Children and Stuttering Treatment Flashcards
What is your best assessment tool?
Clinician’s ear
What are the standardized tests for stuttering?
N/A
What should you be tracking/counting in assessment?
Count words or syllables % Rate Severity level Qualify concomitants
What are the 3 things you need to assess?
What
Where
When
Describe WHAT
What your client is doing
- the nature of the disfluency
- type of disfluency (repetitions, prolongations, blocks)
- what sounds (vowels, consonants)
- Severity: frequency, duration (how often and how long)
How much is too much?
More than 1 disfluency in a sentence
More than 5 repetitions
More than 5% dislfuent
Concomitant behaviors
Kids don’t usually use a lot of interjections as avoidance
*The presence of a struggle
-little kids with a stutter will change pitch, whisper
-look for embarrassment, abandoning of utterance
Describe WHERE
Location IN THE WORDS where the child is stuttering
Developmental: word initial position
Acquired: final position
Describe WHEN
When does the child stutter?
- Time of day
- Situational variability
- Accompanying strong emotion
- Cyclical
- Patterns in which people stutter
- Situational stuttering (if ONLY at home, soccer, etc) is not stuttering
What questions should you ask in assessment?
- What effect is this having on their life (how handicapping…social, educational, emotional, etc)?
- Family history- does anyone in their family stutter? (look at extended family- including those who “didn’t talk much”- may have avoided stuttering by avoiding talking)
- Parent’s reactions to disfluencies (understand if they are accepting, overly sensitive, horrified…they may need your reassurance. In extreme cases they may need counseling to “get over it”)
- Motivation- asking the client or family. The family is your biggest target for therapy with children.
Why is the family our biggest target in therapy for children?
The family needs to lead therapy. We need regular, active participation from the family. Doing HW, following instructions on approach.
How do kids show willingness in therapy?
Attention
Compliance
Stimulability
How do adults show willingness in therapy?
Doing their “homework”
What do parents need to understand about stuttering?
- The nature of stuttering: it’s not their fault, that it is cyclical, helping them keep perspective (how beautiful and smart their child is)
- Change can take time (slow progress), let them know that this is a long process
- Parents need to REINFORCE NOT ENFORCE. Never make a child feel bad about their stutter. Reinforce good stuff, don’t point out bad stuff.
What information are we gathering in a fluency case history?
a) What are their concerns?
b) Parent/client description
c) When first noticed
d) Have disfluencies changed? (if cycle has started, it’s really stuttering)
e) Why treatment now? (motivation)
f) Does it come and go or is it constant?
g) Child’s reaction to stutter (awareness, struggle/abandon)
h) What do others do to “help”?
i) Does the child use strategies (concomitants)
j) Situational: When questions
k) Family history
l) Previous treatment
m) Is today’s speech typical of them?
n) Is there anything you want me to know? (what is important to them)
o) Do you have any questions for me? (they always ask what causes stuttering. Relieve them of their guilt.)
What are some questions parents may ask?
a) Cause
b) Can it be cured? Say things that sound encouraging
c) Why it comes and goes (cyclical)
d) Should we talk about stuttering? Acknowledgment is so important. They need to encourage their child and praise their efforts. Listen to WHAT the kid is saying, not just HOW.
e) Why do techniques help )whispering, singing)? Concomitants= neurological distraction using different areas of the brain- these stop working over time. Never teach a child that stuttering is “bad” or that fluent speech is “good”- praise all effort.
