treatment of fluency Flashcards
what is the goal of Lidcombe porgram
eliminate suttering
describe the 2 main parts of lidcombe program
clinical eval: within clinic speech sample; at home sample
case history: onset, type, changes since onset, family hx, previous therapy
case selection criteria for using lidcombe program
tx begins if stutteringhas persisted for more than 6 months after onset
what are child parent and clinician tx goals for lidcombe program
child: eliminate stuttering in all situations and maintain that for 12 months
parent: learn how to conduct tx and measurement activities sufficiently to help child achieve goal
clinician: assist parent in achieving their goal
describe tx procedures of lidcombe program
child and parent/caregiver (whoever spends subtantia amount of time with child) must attent every clinic session togehter
contingent based program
form a working relationship with parent/caregiver
maintenance
lidcombe program therapy continues until the client meets what criteria
over 3 conseecutive weeks:
-%SS less than 1.0 w/in clinic
-SR less than 2.0 outsife the clinic
-SMST less than 1.5 outside clinic
once criteria is met child enters maintenance phase
describe maintenance phase of lidcombe program
parent continuees with program and child returns to clinic in intervals of :
-2 weeks (x2)
-4 weeks x2
-8 weeks x2
-16 weeks x2
what is the goal of Family focused treatment program
desinged to help young children who stutter (age 2-6) achieve and maintain normal fluency while developing healthy, appropriate communication attitudes and effective communication skills
what are the tx components of FFT
Parent-focused: help parents modify their communication behaviors and reduce their concerns about stuttering
child-focused: help children modify their communication behaviors and develop healthy, appropriate communication attitudes
a parent-child training program that is ddivided into 3 comnponents
family focused treatment program
what are the 3 components of fft
- parent communication counseling
- parent and child acceptance of stutteering
- child communication modifications
describe the parent communication counseling component of FFT
parents learn about communication and stuttering, reduce their concerns about their childs speech, discuss the importance of responding to suttering in a supportive manner, and consider other aspects of the childs development to ensure that they do not interfere with treatment
describe the parent and child acceptance of suttering component of FFT
goal is to get the parents and child to understand stuttering and teaching acceptance
tasks include: identification of communication stressors, desensitization, understanding communication, acceptance
describe the child communication modification component of FFT
can include both fluency shaping and stuttering modification strategies as needed
tasks include: fluency shaping, stuttering modification, overall communication skills, concomitant disorders
what happens at the end of FFT program
review and re-assess where parents evaluate their use of the tx strategies and consider the impact of those strategies on the childs fluency
what is the goal of RESTART or Demands and Capacities Model on Treatment
to decrease demand or increase capacities
list the treatment specifics of RESTART
begin session with 10 minute play period
slp provides parent with at home tx instructions during session
slp and parent evaluate child’s speech during play to allow them to select target procedure
slp models target procedure, has parent practice it, then slp provides feedback
15 min of undivided attetnion for home practice
Describe the daily special interaction time for RESTART approach
parent sits down for 15 minutes to five child their undivided attention
goal is to bnoot the childs self-confidence during activties that involve talking or reading
describe changing parental speech rate in the RESTART approach
parent talks with longer pauses,, slower speech movements, and also maintaining a natural intonation
describe substituting modeling and self-talk for demand speech in the RESTART approach
parent is instructed not to ask the child for speech performance. instead parent talks and provides a model
what is the goal of palin parent-child interaction therapy
parents are trained to model helpful strategies and guide their children towards more fluency w/support of their therapist
when is PCIT therapy recommended
child is considered to be at risk of presistent stuttering
parents are concerned and seeking support
child is reacting negatively to the stuttering
describe session structure of PCIT
session1: special time is negotiated where each parent has a 5 minute playtime period approximately 3 and 5 times per week to practice their chosen interaction target in a relaxed, one-on-one setting; parents are asked to make a written record of their special time to allow SLP to provide feedback
Session 2-6: start with feedback from special time; playtime is recorded and then evaluated by parents to discuss possible changes
what is considered to tbe the foundation of PCIT
special time
What are some common goals seen in treatment for teens and adults
reducing frequency and form of stuttering
reducing negative thoughts and feellings about stutering
decreasing avoidance
understanding stuttering and communication
responding to stuttering and bullying
Who is the successful stuttering management program designed for
adolescents and adult secondary stutterers
what is the goal of SSMP
become a successful communicator and enter all speaking situations in a persons life
what does SSMP improve
intensive fluency, speech, stutter, communication, and language skills
what age would you use precision fluency shaping
teens and adults
describe precision fluency shaping
stuttering is treated as a behavioral problem
what is the goal of precision fluency shaping
client relearns the proper means of producing the elemetary speech sounds and then rebuilds thier abiliit to correctly produce syllabes, words, and complete sentences
who is the camperdown program designed for
adults and adolescents
describe the camperdown program
clients are instructed hoow to minimze suttering through use of a fluency technique like prolonged speech
continued practice and shpaing allows client to lern to achieve naturalness and fluency together in their speech
in the camperdown program when is a client placed on a maintenance program
when their speech outside of the clinic becomes highly fluent for several consecutive weeks
who is the american institue of stuttering program meants for
adults, teens, and older children
describe the american institute of stuttering program
its an intensive residential program where you:
-manage and improve speech fluency
-reduction or elimination of fear and avoidance
-strengthen confindence and self-esteem
-development of a new attitude
what is fluency shaping
finding a method of speaking that is incompatible with stuttering and using that strategy for talking all the time
what is the primary goal in therapy when using fluency shaping
the alteration of all speech to a manner incompatible with stuttering
what is not focused on in fluency shaping
-moment of stuttering is not modified
-attitudes, speech fears, and avoidance are generally not dealt with
-do not analyze their stuttering behaviors
how is data kept in fluency shaping
quantitative manner
what is the emphasis of therapy when using fluency shaping
conditioning and reward
when to use fluency shaping
-client can easily modify their fluency’0client seeks high levels of fluency
-client exhibits no or very little fear or avoidance
-client does not have cogntivie ability to use a stuttereing modification program
list the keys to fluency shaping
-find out where fluency breaks down
-assess best method to eliminate stuttering
-behavior modification to reinforce use of technique
-progress up a hierarchy of difficulty
-carryover can be difficult , so plan for it immediately
define stuttering modification
teach person to learn, undesand and monitor their stuttering and when they stutter, they can choose waht to do to make the stuttering easier
what is the primary goal of stuttering modification
modify the moment of stuttering
what is the emphasis of therapy when using stuttering modification
rapport, counseling, teaching, motivation, and self-monitoring skills
what is focused on in suttering modification
attitude, speech fear and avoidance, client must analyze and evaluate their stuttering behaviors
how is data kept in suttering modification
qualitative manner
when to use stuttering modification
-client has difficulty modifying fluency
-client shows significant fear or avoidance
-client does not seek total fluency
-poor attitude or little knowledge of stuttering
keys to stuttering modification
get person to stutter more easily
combination of:
-understanding, monitoring, desensitizing, accepting, and modifying the moment of stuttering
things to keep in mind with stuttering modification
get client to accept stuttering, then give them a technique to improve fluency when they choose to improve
list the 5 domains of traiditonal van riper therapy
-motivatio
-identification
-desensitization
-variation
-stabilization
define van ripers “motivation”
identifying goals, taking to others who stutter, building the therapeutic relationship to develop trust
define van ripers “identification”
education, namaing stuttering (and other behaviors) in others
define van ripers “desensitization”
advertising, pseudostuttering
define van ripers “variation”
freezing, cancellation, pullout, preparatory set
define van ripers “stabilzation”
support groups, self-help
when is a stuttering modification proram appropraite
-when stuttering still persists after fluency induction techniques have been used
-client exhibits significant fear and uses many avoidance behaviors
-consistency is high and adaptation is low
-client doe not want total fluency
when is fluency shaping program appropriate
-when stuttering can be easily eliminated with the use of fluency induction techniques
-client shows very few feards and avoidances
-client can’t understand and/or monitor the tecniques used in stuttering mod therapy
when is a hybrid/mixed approach appropriate
-when someone stuttering remains after fluency inductions, but the client doesn’t show significant fears
-client can modify speech successfully, but lacks understanding of normal speech, stuttering
-client can modify speech successfully, but doesnt want to always use it
list some fluency induction techniques
-DAF
-FAF
-MASKING
-choral speech
-easy onset
-prolonged speech
-rhythmix speech
-reduced rate
-flat intonation
-decreased volume
-modification of respiration
-combinations
what is fluency DAF
delayed auditory feedback: device where you hear speech playback a few seconds later
what is FAF
Frequency altered feedback
what is masking
act like you dont stutter
what is choral speech
group speaking togethre
what is rhytmic speech
speak along to beat; hand clapping/tapping
