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Fluency > Chapter 8 > Flashcards

Chapter 8 Flashcards

1
Q

Diagnostic

–Requires at least a 4-stage assessment of
A) ______
B) ______
C) ______
–perceived “loss of control” will be conducted

A

–Requires at least a 4-stage assessment of
A) affective- attitudes, feelings emotions about stuttering,
B) behavior - speech behavior,
C) cognitive - cognitions, thinking, beliefs about stuttering, and
–perceived “loss of control” will be conducted

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2
Q

Diagnosis

  • Defined:
  • Differential Diagnosis
A
  • Defined: “the identification of a specific condition usually not apparent at the beginning” (p. 199)
  • Differential Diagnosis - discerning the nature of a disorder as different from other possible clinical entities
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3
Q

Differential Diagnosis – Examples

  • Stuttering vs. __ ___
  • __ Stuttering vs. ___ Stuttering
  • Stuttering that will ___ vs. Stuttering that will ___
  • Stuttering vs. ____
  • Stuttering (Developmental) vs. ____ Stuttering
A

Differential Diagnosis – Examples

  • Stuttering vs. Normal Disfluencies
  • Early Stuttering vs. Advanced Stuttering
  • Stuttering that will Recover vs. Stuttering that will Persist
  • Stuttering vs. Cluttering
  • Stuttering (Developmental) vs. Neurogenic Stuttering
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4
Q

Assessment Objectives

  • Establish ___
  • Obtain ___/____
  • Describe __ ___
  • Consider __ ___ ___environments
  • Note __ ___ ___
  • Understand the ____ on the client’s life
  • Provide info. about ___ and ____
  • Recommend a __ __ ___
A
  • Establish rapport
  • Obtain background/case history
  • Describe speech characteristics
  • Consider home/social/work environments
  • Note conditions affecting speech
  • Understand the impact on the client’s life
  • Provide info. about stuttering and therapy
  • Recommend a plan of action
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5
Q

Case History Areas

  • Stuttering ____
  • ___History
  • ___ ___Description
  • ___ Variables Affecting Speech
  • Impact of Stuttering on ____
  • Other Relevant __ ___
  • ____ Perspective
  • _____ Information

all happens before you hear their speech- hear their story and their perceptions

A
  • Stuttering (including family) History
  • Treatment History (results of previous treatment)
  • Current Speech Description
  • Environmental Variables Affecting Speech (hardest/easiest thing)
  • Impact of Stuttering on Quality of Life (social life)
  • Other Relevant Case History (medications)
  • Client’s Perspective (feeling and mood and their effects)
  • Identifying Information (who referred and technical info)
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6
Q

Interviewing School-Age Children

  • What ___ in school?
  • Which ____ liked most? Least?
  • _____activities? Skills/Hobbies?
  • What do you like to do best? Why?
  • Tell me about things you do ___
  • Like ____? When/Where/How much?
  • ___ response? Teachers’ response?
A
  • What grade in school?
  • Which subjects liked most? Least?
  • After-school activities? Skills/Hobbies?
  • What do you like to do best? Why?
  • Tell me about things you do well.
  • Like talking? When/Where/How much?
  • Peers’ response? Teachers’ response?
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7
Q

Interviewing Parents

  • Does stuttering affect the child in ___?
  • Is it the same at __ and at ___?
  • Describe the child’s __- ___.
  • Besides speech, any other trouble areas?
  • Is ___ or ___affected?
  • Any other ____ on the family?
  • Is speech____ to your child?
A
  • Does stuttering affect the child in school?
  • Is it the same at school and at home?
  • Describe the child’s typical day.
  • Besides speech, any other trouble areas?
  • Is playing or socializing affected?
  • Any other impact on the family?
  • Is speech important to your child?
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8
Q

Speech Analysis Decisions

-After sample collection, determine:
1.__ _ ___:
~Examples: ___ types? Stuttering ___? Fluent ___?
2. __ __ __ ___:
~Examples: Syllables? Words? Time intervals?

A

-After sample collection, determine:
1. behaviors of interest:
~Examples: Disfluency types? Stuttering events? Fluent words?
2. units to be analyzed:
~Examples: Syllables? Words? Time intervals?

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9
Q

Metrics of stuttering / disfluency counts

  • Percent of __ ___
  • Percent of ___ ___
  • Number of ____ or ____
  • ____ Units
A

-Percent of words stuttered
-Percent of syllables stuttered
-Number of disfluencies per 100 words
or per 100 syllables
-Repetition Units

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10
Q

Also important to measure…

  • ____ concomitants
  • __ ___
    1. overall __ ___ (words spoken/talking time) X 60
    2. __ ___ (per second)
  • Communication skills in general
  • other ____ conditions
A
  • physical concomitants
  • speaking rate
    1. overall speech rate (words spoken/talking time) X 60
    2. Articulatory rate (per second)
  • Communication skills in general
  • other speaking conditions
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11
Q

Analyzing the Speech Sample

  • SSI-4: __ __ __– Fourth Edition is a reliable and valid norm-referenced stuttering assessment that can be used for both ____.
  • It measures stuttering ___ in both __ & __ in the four areas of speech behavior:
    (1) ___,
    (2) ____,
    (3) ___ ___, and
    (4) ____of the individual’s speech
A
  • SSI-4: Stuttering Severity Instrument – Fourth Edition is a reliable and valid norm-referenced stuttering assessment that can be used for both clinical and search purposes.
  • It measures stuttering severity in both children and adults in the four areas of speech behavior:
    (1) frequency,
    (2) duration,
    (3) physical concomitants, and
    (4) naturalness of the individual’s speech
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12
Q

Analyzing the Speech Sample

__ ___of the 3 longest stuttering behaviors

A

Mean Duration of the 3 longest stuttering behaviors

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13
Q

Analyzing the Speech Sample

  • For instance, the client says
    1. buh-buh-buh-aseball with tension.
  • This would be evaluated as a ___ (part-word) and ____ (tense pause).
    1. The coding procedure consists of ____ the word(s) where the disfluency occurred, and then placing the letters from the __ __ above the word in a transcript. In this case, it is a cluster.
A
  • For instance, the client says
    1. buh-buh-buh-aseball with tension.
  • This would be evaluated as a sound syllable repetition (part-word) and block (tense pause).
    1. The coding procedure consists of underlining the word(s) where the disfluency occurred, and then placing the letters from the disfluency categories above the word in a transcript. In this case, it is a cluster.
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14
Q

Analyzing the Speech Sample

  • In this example the letters Rss and B would be placed above the word “baseball” in the transcription.
  • CL [Rss(2) + B]
  • This is a baseball. It is really easy to throw.
    1. This means that two types of disfluencies (This would be evaluated as a sound syllable repetition (part-word) and block (tense pause) occurred on that one word. You would record this as a cluster.
A
  • In this example the letters Rss and B would be placed above the word “baseball” in the transcription.
  • CL [Rss(2) + B]
  • This is a baseball. It is really easy to throw.
    1. This means that two types of disfluencies (This would be evaluated as a sound syllable repetition (part-word) and block (tense pause) occurred on that one word. You would record this as a cluster.
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15
Q

Stuttering Severity

  • “the level of ___ in the delivery of __ ___”
  • ___ may not correspond to the __ or ___ of the disorder
  • Stuttering can be ___, but cause minimal ___ or __ __
  • tuttering can be mild, but cause deep concern and negative social impact
A
  • “the level of disruption in the delivery of continuous speech” (p.219)
  • Severity may not correspond to the impact or experience of the disorder
  • Stuttering can be severe, but cause minimal concern or social impact
  • Stuttering can be mild, but cause deep concern and negative social impact
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16
Q

Severity rating Scale (Wingate, 1976)

Very mild = 
mild= 
moderate= 
severe= 
very severe=
A 
Very mild = 3%
mild= 5%
moderate= 10% 
severe= 20%
very severe= 25%
17
Q

Situational Rating Protocols

  • Stutterer’s _____(SSR)
  • Southern Illinois University ___
  • ___ to Selected Speaking Situations
  • ______(SESAS & SEA Scale)
  • ________
A
  • Stutterer’s Self-Ratings of Reactions to Speech Situations (SSR)
  • Southern Illinois University Speech Situation Checklist
  • Reactions to Selected Speaking Situations
  • Self-Efficacy Scales (SESAS & SEA Scale)
  • Individualized situation hierarchy
18
Q

Attitude Rating Scales

  • _____(S-24)
  • Communication Attitude Test (CAT-R)
  • Overall Assessment of the Speaker’s Experience of Stuttering (OASES)
  • ________(4S)
  • Individualized interview regarding attitudes and emotional reactions
A
  • Modified Erickson Scale (S-24)
  • Communication Attitude Test (CAT-R)
  • Overall Assessment of the Speaker’s Experience of Stuttering (OASES)
  • Self-Stigma of Stuttering Scale (4S)
  • Individualized interview regarding attitudes and emotional reactions
19
Q

Overall Assessment of the Speaker’s Experience of Stuttering (OASES)

important slide

  1. Yaruss & Quesal adapted the World Health Organization’s (2001)_____ (ICF)
  2. The ICF model describes disorders in terms of:
    a) impairment of ___ or ___(observable stuttering behavior)
    b) ____ Factors (personal and environmental reactions to stuttering)
    c) ___ or ____in ability to participate in daily activities
A
  1. Yaruss & Quesal adapted the World Health Organization’s (2001) International Classification of Functioning, Disability, Health (ICF)
  2. The ICF model describes disorders in terms of:
    a) Impairment in body function or structure (observable stuttering behavior)
    b) Contextual Factors (personal and environmental reactions to stuttering)
    c) Limitations or restrictions in ability to participate in daily activities
20
Q

Overall Assessment of the Speaker’s Experience of Stuttering (OASES)

  • -“The scope of practice in speech-language pathology encompasses all____ identified in the ___ framework…That is, speech-language pathologists work to improve ____by reducing impairments in body ___ and ___, activity ____, ___ restrictions, and ___ barriers…”
    • ASHA (2007) Scope of Practice
A
  • -“The scope of practice in speech-language pathology encompasses all components and factors identified in the WHO framework…That is, speech-language pathologists work to improve quality of life by reducing impairments in body functions and structures, activity limitations, participation restrictions, and environmental barriers…”
    • ASHA (2007) Scope of Practice
21
Q

Overall Assessment of the Speaker’s Experienceof Stuttering (OASES)

  • 100 items in 4 sections, each on a 5-point scale
  • Sections are closely related to the ICF Model
    1. Section I: __ ___ about Stuttering
    a. __ __of the Impairment and general knowledge and perception of the stuttering disorder
    2. Section II: ___, ___, ___Reactions
    3. Section III: Communication in __ ___
    a. ___ Limitation /___ Factors
    4. Section IV: Impact of Stuttering on ____a. a. ____ Environmental Factors
A
  • 100 items in 4 sections, each on a 5-point scale
  • Sections are closely related to the ICF Model
    1. Section I: General Information about Stuttering
    a. Speaker’s perception of the Impairment and general knowledge and perception of the stuttering disorder
    2. Section II: Affective, Behavioral, Cognitive Reactions
    3. Section III: Communication in Daily Situations
    a. Activity Limitation / Environmental Factors
    4. Section IV: Impact of Stuttering on Quality of Life
    a. Participation Restriction Environmental Factors
22
Q

ANALYSIS of ASSESSMENT TOOLS

  • Age
  • Administration Time
  • Manual
  • Case History Obtained
  • Audio recording required
  • Video recording required
  • Verbatim Transcript required
A
  • Age
  • Administration Time
  • Manual
  • Case History Obtained
  • Audio recording required
  • Video recording required
  • Verbatim Transcript required
23
Q

So, back to diagnosis…

  • Even more important to __, __,___aspects of it
  • Remember to consider “__ ___”
    1. There is often “more than meets the eye”
  • Importance of multiple samples
A
  • Even more important to describe, quantify and assess aspects of it
  • Remember to consider “life impact”
    1. There is often “more than meets the eye”
  • Importance of multiple samples
24
Q

Tx Recommendations

  • Need tx?
  • What type?
  • __- ___?
  • What kind of __ ___ needed?
  • Deal with __/____, coping mechanisms, etc.?
  • Work on basic communication skills?
  • Deal with __ ___?
A
  • Need tx?
  • What type?
  • Client’s goals?
  • What kind of speech change needed?
  • Deal with attitudes/avoidances, coping mechanisms, etc.?
  • Work on basic communication skills?
  • Deal with secondary behaviors?

Fluency (9 decks)

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