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SPSC 451 - Fluency > Week Five > Flashcards

Week Five Flashcards

1
Q

How does treatment differ for adults and children?

A

Children can recover from stuttering, adults cannot.

Therefore, treatment goals and interventions look different.

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2
Q

What are some general areas treatment of stuttering in children can cover?

A
  • Altering parent-child interactions
  • Modifying speech motor patterns
  • Modifying the emotional domain
  • Reinforcing fluency and ‘punishing’ stuttering via operant conditioning
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3
Q

What are four evidence based programmes for CWS?

A
  1. Lidcombe Programme
  2. Slow-stretched/rhythmic speech
  3. Palin Parent-child interaction approach (PCI)
  4. Demands and capacities model intervention (RESTART-DCM)
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4
Q

What is the different between indirect and direct interventions?

A

Direct directly target fluency

Indirectly target fluency but still work one-on-one with the child (e.g., makes environmental changes)

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5
Q

What is the goal of intervention for CWS?

A

Achieve typical fluency for child’s age

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6
Q

True/false, all the interventions follow different approaches

A

True, they all have different approaches.

However, they do have similarities

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7
Q

What age is the Lidcombe Programme designed for?

A

For children up to 6 years old, but there is research supporting its use in older children.

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8
Q

When would use of the Lidcombe Programme be appropriate?

A

Enough time for natural recovery has passed (1 year)

OR severity ratings do not show decline
OR high levels of distress
OR known risk factors for persistance

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9
Q

What is the goal of Lidcombe?

A

Nearly stutter free speech for one year or more

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10
Q

Overview of Lidcombe method

A
  • Parent delivered
  • Direct stuttering treatment
  • Operant conditioning: stuttering can be changed via verbal consequences delivered by parents
  • Doesn’t focus on environmental or emotional aspects
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11
Q

What are the two stages of Lidcombe?

A

Stage One
- Weekly therapy sessions
- Daily 15 minute practise sessions at home with parent (Talking Time) with aim of achieving SR of 0-1
- Parents structure speech to be as simple as necessary but as complex as possible
- Verbal contingencies given
- Daily monitoring of SR rating
- Aim to achieve daily SR ratings of 0-1 for 3 weeks before moving to stage 2

Stage Two
- To prevent relapse
- Typically lasts around 12 months
- Withdraw reinforcement
- Reduce clinic visits

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12
Q

What is the goal of slow-stretched/rhythmic speech?

A
  • (nearly) stutter-free speech
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13
Q

Overview of slow-stretched/rhythmic speech

A
  • Based on the idea that stuttering results from articulatory discoorindation due to mistiming of speech movement
  • Home practise 4-6 times a day for 5-10 minutes administered by parents
  • Saying each syllable with equal stress to a rhythmic beat
  • Daily SR ratings
  • Maintenance period
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14
Q

What is the goal of the Palin parent-child interaction?

A
  1. Reduce negative impact of stuttering on child
  2. Decrease children’s stuttering to WNL
  3. Reduce family anxiety about stuttering
  4. Increase parent’s abilities to manage stuttering
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15
Q

Overview of the Palin parent-child interaction?

A
  • Children up to 7 years old
  • Decision to start treatment is based on impact of stuttering on parents or child
  • Based on the multifactorial model of stuttering
  • Treatment aims to reduce environmental pressures through parent training
  • Indirect approach
  • Intervention strategies introduced through 5 minute special time, 5 times a week
  • initial block of 6 in-clinic sessions, followed by 6-weeks homes consolidation period
  • Treatment is solutions focused
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16
Q

What are some Palin parent-child interaction strategies that might be used in therapy?

A

Parent Interaction Strategies:
- Following child’s lead in play
- Using pausing
- Matching child’s speech rate
- Monitoring Language Complexity through play

Family Strategies:
- Building confidence
- Managing child’s emotions
- Family turn-taking
- Talk openly about stuttering for desensitization
- Fluency only one aspect of communication

17
Q

What are the goals of RESTART-DCM?

A

Achieve normal fluency

Specific goals differ across families
- Reduce stress on the child
- Enhance child’s capacity for fluency

18
Q

Overview of RESTART-DCM

A
  • For children aged 2-6 year olds
  • For children who show signs of physical struggle/other reactions to stuttering or have risk factors for chronic stuttering
  • Based on the demands and capacities model of stuttering: stuttering is caused by an imbalance between the demands and capacities
  • Intervention aims to achieve balance between demands to communicate and motor, linguistic, socioemotional and/or cognitive capacities
  • If stuttering persists, direct approach by modelling slower, more relaxed and smoother speech

Approach includes:
- Video recorded parent-child interaction
- weekly 1 hour treatment sessions
- 15 minutes of “parent child special time” per day, minimum 5 days per week

  • Parents keep daily logbook
19
Q

What are some similarities between the different treatment approaches?

A
  • All have one-on-one time with parents/children
  • All use praise and support for the child
  • All assess progress
  • All have clinic visits/SLT support
  • Time demand for parents
20
Q

What are the four domains of DMC?

A
  1. Motoric domain
  2. Linguistic domain
  3. Emotional domain
  4. Cognitive domain

These domains apply to both the demands and capacities

21
Q

What are the phases of RESTART-DCM?

A
  1. Assessment
  2. First Parent conference
  3. Therapy Phase One: Lowering demands
  4. Therapy Phase Two (if necessary): Increasing capacities
  5. Therapy Phase Three (if necessary): Enhancing fluency more directly
  6. Tapering off treatment
22
Q

What is covered in the RESTART-DCM assessment phase?

A
  • Parent interview
  • Parent/child interaction analysis
  • Child assessment
  • Assessment form
23
Q

What is covered in the RESTART-DCM first parent conference phase?

A
  • Explain DCM model and Ax results
  • Explain treatment process (focus and starting point; log book; 15 minutes special time)
24
Q

What is covered in the RESTART-DCM therapy phase One?

A
  • 1 hour session, once a week
  • Reducing demands
  • After 4 clinician-parent-child sessions, 1 session without child
  • Step wise approach
  • Clinician models behaviour change during free play, parent observes ——— parent applies modeled behaviour during play ——- SLT and parent discuss attempt
25
Q

What is covered in the RESTART-DCM therapy phase two?

A
  • Increasing capacites
26
Q

What is covered in the RESTART-DCM therapy phase three?

A
  • Targeting fluency more directly
27
Q

What is covered in the RESTART-DCM therapy phase four?

A
  • Tapering off therapy

SPSC 451 - Fluency (11 decks)

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