treatment of fluency Flashcards

1
Q

what is the goal of Lidcombe porgram

A

eliminate suttering

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2
Q

describe the 2 main parts of lidcombe program

A

clinical eval: within clinic speech sample; at home sample

case history: onset, type, changes since onset, family hx, previous therapy

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3
Q

case selection criteria for using lidcombe program

A

tx begins if stutteringhas persisted for more than 6 months after onset

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4
Q

what are child parent and clinician tx goals for lidcombe program

A

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

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5
Q

describe tx procedures of lidcombe program

A

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

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6
Q

lidcombe program therapy continues until the client meets what criteria

A

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

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7
Q

describe maintenance phase of lidcombe program

A

parent continuees with program and child returns to clinic in intervals of :
-2 weeks (x2)
-4 weeks x2
-8 weeks x2
-16 weeks x2

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8
Q

what is the goal of Family focused treatment program

A

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

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9
Q

what are the tx components of FFT

A

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

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10
Q

a parent-child training program that is ddivided into 3 comnponents

A

family focused treatment program

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11
Q

what are the 3 components of fft

A
  1. parent communication counseling
  2. parent and child acceptance of stutteering
  3. child communication modifications
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12
Q

describe the parent communication counseling component of FFT

A

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

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13
Q

describe the parent and child acceptance of suttering component of FFT

A

goal is to get the parents and child to understand stuttering and teaching acceptance

tasks include: identification of communication stressors, desensitization, understanding communication, acceptance

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14
Q

describe the child communication modification component of FFT

A

can include both fluency shaping and stuttering modification strategies as needed

tasks include: fluency shaping, stuttering modification, overall communication skills, concomitant disorders

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15
Q

what happens at the end of FFT program

A

review and re-assess where parents evaluate their use of the tx strategies and consider the impact of those strategies on the childs fluency

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16
Q

what is the goal of RESTART or Demands and Capacities Model on Treatment

A

to decrease demand or increase capacities

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17
Q

list the treatment specifics of RESTART

A

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

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18
Q

Describe the daily special interaction time for RESTART approach

A

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

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19
Q

describe changing parental speech rate in the RESTART approach

A

parent talks with longer pauses,, slower speech movements, and also maintaining a natural intonation

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20
Q

describe substituting modeling and self-talk for demand speech in the RESTART approach

A

parent is instructed not to ask the child for speech performance. instead parent talks and provides a model

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21
Q

what is the goal of palin parent-child interaction therapy

A

parents are trained to model helpful strategies and guide their children towards more fluency w/support of their therapist

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22
Q

when is PCIT therapy recommended

A

child is considered to be at risk of presistent stuttering

parents are concerned and seeking support

child is reacting negatively to the stuttering

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23
Q

describe session structure of PCIT

A

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

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24
Q

what is considered to tbe the foundation of PCIT

A

special time

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25
Q

What are some common goals seen in treatment for teens and adults

A

reducing frequency and form of stuttering

reducing negative thoughts and feellings about stutering

decreasing avoidance

understanding stuttering and communication

responding to stuttering and bullying

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26
Q

Who is the successful stuttering management program designed for

A

adolescents and adult secondary stutterers

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27
Q

what is the goal of SSMP

A

become a successful communicator and enter all speaking situations in a persons life

28
Q

what does SSMP improve

A

intensive fluency, speech, stutter, communication, and language skills

29
Q

what age would you use precision fluency shaping

A

teens and adults

30
Q

describe precision fluency shaping

A

stuttering is treated as a behavioral problem

31
Q

what is the goal of precision fluency shaping

A

client relearns the proper means of producing the elemetary speech sounds and then rebuilds thier abiliit to correctly produce syllabes, words, and complete sentences

32
Q

who is the camperdown program designed for

A

adults and adolescents

33
Q

describe the camperdown program

A

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

34
Q

in the camperdown program when is a client placed on a maintenance program

A

when their speech outside of the clinic becomes highly fluent for several consecutive weeks

35
Q

who is the american institue of stuttering program meants for

A

adults, teens, and older children

36
Q

describe the american institute of stuttering program

A

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

37
Q

what is fluency shaping

A

finding a method of speaking that is incompatible with stuttering and using that strategy for talking all the time

38
Q

what is the primary goal in therapy when using fluency shaping

A

the alteration of all speech to a manner incompatible with stuttering

39
Q

what is not focused on in fluency shaping

A

-moment of stuttering is not modified
-attitudes, speech fears, and avoidance are generally not dealt with
-do not analyze their stuttering behaviors

40
Q

how is data kept in fluency shaping

A

quantitative manner

41
Q

what is the emphasis of therapy when using fluency shaping

A

conditioning and reward

42
Q

when to use fluency shaping

A

-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

43
Q

list the keys to fluency shaping

A

-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

44
Q

define stuttering modification

A

teach person to learn, undesand and monitor their stuttering and when they stutter, they can choose waht to do to make the stuttering easier

45
Q

what is the primary goal of stuttering modification

A

modify the moment of stuttering

46
Q

what is the emphasis of therapy when using stuttering modification

A

rapport, counseling, teaching, motivation, and self-monitoring skills

47
Q

what is focused on in suttering modification

A

attitude, speech fear and avoidance, client must analyze and evaluate their stuttering behaviors

48
Q

how is data kept in suttering modification

A

qualitative manner

49
Q

when to use stuttering modification

A

-client has difficulty modifying fluency
-client shows significant fear or avoidance
-client does not seek total fluency
-poor attitude or little knowledge of stuttering

50
Q

keys to stuttering modification

A

get person to stutter more easily

combination of:
-understanding, monitoring, desensitizing, accepting, and modifying the moment of stuttering

51
Q

things to keep in mind with stuttering modification

A

get client to accept stuttering, then give them a technique to improve fluency when they choose to improve

52
Q

list the 5 domains of traiditonal van riper therapy

A

-motivatio
-identification
-desensitization
-variation
-stabilization

53
Q

define van ripers “motivation”

A

identifying goals, taking to others who stutter, building the therapeutic relationship to develop trust

54
Q

define van ripers “identification”

A

education, namaing stuttering (and other behaviors) in others

55
Q

define van ripers “desensitization”

A

advertising, pseudostuttering

56
Q

define van ripers “variation”

A

freezing, cancellation, pullout, preparatory set

57
Q

define van ripers “stabilzation”

A

support groups, self-help

58
Q

when is a stuttering modification proram appropraite

A

-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

59
Q

when is fluency shaping program appropriate

A

-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

60
Q

when is a hybrid/mixed approach appropriate

A

-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

61
Q

list some fluency induction techniques

A

-DAF
-FAF
-MASKING
-choral speech
-easy onset
-prolonged speech
-rhythmix speech
-reduced rate
-flat intonation
-decreased volume
-modification of respiration
-combinations

62
Q

what is fluency DAF

A

delayed auditory feedback: device where you hear speech playback a few seconds later

63
Q

what is FAF

A

Frequency altered feedback

64
Q

what is masking

A

act like you dont stutter

65
Q

what is choral speech

A

group speaking togethre

66
Q

what is rhytmic speech

A

speak along to beat; hand clapping/tapping