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Clinical Methods > 3.01 - Treatment for Fluency Disorders > Flashcards

3.01 - Treatment for Fluency Disorders Flashcards

(65 cards)

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1
Q

What are the four fluency disorders?

A

Stuttering

Cluttering

Neurogenic Stuttering

Psychogenic Stuttering

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2
Q

What four things does fluent speech contain?

A

Rate

Continuity

Rhythm

Effort

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3
Q

Over ________ Americans stutter.

A

3 Million

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4
Q

The male to female ratio for stuttering is __:__.

A

4:1

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5
Q

What is the cause of stuttering?

2

A

Unknown

Neuro-motor basis seems influenced by genetic & environmental factors

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6
Q

What are the three core behaviors of stuttering?

A

Repetitions

Prolongations

Blocks

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7
Q

What are secondary behaviors to stuttering?

A

Those that develop as a reaction to the core stuttering behavior

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8
Q

What are the two categories of secondary behaviors to stuttering?

A

Escape

Avoidance

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9
Q

What are escape behaviors to stuttering?

3

A

Head nods

Blinks

Jaw tremors

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10
Q

What are avoidance behaviors to stuttering?

3

A

Substitutions

Tension

Pauses

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11
Q

What is another important element to stuttering therapy?

A

The client’s attitudes and emotions towards stuttering

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12
Q

Stuttering is a ______ speech disorder wherein there are _____ or _____ speech/language networks in the brain.

A

Neural Motor

Slow developing

Inefficient

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13
Q

Some children persist in stuttering because of what two things?

A

Factors within the child

Factors within the environment

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14
Q

What factors within the child can contribute to stuttering?

4

A

Family history

Sensitive temperment

Male gender

Presence of other speech/language disorders

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15
Q

What factors within the child’s environment can contribute to stuttering?

(4)

A

Rapid-fire, high-pressure, high-level conversation

Impatience or anxiety about the child’s stuttering

“Traumatic” events in the child’s life

High expectations

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16
Q

What are normal nonfluencies?

A

Effortless disfluencies associated with linguistic developement

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17
Q

What are normal nonfluencies experienced by many children between 2-8 years?

(5)

A

Phrase repetitions

Interjections (um)

Revisions

Normal rhythm and stress is maintained

No tension or tremors

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18
Q

What three things may signal an “abnormal” disfluency in young children?

A

Frequent (More than 10%)

Occurs in several situations

Occurs over longer periods of time

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19
Q

Dysfluencies primarily occur on ______.

A

The first sound/syllable

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20
Q

What types of disfluencies tend to not be normal?

4

A

Repetitions of sounds or syllables

Repetitions of short words

Prolongations

Blocks

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21
Q

When dealing with preschool stuttering, we need to distinguish between ____________.

A

Normal nonfluencies and stuttering

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22
Q

When dealing with preschool stuttering, it is important to address _________.

A

Parental concern

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23
Q

What four things can parents of stuttering preschoolers do?

A

Give the child more time to talk (1 second pause)

Talk more slowly

Use shorter, simpler sentences and ask fewer questions

Don’t correct or tell the child to slow down (adds pressure)

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24
Q

What two things does direct intervention for stuttering preschoolers contain?

A

Exploring speech and stuttering

Helping a child to modify speech

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25
When working with older children and adults who stutter, what is the focus not on? What is it on?
Not on whether or not the person is stuttering On what they can do when they are disfluent to become more fluent
26
When working with older children and adults who stutter, what two types of assessment do we do? (2)
Measure core stuttering behaviors, secondary behaviors, and attitudes/emotions Dynamic assessment to identify strategies to help them be more fluent
27
When working with older children and adults who stutter, what sorts of treatment can we offer? (4)
Using fluency shaping techniques to establish fluent speech Stuttering modification techniques to help in moments of stuttering Helping to generalize skills to spontaneous speech Helping the client carryover skills to environment outside the clinic
28
How do we measure the frequency & type of disfluency? | 2
Count each disfluency one time (1 pt per word) Divide the number of disfluencies by the total number of syllables
29
When might we measure the length of a stutter?
In severe stuttering moments
30
Are there scales to measure each type of disfluency: repetitions, prolongations, & blocks?
Yes
31
Are there scales to measure attitudes and emotions?
Yes
32
Should we assess situations & explore techniques that can increase or decrease fluency?
Yes
33
What is fluency shaping? | 3
Goal is to increase fluent speech You teach the client techniques to produce fluent speech You gradually shape the techniques to sound as normal as possible
34
What is stuttering modification? | 3
Goal is to teach the client to stutter more easily You help the client identify what to do when they stutter You teach strategies to modify speech during stuttering moments
35
Do you have to chose a fluency shaping or a stuttering modification technique?
No. You can combine them
36
What are six Fluency Shaping/Enhancing techniques?
Easy onsets Decrease speaking rate Light articulatory contact Continuous phonation Change the overall speech pattern Delayed auditory feedback
37
What are the two treatment techniques for stuttering?
Modifying stuttering making episodes acceptable Focusing on the moment of stuttering
38
What are the six ways we can focus on the moment of stuttering?
Identification Desensitization Relaxation Pull-Outs/In-Block Corrections Post-Block Corrections Preparatory Sets (rehearse fluent speech)
39
Who came up with the Techniques to Treating the Entire Disorder (Stuttering)?
J. Scott Yaruss, Ph.D.
40
What are the main points of the Techniques to Treating the Entire Disorder (Stuttering)? (5)
Addressing Impairment: Improving Fluency Addressing Impairment in Body Function: Techniques to Modify Stuttering Behaviors Reducing Physical Tension Easy Stuttering - Voluntary Behaviors Addressing the Rest of the Disorder
41
How do we address the impairment and improve fluency?
Focus on changing timing or tension Learning guidelines to reduce speaking rate Changing timing through pausing Changing timing through pacing Changing tension through light contact Changing timing & tension through easy starts
42
How do you focus on changing timing? (stuttering) | 3
Reducing rate & pace Pausing & phrasing Easy starts
43
How do you focus on changing tension? (stuttering) | 4
Light contact Easy starts/easing in Pulling/easing out Cancelation
44
How do you learn guidelines for reducing speaking rates? (stuttering) (4)
Practice learning the slow rate before you try it for real Use natural intonation and rhythm Do not use choppy/robot speech or stretch out all the words Slower, natural rates can be incorporated into all activities
45
How can you change timing through pausing? (stuttering) | 3
Increase the length of time between words and phrases Put pauses in natural locations Pauses should not be too long (uncomfortable silence)
46
How can you changing timing through pacing? (stuttering) | 2
Manage the pace Goal is effective and successful speech
47
How can you change tension through light contact? (stuttering) (2)
Try to reduce physical tension as articulators touch Practice
48
More tension means more ______.
Stuttering
49
How can you change timing & tension through easy starts? | 2
Reduce the pace and physical tension at the beginning of phrases Use when the individual knows they are about to stutter
50
How can you address impairment in body function: techniques to modify stuttering behaviors? (2)
Explore stuttering Learn what they are doing when they stutter
51
How do you explore stuttering? | 5
Learn about the speech mechanism Learn how articulators move during stuttered and fluent speech Stay in the block to learn how to move articulators to change stuttering Develop self-monitoring skills & desensitize stuttering Pretend to stutter (pseudostuttering)
52
How can you reduce physical tension? (stuttering) | 3
Tension & struggle are normal reactions Physical tension during stuttering is a learned reaction Reduce tension during pseudostuttering (cancellation, pull outs) and practice with real stutters
53
What is easy stuttering: voluntary behaviors? | 2
Learning that the way you stutter can change Reduces the tendency to hide stuttering
54
How can you change the way you stutter?
Bouncing Gliding Stretching
55
Why is hiding stuttering bad?
The more it is hidden, the more likely it is to occur Comfort with stuttering releases muscular tension and prevents bigger blocks
56
What is addressing the rest of the disorder? (stuttering)
Techniques for addressing the individual's ABC reactions
57
What are the ABC reactions to stuttering?
Affective Behavioral Cognitive
58
What are the Affective reactions to stuttering?
The experience of embarrassment, shame, isolation, fear, and/or anxiety about speaking
59
What are the Behavioral reactions to stuttering? | 2
Physical tension and struggles when speaking Avoiding speaking situations
60
What are Cognitive reactions to stuttering?
Evaluating oneself negatively as a communicator due to stuttering
61
How do you address stuttering reactions directly? | 3
Explore stuttering to learn more about stuttering and to reduce anxiety Easy stuttering teaches that they have control of the speech musculature Easing out helps to reduce behavioral reactions
62
What do we do when dealing with affective reactions to stuttering? (5)
Talk about the stuttering in a safe environment Provide a vocabulary & analogies Be open and honest Express emotions Reduce shame
63
What do we do when dealing with behavioral reactions to stuttering? (2)
Use techniques to unlearn physical tension, struggle, & avoidance Reduce the underlying causes of these reactions (emotions, lack of understanding, etc.)
64
What do we do when dealing with cognitive reactions to stuttering? (4)
Understanding (learn about stuttering) Perception (disfluencies are a normal part of speech) Tolerance (it's ok to stutter) Support (meet other stutterers)
65
What are the four general treatment guidelines for stuttering?
Systematically increase the difficulty of the linguistic task and environment Work towards increasing the naturalness of the speaking task Move the client towards self-monitoring Support groups can help deal with negative attitudes and emotions

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