Flashcards in Outline 5 parents need to Deck (32):
In regards to motivation we can switch that to what with children?
how do children show readiness?
being able to sit still and pay attention
What do parents need to understand about stuttering?
1. nature of stuttering
2. behavior change can be slow
3. Reinforce fluency and don't punish disfluency
What should parents know about the nature?
-cyclical, we don't understand the cycles
-nobody or anything that has happened can make a child stutter. It's nobody's fault.
What do we know about behavior and therapy?
The changes is slow and it is a time consuming process.
How will parents need to participate in therapy?
and reinforcement fluency
What are the 15 case history questions we should ask?
1. Parent concerns
2. parent description of disfluencies
3. when did parents first notice disfluency
4. have the disfluencies changed? If so in what way?
5. why seeking eval/ treatment now
6. does the disfluency come and go or is it constant?
7. how does the child react?
-aware? struggle and abandon?
8. what do parents/others do to help?
9. does the child seem to have strategies he uses?
10. What situations is the child most fluent/disfluent?
11. family history?
12. previous treatment?
13. does the child's speech today represent the norm?
14. anything we need to know that we didn't ask?
15. parent questions?
Why do we ask about the situations for fluent/ disfluent speech?
Because for a very small child (3-5) we want to increase fluent situation because we are treating stuttering as a motor pattern.
What is the best thing to do for these tiny kids?
Assess and treat as early as possible
Consistency is key, also monitor the child
Why is stuttering cyclical?
we don't know. But what we do know is that it is common
Should the family discuss the stuttering?
Yes it should be openly discussed because if it isn't it can become something that is shameful.
What types of groups can you suggest to a family?
Why does singing or whispering help?
because it lights up a different part of the brain than talking.
-explain that this is neurological: when you change something fundamentally neurological (the way we talk) and it changes the stutter. The only problem with this is it can become a concomitant feature.
When you are looking at someone who will be cured or a persistent chronic stutterer...
What are the 6 risk factors we need to look at for a child who may be stuttering?
1. what is the nature of the stutter
2. frequency of disfluencies
3. situational variability
4. presence of struggles behaviors
5. family history
What is the nature?
is the child exhibiting core or normal disfluencies?
frequency of disfluencies?
more than 5% disfluent overall, or more than one disfluency in a sentence.
Can you make the child stutter in your office w/pressure, reading, stress? If not the child may not be a stutterer.
presence of struggled behavior?
What are the child's reactions to the stutter? Are the struggling and abandoning? Can you see a physical struggle and does the child react to it?
Is there a family history? If the parent says no then ask if there was a quiet grandfather, uncle, etc?
Boys are more likely to stutter than girls
What are the 4 possible outcomes after the assessment?
3. child is at risk
The child is fine
-affirm parent concerns, praise them for being aware and concerned.
-Lets parents know to contact you if anything changes.
You are not sure, but there is not a huge concern but you also don't want to let them go.
-you will need more information, so have the parents, teacher, yard duty track the child's speech. You will teach the parent how to track and what do to. Provide tracking sheets, journal etc.
-Have parents not when and where the disfluencies are happening, and any changes.
-Have parent reschedule a follow up appointment.
3. Child is at risk
-enroll child in tx
-parents will need to track disfluencies
-talk with parents at tx sessions, ask what works and what doesn't.
-ask parents to increase fluency but avoiding disfluent situations, this will treat the stuttering as a motor pattern.
-make sure parents praise fluency
-sont ask the parents to do anything but track and praise fluency
-all risk factors are there
-enroll in tx
-parent will still track
-increase fluent situations
-parents need to be involved
Tx for littles (3-5) 3 parts
What are some simple methods you can teach to the little kids?
horse race talk
What should you model to the kids, you can teach the parents to model this also
What should we ask parents to do about stress?
keep it to a low level
stress/tension does not cause stuttering but it can make it worse
We need to identify what?
Where the child is fluent and disfluent?