OSCE Flashcards
How do you count stuttering moments
Syllables stuttered (SS%)
Define stuttering
- A genetically inherited condition that can result in neurological differences.
- people who stutter can have difficultly coordinating the various movements required for speech.
- Coordination becomes even harder when linguistic demands (e.g. language burst) and physiological arousal (e.g. anxiety) are heightened.
How is stuttering identified
- Objective = you hear or see the behaviour
- Internal = the person describes the feeling of stuttering (loss of control)
- Perceptual = consensus between clinicians
What are the different types of stuttering?
- Repeated movements
- Fixed Postures
- Superfluous behaviours
What are the different types of repeated movements?
- Syllable repetition (AKA Word repetition) Eg.Can-can-can, If.. if.. if..
- Incomplete syllable repetition (AKA Part-word repetition) eg. mu..mu…mummy gone home, wh wh
- Multi-syllable unit repetition (AKA Whole phrase) Eg. I can, I can, I can, can we can we can we,
What are the different types of fixed postures?
- Audible airflow (AKA prolongation) Eg. Maa-aa-mmy gone home, I’mm-mm meeting, I wa-a-ant to leave,
- Without audible airflow (AKA block) Eg. Mu-…-mmy gone, I wa-…-ant to go home, I ca-…-an go to the shops, we we-…-nt to the beach,
What are the different types of superfluous behaviours?
- verbal (AKA Verbal additions to speech / interjections) Eg. I um went um to the shops um today, I willow want to willow
- non-verbal. Eg blinking, face grimacing, head movements
How does stuttering impact a person’s life?
Most common negative effect is social anxiety
What are 6 conditions that reduce or eliminate stuttering?
- Acting
- Singing
- Speaking in unison
- Speaking in rhythm
- Whispering
- Delayed auditory feedback
What is speech restructuring?
Where individuals are taught a novel speech pattern to control their stuttering e.g. the Camperdown Program
What is operant conditioning in relation to stuttering treatment?
Method of learning that uses rewards and punishments. Only effective if the behaviour trying to change is under voluntary control. Stuttering is not under voluntary control, but there is some evidence to suggest that stuttering responds to operant methods in particular in children, e.g. The Lidcombe Program.
Average age of onset
33m
How likely is natural recovery?
2/3 -3/4 of children will recover without formal treatment, 90% within the first-year post onset. We cannot predict if natural recovdery will occur.
Predictors of onset
- Male
- Twin
- Advanced vocabulary
- Maternal educational attainment
Predictors of non-natural recovery
- Male
- Severe
- Family history
What causes stuttering?
- Much research but no comprehensice answer
- Likely neurological, genetic link (family history)
- A slight glitch or missed timing in the part of the brain involved in speech. What happens in the brain is minor but leads to significant interruptions to speech
- Not caused by parenting, traumas, psychological factors however we know these factors can increase stuttering severity - Risk factors can cause increases to stuttering severity
What is cognitive behaviour therapy in relation to stuttering?
Targets the thoughts and beliefs the person has directly. These thoughts and beliefs are the cause for anxiety, not the stuttering itself (e.g. what will people think if I stutter)
Cognitive therapy - Challenging people’s beliefs directly through discussion - logically challenging the thoughts
Behaviour therapy - target thoughts indirectly through exposure exercises and examining what outcomes actually occur - discussing what actually occurs
What is the link between stuttering and anxiety.
There is a link but there is now evidence to show that anxiety does not cause stuttering. Stuttering cvan be worse when person is feeling anxious. And stuttering can also cause social anxiety.
What are some tools that could be used to assess if anxiety is present?
- The Unhelpful Thoughts & Beliefs About Stuttering (UTBAS)
- The Safety Behaviour Checklist
- The Fear of Negative Evaluation (FNE) scale
- Subjective Units of Distress Scale (SUDS)
- Communication Attitude Tests: CAT, KiddyCat, BigCat
- Overall Assessment of the Speaker’s Experience
of Stuttering
What is the UTBAS
Unhelpful Thoughts and Beliefs About Stuttering
- A stuttering-specific measure of the unhelpful thoughts and beliefs that may drive social anxiety for those who stutter.
What is IGlebe?
A standalone online CBT for Stuttering - found to be as effective as face to face treatment with a psychologist
What are safety behaviours? Examples?
looking away, avoiding eye contact, overusing non-verbal communication, shortened utterances
Why are severity ratings important?
- Monitoring Progress
- Immediate Feedback
- Guiding Therapy Adjustments
- Engagement and Motivation
- Objective Measurement
- Communication with Therapists
- Early Identification of Issues
What are the main components of Lidcombe?
- Severity ratings
- Verbal contingencies
What are the main components of Westmead?
- Severity ratings
- Using syllable timed speech
What are the main components of Oakville?
- Severity ratings
- Using syllable timed speech
- Verbal contingencies
What are the main components of Restart?
What are the main components of Camperdown?
What are the main components of SITO?
What age group is Lidcombe suitable for?
What age group is Westmead suitable for?
What age group is Oakville suitable for?
What age group is Restart suitable for?
What age group is SITO suitable for?
Older school aged children and adolescents
When should stuttering treatment start?
As soon as possible after onset for best chance at success
What is The Safety Behaviour Checklist?
Safety behaviours are used by those who are socially anxious as an attempt to prevent a
perceived threat or negative event from occurring. There are five categories on the checklist
* General Safety Behaviours
* Practice and Rehearsal
* General Avoidance
* Choose Safe and Easy People
* Control Related
What is the The Fear of Negative Evaluation (FNE) scale?
What is the Subjective Units of Distress Scale (SUDS)
What are the Communication Attitude Tests: CAT, KiddyCat, BigCat?
The Communication Attitude Tests are a series of tools designed to assess the attitudes and feelings of individuals who stutter towards their communication. They aim to understand the psychological and emotional aspects of stuttering, which can significantly impact therapy outcomes.
* Communication Attitude Test (CAT): ages 6-14
* KiddyCAT: ages 3-6
* BigCAT: Adults and adolescents
The tests allow clinicicians to
* Identify Negative Attitudes
* Personalise therapy
* Track Progress
* Improve Outcomes
What is the OASES?
Overall Assessment of the Speaker’s Experience of Stuttering
A stuttering impact measure for adults, adolescents and schoolage
children involving domains of general information, reactions to stuttering, communication in daily situations, and quality of life.
What are the different verbal contingencies?
Stutter free speech - teach these ones first
* Praise - that was lovely smooth talking
* Request for self evaluation - was that smooth? Were there any bumps then?
* Acknowledge - that was smooth
Unambiguous stuttering
* Acknowledge - that was bumpy, that wqas a stuck word
* Request for self correction - can you say that again? Can you say that smoothly? OR model and the chuild copies
What is the hierarchy of independent practise tasks in Camperdown?
- Reading the text (anaconda passage)
- Reading something else
- Picture description
- Monologue
- Easy conversation
- More challenging conversation (eg clinician asking technical questions)
Hierarchy of tasks in syllable timed speech
Stages of Lidcombe
Stages of Camperdown
Stages of Oakville
