Fluency Intervention

Question 1

What are core behaviors?

Answer 1

Basic manifestations that seem beyond the voluntary control of the stutterer
repetitions
prolongations
blocks

Question 2

What are secondary behaviors?

Answer 2

Learned reactions to core bxs
Escape- head nods, eye blinks, foot taps, jaw tremors
Avoidance- Circumlocutions (talk around words that cause stuttering), unfilled pauses, interjections

Question 3

What are categories of stutter bxs?

Answer 3

Core and secondary

Question 4

What is the ultimate goal of treatment? What are the four components to it? What is common?

Answer 4

Spontaneous fluency! Rate, continuity, rhythm, effort. Goal may be controlled fluency or acceptable stuttering levels. Relapse is common!

Question 5

Effective treatment must incorporate

Answer 5

objective measures of f and duration of stuttering
clients emotions and attitudes
client’s willingness to participate in interactions with variety of people

Question 6

EBP conclusions? What still needs to be addressed?

Answer 6

Preschool kids do benefit
School age info is scant
Prolonged speech (slower) and easy onsets are most effective for adults
-- Need to address naturalness of speech, attitude changes, long term outcomes

Question 7

What is the indirect approach?

Answer 7

Listen to message, not speech pattern
Don't speak for child
Avoid stress/pressure
Decrease demands
Avoid interrupting
Avoid questions that demand lengthy responses
Maintain ec during dysfluency
Don't speak rapidly
Don't ask questions that require lengthy response

Question 8

What is fluency shaping? What doesn’t it address? What do we use to do it?

Answer 8

Focus on eliminating dysfluencies by practicing fluent speech. Doesn’t address secondary bx or feelings/attitudes.
early onset/prevoice exhalation
light articulatory contacts
continuous phonation (say every sound)
delayed auditory feedback (hear selves very lagged to slow speech down) begin at 250– decrease in 50 intervals
decrease speaking rate

Question 9

What is stuttering modification? What do we use in it?

Answer 9

Teach to stutter more fluently. Goals are to modify each disfluent moment by stuttering more easily and to eliminate struggle and avoidance bxs.
self analysis-increase awareness of types, severity, secondary bxs…
relaxation- discrim btwn tension and relaxation moving prog toward head
desensitization- decrease sensitivity to stuttering in front of others.
develop hierarchy of feared situations- where, who, what, when…
cancellations- stick with stutter, think about, rehearse, repeat
pull out- stop stutter, think, repeat
preparatory set- anticipate dysfluency, pause, rehearse, attempt