EXAM Adult Ax of Stuttering

Question 1

INTAKE FORM: Medical History, Demographic information
Why have you come in today?
Do you use any language other than English? Communication requirements/contexts for each language? % usage for each. Rating of competency for each. - we will estimate stuttering severity for each later…

Answer 1

 Understand their social situation  is there someone available who can help with their treatment? Do practice with them? Do covert recording if required.
 Avoidance (circumlocution, cognitively scanning ahead…)
 Avoidance of speech contexts (phone, parties etc). Engagement with speech contexts? Contexts you really want to control your stuttering in/those you don’t care about? Needs/uses for fluent speech?

Question 2

2.

Impact on ICF activities and participation (WHO, 2001)
Relapse or new stuttering?

Goal: Find out how previous treatment may affect attitude and motivation for future treatment –>

Answer 2

Previous treatment - successful to what degree? How low did %SS go?
-> How long until relapse? Bad/good experience?
Was treatment acceptable (or make them sound unnatural? Did their previous SLP talk about possible relapse?
->Do you think there was a trigger/reason for relapse? Are you better/worse/same than before you were initially treated for stuttering?
->[Which language was treatment in? Did it transfer across languages? What are attitudes to stuttering within your culture/family?]

Question 3

3.
 What strategies do you use (personal) to try to control your stuttering? Successful or not?
 What is client’s goal for treatment? What kind of a time commitment do you expect to make?

Answer 3

Ask about life factors which will impact on readiness for treatment (financial/time commitment, stressful life events currently occurring).
 Ask about factors influencing/person motivation.

RATING SPEECH SAMPLES SRS 1-8 point scale. PRACTICE RATING SAMPLES in both languages WITH THEM.

Question 4

4.
RATING SPEECH SAMPLES SRS 1-8 point scale. PRACTICE RATING SAMPLES WITH THEM.
Are these all representative of your stuttering severity?

Answer 4

Other contexts you typically stutter more or less in? Typical of your stuttering over last week/month? Current Onset, variability and increasing/decreasing severity of stuttering. Representative of all languages, all contexts?
 If not representative, arrange covert sample (with permission)

Question 5

Speech samples: - REPRESENTATIVE OF NORMAL LIFE

DIFFERENT CONVERSATIONAL PARTNERS / CONTEXTS / TASK COMPLEXITIES - across relevant languages

Answer 5

2-3 BC Speech samples (500 spm ~10 minutes)
1-2 WC
(If WC not representative)
arrange Covert sample (with permission)

Question 6

Adult sample: Chose something for a baseline that can be repeated fairly easily, so next time I assess the cognitive/emotional demands are relatively similar.
WC samples:
Observe during case history interview - 1 sample
Recount - tell me how to make a cup of tea - 2nd sample
Picture description task - chose a picture that (I think) won’t trigger anxiety.
CONTINGENCIES - probing questions, picture supports (on ipad?)

Answer 6

BC samples:
->With intimate partner at home
->More formal context on the phone
->Visiting the in-laws for dinner
->Conversation with son in the car
ASK - ARE THESE REPRESENTATIVE. GET CLIENT SR FOR THEIR STUTTERING ACROSS EACH - ARE YOU EVER WORSE THAN THIS? ARE YOU EVER BETTER THAN THIS?
–> Reading sample if reading is an area of need/concern

Question 7

Multilingual:
Practice doing SRS with clients - do they think their SRs are different across their different languages and contexts? Get them to rate in each language and context. Record this.

Answer 7

RATING SPEECH SAMPLES SRS 1-8 point scale. PRACTICE RATING SAMPLES WITH THEM.
Are these all representative of your stuttering severity? all languages, all contexts?
Typical of your stuttering over last week/month? Current Onset, variability and increasing/decreasing severity of stuttering.

Question 8

Standardised tools:

–>Social Anxiety Screener (Iverach et al., 2011)

–> QoL measure based on ICF

Answer 8

Adults:
• Unhelpful thoughts and beliefs about stuttering scale (UTBAS I, II, III for adults) FOR ALL LANGUAGES IF MULTILINGUAL
• OASES (Yaruss + Quesal, 2010) - 18+ yrs

Question 9

–>Social Anxiety Screener for people who stutter (Iverach et al., 2011)

–> USE this test to assess social anxiety in each language (can use Enlish version, thinking of using other language)

Answer 9

(UTBAS I, II, III) for adults
(Iverach et al., 2011)

Unhelpful thoughts and beliefs about stuttering scale - Available in a number of languages, chose English if client can do in English (unless SLP speaks the other language)

Question 10

–> QoL measure for people who stutter, based on ICF

Yaruss + Quesal, 2010

Answer 10

OASES (Yaruss + Quesal, 2010) - 18+ yrs