Week Three

Question 1

What are the ABCs of stuttering?

Answer 1

Affective
- emotional makeup of a child and their responses

Behavioural
- What a child does/doesn’t do
- what others do/don’t do in response to stuttering

Cognitive
-Thoughts and attitudes about stuttering and communication

Question 2

What are some differences in assessment between children and adults who stutter?

Answer 2

• More reliance on parents
• History of stuttering/onset more accurate with children
• Children can’t always verbalise how they feel
• might be co-occurring disorders with children e.g., speech sound disorders
  Different ways may be needed to elicit speech in children

Question 3

What does an assessment of a pre-schooler who stutters look like?

Answer 3

• Obtaining information from caregivers
• Observing and testing the children
• Making prognosis
• Concluding parent conference

Question 4

What is involved in a case history?

Answer 4

1) Personal & family information
- parents and stuttering history
- siblings and stuttering history
- languages at home
- stuttering history of other relatives

2) Time and Circumstances at onset
- when stuttering was first noticed (most important question)
- sudden or gradual onset
- contributing health and emotional factors

3) Symptomology at onset and present
- primary and secondary characteristics
- important to know at onset and current symptoms so we can see if things are getting better or worse
- Scales (Yairi’s scale, Lidcombe scale)

4) general health and development
- motor development, behavioural problems
- co-existing problems

Question 5

What is the most important question in a case history?

Answer 5

Time since stuttering onset. The longer the amount of time since onset, the less likely spontaneous recovery is.

Question 6

What is a caregiver interview?

Answer 6

After observation but before more comprehensive formal Ax procedures
- what do they want to learn from this assessment
- what are their best hopes for your child

Question 7

What are some caregiver report instruments?

Answer 7

• Impact of stuttering on preschool children and parents (ISPP)
• Palin Parent rating scales (Palin PRS)

Question 8

What is involved in observing and testing preschoolers?

Answer 8

1) speech samples
- at least 2 samples in clinic on different days + 1 at home
- in clinic >500, preferably 1000 syllables
- not just total number of disfluencies but also type, and length

2) secondary characteristics
- head turn, lip pursing, eye blinking observed in 75% of children near onset
- Severity rating

3) awareness and emotional reactions
- puppet test
- direct questioning
- Parent report
- KiddyCAT (assesses communication attitudes of CWS)
- Impact of stuttering on preschoolers and parents (ISPP)

4) anxiety, temperament & personality
- Short behavioural inhibition scale (SBIS)

5) lanaguage, phonology, motor and hearing skills
- CELF-P

6) overall diagnosis and severity
- scales (Yairi 8 point scale, Lidcombe 10 point scale)
- Test of childhood stuttering (TCOS)
- Stuttering severity instrument (SSI-4)

Question 9

What are some additional risk factors to take into consideration when making a prognosis?

Answer 9

• family history
• male sex
• above 3.5 years at onset
• Higher rate of SLD
• lower speech sound skills
• lower receptive language
  -lower expressive language
• stuttering trajectory
• emotional reactivity

Question 10

What is involved in concluding parent conference?

Answer 10

Outline main characteristics of child’s stuttering

Discuss possible future course

Give advice about:
Stuttering treatment

Home environment
- decrease various pressures
- decrease emotional and physical excitement
- more relaxed slow paced activities
- speak slower
- promote child’s self confidence

Handling stuttering
- listen patiently
- repeat child’s stuttered word: easily and stretched a bit
- reinforce fluency
- show empathy