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slp 573: fluency disorders > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

increased _______________ is associated with decreased adverse impact of stuttering

A

spontanaity

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2
Q

which of the following can empower clients and reduce the impact of stimga?

A

self-disclosing

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3
Q

which 3E component is described here: pseudostuttering: educating others on stuttering

A

empowerment

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4
Q

which 3E component is described here: learning all about therapy approaches, reviewing the research base on the stuttering experience

A

education

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5
Q

which 3E component is described here: monitoring secondary behaviors; practicing speech techniques

A

ease

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6
Q

caregivers are relatively ___________ at identifying their child stuttering

A

good

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7
Q

which questionnaire is used directly with the child?

A

kiddyCAT

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8
Q

T or F: low speech sound skills may put a child who stutters at greater risk to persist

A

true

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9
Q

what can help caregivers to narrow down their child’s stuttering onset?

A

recalling specific events/data around the time they noticed the child stuttering

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10
Q

the Palin Parent rating scales are helpful in evaluating parent perceptions of the child’s

A

attitudes and awareness towards stuttering

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11
Q

which of the following is least valuable when diagnosing stuttering with a child learning english as a second language?

A

repetitions

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12
Q

which of the following is not a recommended therapy approach/strategy to use with children with autism and concomitant stuttering disorders?

A

fluency shaping

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13
Q

which of the following 2 characteristics are not typically seen in children with autism with concomitant stuttering?

A

negative attitudes towards communication, avoidance of different situations (related to stuttering)

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14
Q

which of the following treatment formants reflects targeting the primary impairment until it is remediated before addressing the secondary impairment

A

sequential

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15
Q

example of a self-disclosure goal

A

the client will self-disclose with 10 unfamiliar listeners over the phone as measured by SLP data collection

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16
Q

example of an education goal

A

the client will present to their class on stuttering including at least 5 facts about stuttering and 1 thing they want to do when they stutter as measured by SLP data collection

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17
Q

example of a participation goal

A

the client will introduce themselves in four of their largest feared scenarios (e.g. ordering pizza, drive-thru, class presentations, etc) as measured by the clinician or client self report.

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18
Q

examples of avoidances

A

word/sounds, situations, being identified as a PWS, showing struggle, feeling shame, potential thoughts of others

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19
Q

T or F: PWS choose to avoid for many reasons including momentary relief, preventing emotional suffering, and obtaining control

A

True

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20
Q

ABC’s

A

a = affective
b = behavior
c = cognitivee

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21
Q

example of A (ABC’s)

A

“i’m scared to stutter”

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22
Q

example of C (ABC’s)

A

“stuttering means I’m a failure or ‘there’s something wrong with me’“ex

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23
Q

example of B (ABC’s)

A

“I avoid talking”

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24
Q

characteristics of CBT

A

exposire
cognitive restructuring
behavioral experiments
attentional training

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25
Q

cognitive restructuring

A

challenging negative thoughts and judgments by (a) considering alternative points of view and (b) evaluating the evidence

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26
Q

examples of cognitive restructuring

A
  • what evidence do you have for the thoughts?
  • what does the thought do for you? how does it make you feel? is it helpful in any way, or is it just distressing?
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27
Q

components of behavioral experiments

A

form hypothesis
collect data
analyze data
consider results

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28
Q

T or F: desensitization is not the same thing as exposure

A

false

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29
Q

___________________ is a desensitization strategy characterized by gradually experiencing feared situations in a supportive environment using a controlled, systematic hierarchy

A

exposure

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30
Q

psuedostuttering

A

this is a technique that involves intentionally stuttering

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31
Q

benefits of pseudostuttering

A

it enables the PWS to experiment with a variety of fluent and non fluent speech behaviors
it breaks the link between stuttering and being out of control

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32
Q

pseudostuttering can result in:

A

decreased stuttering
increased confidence/feelings of freedom
decreased fear

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33
Q

positive impact of voluntary stuttering increases when:

A

used outside the therapy room
it mirrors a person’s true stuttering patterns

34
Q

self disclosure

A

identifying oneself as a person who stutters

35
Q

T or F: self disclosure is an informative manner results in more friendly and outgoing evaluations of the speaker

A

true

36
Q

informative disclosure

A

a more “matter of fact way” of self-disclosing

37
Q

an example of informative disclosure

A

“before we get started, I want to let you know that I stutter. You may hear me repeat sounds or phrases, but if there is anything that I say that you do not understand, don’t hesitate to ask me”

38
Q

apologetic disclosure

A

a more apologetic and emotional way to self-disclose

39
Q

an example of an apologetic disclosure

A

“before we get started, I should let you know that I stutter, so this might be hard in spots, bear with me”

40
Q

adult simulation treatment plan

A

education related to stuttering (e.g. stuttering iceberg, specific theory, normal talking process) that helps to understand your therapy plan
a fluency shaping and/or stuttering modification strategy - collect quantitative data desensitization/exposure activity (e.g. pseudostuttering, self-disclosure practice, evaluate evidence) - collect qualitative data
discuss/assign desensitization homework challenge

41
Q

what is the goal of fluency shaping?

A

increased (controlled) fluency

42
Q

what do fluency shaping techniques target?

A

fluent speech and fluent speech only through manipulation of the motor aspects and timing and tension of speech

43
Q

when are fluency shaping techniques appropriate?

A

when the client expresses the desire to be more fluent
when the use of strategies improves the speaker’s experience communicating

44
Q

light contact

A

focus on minimizing tension
targets light pressure when articulating sounds
listen for light consonants

45
Q

smooth/constant movements

A

focus on elongated constituents and connections between sounds and words
can focus on lips constantly moving
listen for connections between words and elongated sounds

46
Q

easy voicing/easy onset

A

focus on minimizing tension
targets gentle vocal fold vibration on vowels
listen for gently, accelerating vowels

47
Q

phrasing and pausing

A

chunking utterances together into short utterances at natural boundaries
stuttering is less likely to occur during short utterances
listen for 3-5 word phrases that are broken up naturally

48
Q

example of phrasing and pausing

A

I wanted to go / to the store / yesterday

49
Q

shortcomings of fluency shaping techniques

A
  • fluency can come at the expense of spontanaiety
  • it can be hard for clients to generalize the use of these strategies
  • it’s making an automatic process less automatic (greater cognitive load)
  • relapse is common
  • fluency is not associated with perceived quality of life outcomes
50
Q

what is the goal of stuttering modification

A

easier stuttering

51
Q

what do stuttering modification therapies target

A

reducing tension during moments of (anticipated) stuttering and acceptance of your stuttering

52
Q

cancellations

A

used as an in-clinic strategy to help identify places of tension and increase feelings of control
after a client stutters, they are able to
- identify the place of tension
- say the word again but more intentionally and controlled - slower and with less tension (this may not result in fluent production and that is okay)

53
Q

easy stuttering

A

used to gain control of speech and replace tense stuttering with more easy, forward moving stuttering
voluntary, less tense stuttering
often used when stuttering is anticipated

54
Q

pull-outs

A

used to gently move through a moment of stuttering
targets holding onto tension - until it can be identified and the speaker can release the tension and gently move onto the next sound

55
Q

prepatory sets

A

used to gently move into sound the speaker anticipates stuttering on
targets slowing and stretching speech to reduce the liklihood of tension build-up

56
Q

ableism

A

the refusal to see the value in neurodiversity and the instence that normalization is the only solution

57
Q

outcomes that may perpetuate ableist conceptualizations of stuttering

A

increasing fluency
reducing overt disfluencies
teaching strategies that encourage concealment, covering, or avoidance of disfluencies or “passing as a fluent speaker”
improving how speech sounds
these outcomes are listener focused

58
Q

outcomes that may interrupt ableist conceptualizations of stuttering

A

increasing spontaneity, joy, and ease of communication
decreasing physical and mental speaking effort
promoting self-advocacy
improving how speech feels
these outcomes are speaker focused

59
Q

primary clinical questions

A
  1. is this child overtly stuttering (behavior, affective)
  2. is the child or family negatively impacted by the stuttering (cognitive)
  3. is the child at risk to persist? (language/speech)
  4. what seems to be contributing to the stuttering? (environment)
  5. what support is most appropriate? (motivation)
60
Q

what information do you use to make a stuttering diagnosis?

A
  • overt stuttering (3% SLD)
  • parent report of disfluency type
  • impact of stuttering on child and parent
61
Q

what information do you use to determine a prognosis for stuttering?

A

sex, family history, age at onset, time since onset, stuttering/severity/frequency, speech-sound accuracy, receptive language, expressive language, nonword repetition

62
Q

palin PRS

A

this is a parent questionnaire that measures three factors (1) the impact of stuttering on the child, (2) the severity of stuttering and its impact on the parents, (3) the parent’s knowledge about stuttering and confidence in managing it

63
Q

kiddyCAT

A

this is a child questionnaire that gives the clinician information about the child’s attitudes towards their communication

64
Q

test of childhood stuttering observation scale

A

this is a parent questionnaire that asks the parents to assess how frequently (never-often) their child demonstrate certain behaviors

65
Q

overarching goal for therapy

A

the child will communicate whatever the child wants, whenever the child wants, with whomever the child wants, using whatever reasonable manner the child wants

66
Q

common elements of treatment for preschoolers who stutter

A
  1. target communication
  2. emphasize caregiver education and counseling
  3. make it FUN for the child (e.g., play-based therapy)a
67
Q

target communication

A

Set the foundation for the caregivers and the child that communication is more important than fluency; therapy should benefit who would have recovered without it and those who will persist with itep

68
Q

emphasize caregiver education and counseling

A

Caregivers’ understanding of stuttering and the goals/progress of therapy can influence their interactions with the child and adherence to the treatment

69
Q

make it FUN for the child (e.g., play-based therapy)

A

You’re working with a child and, particularly for children who stutter, it’s important to emphasize joyfulness of communication

70
Q

three basic domains of treatment

A

change the home SPEAKING ENVIRONMENT
change the child’s (and caregiver’s) BELIEFS/THOUGHTS about communication
TIME/TENSION aspects of child’s SPEAKING behavior

71
Q

change home SPEAKING ENVIRONMENT

A

Stuttering will be aggravated or maintained by any environment event that increases the chance that the child will RUSH the planning for and/or execution of speech and language production

72
Q

change child’s (and caregiver’s) BELIEFS/THOUGHTS about communication

A

EXTERNAL behavior is motivated by what someone INTERNALLY believes

73
Q

change TIME/TENSION aspects of child’s SPEAKING behavior

A

stuttering is influenced by time and tension

74
Q

Palin PCI

A

12 week program with a focus on family interactions and parent behaviors

75
Q

lidcombe program

A

focus on parent-provided verbal contingencies/operant conditioning

76
Q

popular treatment approaches that may particularly influence the ABC’s, include:

A

praise
regular parent-child interaction time
acknowledgemtn of stuttering

77
Q

special time

A

these times may provide the child with an opportunity for enjoyable low pressure communication

78
Q

acknowledgment of stuttering

A

identifying stuttering in a supportive manner may reduce changes that the child will develop negative thoughtsp

79
Q

praise

A

pointing out what the child does well can support positive feelings

80
Q

what ABC domain does the special time fall under?

A

behavioral domain

81
Q

what ABC domain does the acknowledgment of stuttering?

A

cognitive domain

82
Q

what ABC domain does praise fall under?

A

affective domain

slp 573: fluency disorders (4 decks)

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