Treatment in School Age+

Question 1

Three long-term goals of treatment

Answer 1

1. Improve communication
2. Increase forward-moving speech (not fluency!)
3. Increase autonomy

*Fluency may be a distal goal

Question 2

Principles of change (4)

Answer 2

1. Move toward rather than away from the problem
2. Assume responsibility for taking action
3. Restructure the cognitive view of self and the problem
4. Recruit the support of others

Question 3

Exploring Talking

Answer 3

Gives the client the opportunity to create objectivity by focusing on the anatomy and physiology of speech rather than the emotional aspects. Also helps establish a common terminology between the clinician and the client

Question 4

Freezing

Answer 4

Staying in the moment of stuttering to increase awareness, desensitize the patient, and reduce avoidance

Question 5

Eye contact

Answer 5

Maintaining eye contact during stuttering to desensitize the speaker and help the listener know that the PWS is still talking

Question 6

Types of fluency

Answer 6

1. Automatic fluency
2. Controlled uninterrupted speech (tenuous fluency)
3. Controlled interrupted speech (most stuttering)
4. Automatic dysfluency (rare)

Question 7

Open Stuttering

Answer 7

Stutter openly in session without avoiding it; model this first, then allow practice in session, then out of session; creates desensitization for speaker and lsiteners

Question 8

Pseudostuttering

Answer 8

Insert stuttering into speech. This allows PWS a sense of control while stuttering and desensitizes them. Also builds awareness of what happens physically when they stutter.

Question 9

Education

Answer 9

Client learns more about stuttering, creating a sense of agency. Client can also present information to class or workplace to increase awareness.

Question 10

Reduce time pressure

Answer 10

Increase the patient’s tolerance for time pressure to help desensitize them and increase their sense of control

Question 11

Self-Disclosure

Answer 11

Informing the listener that the PWS stutters; helps desensitize both the speaker and the listener as well as facilitating other speaking strategies

Question 12

Changing rate

Answer 12

Pt. slows overall speech by pausing; has a fluency enhancing effect, possibly because of increased attention and coordination

Question 13

Cancellation

Answer 13

When the pt. stutters
1. Stop
2. Take a pause and reflect on what happened
3. Repeat the sound with easy-onset/light contact
This helps pt. ID stuttering moments, reduces time pressure, and replaces the stuttered production with a fluent production.

Question 14

Pull-out

Answer 14

The client “catches” the stutter, locates the source of tension, and releases that tension to help promote forward moving speech

Question 15

Easy-onset/light contact

Answer 15

Start with an exhalation and low volume; light contact of articulators for consonants

Question 16

EXTREME Anti-avoidance

Answer 16

Strive for worst-case scenarios such as hang-ups on phone or people walking away. This helps desensitize the client and reduces avoidance; also helps pt. advertise in a public space

Question 17

Overarching goal of all therapies

Answer 17

TRANSFER–focus on the process rather than the outcome to help facilitate home practice an generalization of strategies