Fluency Disorders and Treatment Flashcards
How many people in the US stutter?
About 3 million
Is stuttering more common in boys or girls?
Boys. Male to female ratio is 4:1
Can children outgrow stuttering?
Yes
Can stuttering have a onset later in childhood (after other language development?)
Yes
What causes stuttering?
Nobody knows exact ideology.
T/F Stuttering can be cured.
False. There is no cure for stuttering. Just treatment approaches and strategies to help people who stutter control their speech.
What does speech fluency involve?
Rate
Continuity
Rhythm
Effort
Stuttering is an abnormally high _____________ and or ________________ of _______________ in the forward flow of speech.
frequency; duration; stoppages
What are the core behaviors with stuttering? (4)
Repetitions (sounds, syllables & words)
Prolongations
Blocks
Dysfluencies primarily on 1st sound/syllable
What are secondary behaviors with stuttering? (2)
Escape behavior (head nods, eye blinks, tremors) Avoidance behavior (substitutions, tension, pauses)
What factors within the child should be considered when diagnosing stuttering? (4)
Family History
Sensitive Temperament
Male
Presence of Other Speech/Lang Disorder
What factors within the environment should be considered when diagnosing stuttering? (4)
Rapid-fire, high pressure comm patterns in home
Impatience or anxiety about child’s stuttering
Traumatic Events in Child’s Life
High Expectations
What sort of nonfluencies are considered normal in children?
Phase repetitions
Interjections (umm)
Revisions
(experienced by many children between 2-8 yrs.)
When should we view disfluencies as Disordered rather than part of a normal developmental stage?
When disfluencies are:
Frequent (more than 10% of syllables)
Occur in several situations
Occur over longer periods of time
What 4 stuttering treatment components would be used with a preschooler?
Distinguish between normal dysfluencies and stuttering
Address parental concern
Teach parents and caregivers what to do
Direct Intervention (speech therapy)
What things can a parent or caregiver do to help promote fluency in a young child?
Give child time to talk (pause 1 sec)
Talk more slowly
Use shorter, simpler sentences; limit questions
Don’t correct or tell the child to slow down (don’t add pressure)
T/F: With older children and adults, you need to focus on whether or not the person is stuttering.
False. Focus on what they do when they are disfluent and how the SLP can help them be more fluent.
What are the 4 components to stuttering treatment for older children and adults?
Use fluency shaping techniques
Stuttering modification techniques
Generalize skills to spontaneous speech
Help client carry over skills to natural environment
What things are measured when assessing and diagnosing a person who stutters? (5)
Frequency and Type of Disfluency
Average length of Most Severe Stuttering Moments
Types of Disfluencies (how many repetitions? how many prolongations? how many blocks?)
Attitudes and Emotions Measure
Situational Assessment
What are the three main approaches to treatment of disfluent speech?
Fluency Shaping (teach to produce fluent sound) Stuttering Modification (teach to stutter more easily) Combination of Both of these
What are the Fluency Shaping/Fluency Enhancing Techniques?
Easy Onsets Decrease Speaking Rate Light Articulation Contacts Continuous Phonation Change Overall Speech Pattern (not just stuttering moment) Delayed Auditory Feedback
What are the Stuttering Modification Techniques?
Cancellations
Pull Outs
Preparatory Sets
What are the 3 Areas of Focus when “Treating the Entire Disorder” ?
Addressing Impairment: Improving Fluency (Timing, Rate, Tension)
Addressing the Impairment in Body Function (Speech Machine, Physical Tension)
Addressing the Rest of the Disorder (ABC Reactions)
What are the “ABC Reactions” that a child might have?
Affective (shame, embarrassment, isolation, anxiety)
Behavioral (physical tension, avoids being social)
Cognitive (evaluates himself negatively as a communicator)
What techniques can be used to address the timing and tension in a person who stutters?
Change timing through pacing
Change tension through light contact
Change timing and tension through easy starts
What techniques can be used to address the impairment in body function?
Learn about “speech machine”
Staying “the the block” to explore what is happening during the stuttering moment
Pseudostuttering to reduce tension
What are the General Treatment Guidelines for stuttering?
Systematically Increase Difficulty Level
Work Towards Naturalness of Task
Move Client Towards Self-Monitoring
Refer/Provide Support Group
What 3 techniques can be used to minimize a client’s reaction to loss of speech control?
Self-Analysis (increase client’s awareness)
Relaxation (reduce the client’s anxiety and tension)
Desensitization (reduce negative emotions associated with stuttering-can be done through voluntary stuttering)
How does assessment and treatment for adults who stutter differ from preschoolers with disfluencies?
With adults, the focus is not on whether or not the person is stuttering. With young children, it is important to determine what is disordered and what might be a developmental disfluency.
