goals of treatment, and treatment processes (and timing).
40
Q

OASES (Yaruss + Quesal, 2010)

A 
Formal tool to assess overall impact of stuttering.  Based on ICF.
7-12 yrs
13-17 yrs
18+ yrs
- several languages
41
Q

A helpful tool for screening adults who stutter for social anxiety:
-self-report. excellent validity and reliability (Iverach et al., 2011)

A

Unhelpful thoughts and beliefs about stuttering scale (UTBAS I, II, III for adults) (Iverach et al., 2011)
INCLUDES:
UTBAS I - Ax of frequency of unhelpful thoughts and beliefs about stuttering
UTBAS II - Ax of extent to which an individual believes these thoughts
UTBAS III - Ax of how anxious these thoughts make an individual feel

42
Q

A helpful tool for screening adolescents who stutter for social anxiety (Iverach et al., 2011):
-self-report.

A

Unhelpful thoughts and beliefs about stuttering scale (UTBAS I, II, III for adolescents)

43
Q

The Lidcombe Program (Onslow, Packman, + Harrison, 2003)

A

median 7 sessions, ~17hrs, then 1 year maintenance…

44
Q

There is currently no credible research to justify asking a bilingual child to become monolingual. True or false?

A

True.

Shenker, 2011 p. 191

45
Q

Detailed language history: a) first exposure to each language b)course of language acquisition for each c) speech/language concerns d) contextual use of each language

  • -> SRS for each language by parents, confirmed by SLP observation.
  • ->Interpreter (linguistic/cultural aspects of language) can help confirm child-language proficiency across contexts.
A

Include in Case History interview for Bilingual/Multilingual children

46
Q

In addition to case history interview, what other kind of interview is helpful in assessing bilingual children who stutter?

A

Ethnographic Interview: Beliefs, hopes and concerns (re: stuttering, re: treatment)
*Role of family in treatment: including family members in treatment, esp. Lidcombe Program (Onslow, Packman + Harrison, 2003)

47
Q

Possibilities for stuttering treatment for a bi/multilingual child, where the SLP doesn’t share any of the family’s languages:

A

a) liaise
with the parent to identify another person who shares
a language with the clinician and who could become
the primary agent of therapy; b) use the services of an
interpreter; or c) refer the child and parent to a clinician who
speaks at least one of the parent’s languages.

48
Q

Stuttering treatment in one language will often generalise to the other, and the clinician may monitor the language they don’t speak, and treat in the one they do.

A

True

Vong, Wilson + Lincoln, 2011. p 139

–> Good idea for the caregiver to be trained, and collect severity ratings in all languages.

49
Q

The Preschool Anxiety Scale (PAS)

A

Spence + Rapee, 1999

50
Q

The Spence Children’s Anxiety Scale (SCAS)

A

Spence, 1994

SPH512 Fluency (4 decks)

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