lec 2: early childhood ax Flashcards
T or F: if a child is stuttering for 12 months, they should begin therapy at once
true
children 4+ years of age should be referred if stuttering for more than __months.
6
what are the 3 purposes of assessment?
- determine diagnosis of stuttering
- make treatment-related decisions
- orient client’s family and social context to stuttering
based on WHO-ICF, what areas need to be assessed? (7)
- aetiology (genetic vs congenital)
- primary symptom/core behaviour
- affective reactions
- secondary behaviours
- cognitive reactions (ie attitudes)
- participation/activities
- environment (ie context, demands, culture)
what are the 6 main risk factors for stuttering?
- family history or congenital event
- later onset age (3.5+)
- male
- duration (12 months+ = worse prognosis)
- pattern over time
- concomitant speech/lang/motor/cognitive delays
name the steps of assessment/diagnosis (6)
- obtain consent
- gather background info (case histories, recordings…)
- observe client + record speech sample
- interview parents and/or teachers
- formulate diagnosis
- meet w client to review tx options
what kind of questions might you ask in a parent interview? (think: who, what, when, where, why, how)
- who: who wants the therapy? parental concern etc
- what: what does the stuttering look like?
- when: when does the stutter happen? during a typical day? busy day? certain time of day?
- where: situational variability/triggers
- why: why are they here? parents beliefs about disabilities
- how: how do they expect tx to go? beliefs about tx etc
why should we interview the child’s teacher? (3)
- to determine differences in child’s stutter at home vs school
- to learn about secondary behaviours seen at school
- to gain info about social and academic experiences of the child
what capacity/demand factors are we examining when watching parent-child interactions? (6)
- eye contact / responsiveness
- reactions to stuttering
- comments about talking / corrections
- distractions
- speech rate + MLU
- questions
how can we ensure our assessment is evidence-based? in other words, what do we want to gather during ax? (3)
- 150-200 words or syllables
- 2 different samples (ex: home and school) at 2 different times with 2 different people (ex: parent and teacher)
- ask parent if the data is representative
what kind of speech measures are we collecting? (6)
- frequency (% of disfluencies for kids, NOT %SS)
- types of disfluencies (+ ratio of typical:atypical)
- nature and number of stutters
- duration
- secondary behaviours
- rate
how do we count disfluency (kids)? what are the percentages for stuttering diagnoses?
- counting typical vs atypical stuttering-like disfluencies (SLDs)
- > 10% of disfluencies and >50% being SLDs = stutter diagnosis
T or F: you always measure all possible bumps (i.e., interjections) in the client’s speech
false – only applies to children. for adults, you only count the stutters
what is the lidcombe severity rating (SR)?
- 0-9 scale
- 0 = no stuttering, only typical disfluencies
- 9 = most severe stuttering
what is the kiddyCAT? what kind of scores do CWS vs CWNS get?
- attitude test for children who stutter
- CWS: 3-4+ (out of 12)
- CWNS: 1-2 (out of 12)
why is it useful to learn about the child’s temperament?
their temperament gives us an idea of their reactivity to the stuttering
why is logging helpful? (5)
- tracking progress
- setting goals/hierarchies
- ensures weekly practice
- tracking triggers/patterns
- self-monitoring for relapse
what kind of information could we log about stuttering? (8)
- types of stutters
- frequency/severity
- audience
- place/situation
- time of day
- reactions/awareness
- response of others
- what kind of communication was happening?
compare typical disfluency and borderline stuttering in terms of core behaviours, secondary behaviours, feelings/attitudes
- TYPICAL: 10 or less disfluencies per 100 words. no secondary behaviours. no concerning feelings/attitudes.
- BORDERLINE: 11+ disfluencies per 100 words. no secondary behaviours. may show occasional negative feelings/attitudes.
describe beginning stuttering in terms of core behaviours, secondary behaviours, feelings/attitudes
- core: rapid, irregular, tense repetitions.
- secondary: escape behaviours.
- feelings/attitudes: feel aware of disfluency, potentially frustrated.
if you diagnose someone as having typical fluency, what will you recommend? (2)
- provide info on stuttering
- monitor
if you diagnose someone as having borderline or beginning stuttering (EARLY), what will you recommend? (4)
- provide info on stuttering
- provide counselling
- provide log resources
- closely monitor
if you diagnose someone as having borderline or beginning stuttering (LATE), what will you recommend?
immediate treatment
what’s the diff bw an early vs late borderline or beginning stuttering diagnosis?
- early: onset was less than 12 months ago (or less than 6 months ago if child is 4 years old)
- late: onset was more than 12 months ago (or more than 6 months ago if child is 4 years old)
T or F: when counting disfluencies, you count morphemes, not syllables
false – count syllables, not morphemes
what can we ignore when counting disfluencies? (4)
- rote, repetitive responses
- singing, poems, nursery rhymes, silly voices
- toy noises
- unintelligible words/phrases
what are the 5 typical disfluencies?
- interjections (uh, um, like)
- revisions (i lost my… where’s my toy?)
- phrase repetitions
- slow/easy/rhythmic whole or part-word repetitions
- no secondary behaviours or struggle
what are the 5 atypical disfluencies?
- prolongations (sssssssso can we go)
- rapid/tense/arrhythmic whole or part-word repetitions
- secondary behaviours and struggle (ex: eye blinking)
- blocks (struggle + silence)
- clusters (combos of above)
