Lecture 4 Flashcards
ASSESSMENT OF STUTTERING
EXPERIENCE WITH PROBLEM
- History of stuttering from onset to present
- Exacerbations and remissions
- Past treatment
(professional and nonprofessional) - Results of treatment
- Reasons for coming for help
HISTORY
- Birth history
- Family history – in general and re stuttering
- Developmental history
Language development
Motor development - Medical history
- School history
SOCIAL ASPECTS
- Effects on
- Behavior
- School
- Friends
- Family
- Job
PSYCHOLOGICAL ASPECTS
PSYCHOLOGICAL ASPECTS
* Client’s perspective
* Client’s personality
* Client’s adjustment in general
* Client’s objectivity regarding stuttering
VARIABLE COMMUNICATIVE
STRESS
VARIABLE COMMUNICATIVE
STRESS
* Topic variation
* Argument
* Competition and time pressure variation
* Listener reaction variation
* Fatigue variation
* Audience variation
SPEECH SAMPLE
SPEECH SAMPLE
* Conversational speech
* Automatic speech
* Choral speaking/reading
* Oral reading
* Variable communicative stress
THE STUTTERING SEVERITY INSTRUMENT – 4
(SSI-4; RILEY, 2009
Purpose, Norms and sampling task
- Purpose
Rating stuttering severity - Sampling tasks
Oral reading
Conversation/narration - Norms
Client’s performance compared to other people who stutter
Norm range: preschool to adults
STUTTERING SEVERITY INSTRUMENT (SSI)
3 components
- 3 components – frequency, duration, physical concomitance
Frequency
Sample at least 200 words, reads aloud or describes a picture, could be more than one
sample. Frequency counts of each sample translates into the task score. The total
frequency score is calculated
Duration
The 3 longest stuttering events are measured in order to calculate the mean duration
for 3, in seconds. It is converted to a total duration score.
Physical concomitants
* The secondary behaviors are divided into 4 subcategories, from 0 to 5.
* The scores from all 4 are added, to show the physical concomitants score.
The total overall score, frequency, duration, and physical concomitance
Is measured against the severity ratings, ranging from 0 to 45
MEASURES OF STUTTERING
Formula and what do you measure ?
- Fluency Measurement
- Percent words (syllables) stuttered (%SW) / (%SS)
For diagnostic assessment, post-clinic and follow-up
Count the syllables stuttered and the total number of syllables spoken
Formula – total number of stuttered syllables x 100%
total number of syllables spoken
Example – number of stuttered moments 50 x 100
total number of syllables 300
Frequency of stuttering: 16.6%
MEASURES OF STUTTERING
Duration
Overt features
- Duration
Typical measure is average length in seconds - Overt features
Core behaviors
Accessory behaviors
Severe struggle behaviors
SPEECH RATE
- Andrews and Ingham (1971) presented normative data
for adult speaker - For conversation(162-232 SPM – syllables per minute
or 115-165 WPM) - Reading rates are quicker (210—265 SPM or 150—
190 WPM)
SPEECH, LANGUAGE AND HEARING
- Articulation
- Voice
- Rate
- Receptive/expressive language
- Rule out a high level aphasia or apraxia
- Identify any coexisting language problems
- Hearing
OTHER POSSIBLE INFORMATION
Psychological and neurological testing
- Psychological testing
Achievement
Intelligence
Personality and adjustment - Neurological testing
Sensory-motor testing
Motor coordination
EEG
DIAGNOSIS OF THE
PRESCHOOLER
- Speech tasks
- Spontaneous speech – tape recorded
- Self-talk to parallel talk
- Talking about toys, pictures, family pets, friends
- Automatic speech – singing, reciting nursery rhymes
- Listener variations – parents, siblings, clinician
PERSISTENCE OF STUTTERING SIGNS
- Male
- Family history of persistence
- Little or no decrease in SLD by 12 months post-onset
- 2-3 times more SLDs:
- Children Who Stutter (CWS): SLD = 66%
- Normally Fluent Children (NFC): SLD = 28%
- Longer strings of part word repetitions
- Faster repetitions
- More secondary behaviors
- Patterns of clustering
- Relatives who stuttered, didn‘t recover
- Language delay
