Class 4: Treatment of Stuttering in Adolescents and Adults

Question 1

When tackling long term stuttering, what do you focus on FIRST?

Answer 1

Stuttering: focus on reducing the negative emotions and fears surrounding stuttering

Question 2

When tackling long term stuttering, what do you focus on SECOND?

Answer 2

Fluency: new ways of speaking are learned when stuttering is expected or experienced

Question 3

What are some realistic goals for fluency/speech?

Answer 3

• controlled fluency when fluency is important
• easy, mild stuttering when controlled fluency isn’t possible
• little to no avoidance of speaking
• effective communication with others

Question 4

What are some emotional goals?

Answer 4

• countercondtioning (replace negative behaviours with neutral ones)
• deconditioning (volutary stuttering to show that it’s fine)
• openness
• ‘advertising stuttering’
• CBT

Question 5

How can the client become their own clinician?

Answer 5

• teach self-monitoring skills so they can be aware and accepting of their stutter

Question 6

Why is it helpful to record the stutterer and play it back later?

Answer 6

Allows them to see that it isn’t as bad at they thought in a more relaxed environment

Question 7

To maintain fluency, what must the client learn to do?

Answer 7

• observe own behaviour
• evaluate own behaviour
• reinforce own behaviour

Question 8

What are the three related disorders of fluency?

Answer 8

1) Neurogenic
2) Psychogenic
3) Cluttering

Question 9

How is neurogenic stuttering different from real stuttering?

Answer 9

• stutter the same on all types of words
• have few secondary behaviours
• don’t respond to fluency-enhancing conditions (talking to a dog)
• no anxiety around stuttering

Question 10

How do you treat neurogenic stuttering?

Answer 10

• behaviourally, neurosurgically, medications

Question 11

How is pshycogenic stuttering distinguished from real stuttering?

Answer 11

• detailed case history to rule anything else out
• dramatic improvement with trial therapy (placebo)
• increased severity under fluency-inducing conditions
• unusual secondary struggle behaviours

Question 12

What is cluttering?

Answer 12

• sudden bursts of rapid speech that is difficult to understand and somewhat disfluent
• with effort and attention, speaker can usually speak fluently

Question 13

How do you treat cluttering?

Answer 13

• increase client’s awareness of rate

- improve linguistic/language skills