Flashcards in 3- Theories about Stuttering Deck (26):
What does Guitar say is the two-stage model of stuttering?
1) PRIMARY STAGE: simple disfluencies based on how the brain handles speech & language production
2) SECONDARY STAGE: more complex interaction of the child's environment and reaction to disfluencies
Describe the primary stage evidence.
- stuttering often emerges from deficits in left help problems
- deficits can result in primary stuttering because the neural circuitry is working in an underdeveloped area
- moved to an area not suited for rapid speech
Describe the secondary stage evidence.
- some children with stutters have more reactive temperaments
- respond to unpleasant stimuli by increasing tension, speeding up, escaping or avoiding
- causes emotional arousal, leads to deeper learning
What are the 5 types of assessments for fluency?
4) Secondary Behaviours
Describe assessment of frequency.
- percentage of syllables stuttered
- each syllable can only be stuttered once
- count obvious avoidance as a stutter
Describe assessment by type
- If child have >50% stutter-like disfluencies, more likely to be stuttering
- E.g. part-word, prolongations, blocks, avoidances
Describe assessment of duration.
Average the duration of the longest 3 stutters.
Describe assessment fo secondary behaviour.
Differentiate escape and avoidance.
Describe assessment of severity.
More subjective, captures the listener experience. Good for measuring progress in treatments to reduce abnormality of stuttering.
Talk about speech samples in stuttering.
Need to make sure the speech sample is representative, by obtaining 2 samples, one in clinic and one..
1) PRESCHOOL: at home
2) SCHOOL: school/home
3) ADO: work/home
Describe an assessment for Preschoolers.
- child's responses and emotions
- parental concerns and expectations
- lagnauge/artic/voice in tact?
- get video of child speaking spontaneously at home
- in clinic parent-child interaction
- in clinic clinician-child interaction
Describe an assessment for School Age children
- child's responses and emotions
- parental awareness
-how stutter affects child at school/home
- interview with parent
- interview with teacher
- classroom observation
- interview with child
Describe an assessment for teens and adults.
- individual attitudes
- recordings of stuttering outside the clinic
- interview with family
- interview with client (open ended Qs)
3) TRIAL THERAPY
- stuttering modification
- fluency shaping
What are treatment goals for all ages of stutterers?
1) Reduce frequency of stuttering (w/o creating secondaries)
2) Reduce abnormality of stuttering
3) Reduce negative feelings, thoughts and attitudes
4) Reduce avoidance
5) Create fluency-facilitating envionrmnet
6) Reduce negative emotions
7) Reduce negative thoughts and attitudes
What are the 2 major camps of treatment?
1) STUTTERING MODIFICATION: reduce abnormality of the stutter, goal is to stutter easier
2) FLUENCY SHAPING: reduce the frequency of the stutter, goal is to stutter less
What is the sequence of therapy?
1) Explore stuttering
2) Make stuttering easy
3) Learn super fluency
4) Use superfluency
What is exploring stuttering?
The first step in the sequence of stuttering therapy.
Explore the child's beliefs, core behaviours, secondary behaviours, thoughts and feelings
What is making stuttering easy?
Second step of the sequence of stuttering therapy, aim is stuttering modification. Teaches "CANCELLATION (back up)" and "PULL OUT"
What is cancellation?
Stuttering modification technique also known as "back up".
Decrease the tension after the stutter but before the next word. Increase the control & desensitize.
What is pull out?
Stuttering modification technique.
Recognize the stutter and catch it, reduce the tension and continue the word
What is learning super fluency?
The idea of fluency shaping, teaches SLOW/FLEXIBLE RATE, PAUSING and EASY ONSET
What is slow rate?
Superfluency technique also known as flexible rate or slow-mo/
Speak slightly slower but not at an unnatural rate.
What is pausing?
Speak in natural phrases with pauses at appropriate times
What is easy onset
Superfluency technique also known as E-Os
Beginning a word with reduced tension
What is using super fluency?
Start in therapy then extend to the real world