lec 5: adult ix Flashcards
what is the fluency shaping continuum vs stuttering modification continuum?
- fluency shaping = aiming to eliminate stuttering as much as possible (ex: Never Stutter and Camperdown)
- stuttering modification = more self-acceptance focused (ex: Guitar’s Superfluency)
Guitar’s Superfluency: always includes (4)
- self-monitoring
- transfer hierarchies (practicing irl)
- maintenance plans
- transition to be own therapist
Guitar’s Superfluency: always addresses (3)
- attitudes (thoughts)
- anxiety (feelings)
- avoidance (behaviours)
Guitar’s Superfluency: always establishes (4)
- clear expectations
- individual goals
- tx is NOT a cure – always requires effort
- tx is out of comfort zone
Guitar’s Superfluency: goals (4)
- reduce fear / stutter more easily
- increase approach behaviours
- become own clinician
- use and transfer controlled fluency techniques
Guitar’s Superfluency: what are some tasks for goals 1-3?
- explore above and below the iceberg
- high quality stutters (in and out of clinic)
- catch and release (in and out of clinic)
- self-disclosures
Guitar’s Superfluency: true or false – clients work on goals 1-3 while also learning fluency techniques
false – need to do 1-3 first (can’t do techniques well if you’re stressed!)
Fluency Plus: goals (2)
- mostly focuses on teaching fluent speech
- later discusses mental thoughts and dealing with negative thinking
Fluency Plus: describe the program (6)
- 3 weeks, 6-8hrs/day
- 11 month follow-up
- 8 specific skills in hierarchies
- homework everyday
- record mini-program (for future reference)
- for life: records, daily practice, boosters
Fluency Plus: what are the 8 specific skills?
- full breath
- stretch
- pause
- gentle/easy onset
- self-monitoring/correction
- full articulatory movement
- amplitude contour target
- reduce articulatory pressure (light contact)
Fluency Plus: name 4 cognitive restructuring targets
- meeting others who stutter (= self-acceptance)
- addressing situational fears
- feedback/desensitization (listen to own speech and focus on target, not stutter)
- acceptance of new voice
Fluency Plus: what is covert practice?
practicing in your head before speaking
name 4 expectations of adult tx
- roles outlined (be your own therapist)
- client informed about intense nature of tx
- client informed that tx =/= cure
- will have a different voice, less like yourself
why is it important to involve others in tx? (2)
- to manage expectations
- to outline how family/friends can help
Fluency Plus: describe Full Breath (3)
- medium breathing (too big = stutter)
- start talking at top of airflow
- slowness of breath compensates for white matter connections
Fluency Plus: describe 2 Second Stretch (2)
- zombie talking – stretch each syllable to be 2sec long (typical = 0.2)
- some sounds are unstretchable (stops, voiceless fricatives)
Fluency Plus: describe Self-Correction
- stop as soon as you make an error and take a full new breath
Fluency Plus: describe Speech Helpers
- provides client info about breathing, voicing, and articulation
Fluency Plus: describe Gentle Onset (2)
- take full breath
- exhale small amount of air, THEN begin talking
Fluency Plus: describe New Normal
speech that is stretched enough for you to FEEL the targets being completed accurately but natural enough to be used in all outside speaking situations
Fluency Plus: describe Light Contact
- like Gentle Onset but for unstretchable sounds
Fluency Plus: describe Blending (2)
- take full breath
- say 2 syllables on 1 breath
- pause for 1sec to take new full breath, repeat
Fluency Plus: describe Full Movement
- making articulatory movements a bit bigger
- focusing on what this feels like
Fluency Plus: describe Transfer
practicing skills irl
Fluency Plus: describe Maintenance Missions
developing practice program
Camperdown: goals (4)
- controlled fluency using prolonged speech
- rating scales for NAT and SR
- problem solving for generalization
- help client develop maintenance plans
Camperdown: what wpm, NAT and SR do we start at?
- wpm: 40
- NAT: 9
- SR: 0
Camperdown: describe the program structure (2)
- weekly for 20 weeks direct SLP time
- match speech exemplar
Camperdown: describe the four stages
- teaching sessions (learning exemplars)
- stutter-free speech in clinic
- problem solving outside of clinic
- maintenance
Camperdown: what happens if you match the exemplar? what happens if you make errors?
- match = move forward (i.e., more NAT/smaller # but still SR 0)
- errors = start back from NAT 9
Camperdown: what does homework look like? (4)
- choose topic to discuss
- set NAT and SR goals before
- set timer for 3 minutes and talk
- rate yourself after
Essential Pause: goals (3)
- effective communication
- speech that looks and sounds like “normal speech”
- confidence in communication
Essential Pause: why is pausing beneficial? (5)
- normal airflow
- take back control
- let blocks go
- more natural than stretching
- allows time to integrate other techniques
Essential Pause: what is the essential pause? (3)
- frequent
- 2 seconds long
- goal = open airway
Essential Pause: what is Word Repetition Target? (3)
- accepting typical disfluencies as part of fluent speech
- analyze a sample
- compare typical vs atypical
Essential Pause: how is Word Repetition used? (3)
- replaces stutters w more typical disfluencies
- choose a conjunction (and, so, but)
- add eye contact
Essential Pause: what is Easy Speech? (2)
- using easy onset for vowels, voiced continuants and voiceless continuants
- using minimum articulatory pressure for continuants, voiced stops and voiceless stops
Essential Pause: what are the main ideas for Transfer? (4)
- move away from reading ASAP
- move away from practicing w same person ASAP
- should be incorporated into each lesson plan (either in clinic or for homework)
- jointly planned
