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1

What do fluency shaping techniques count/ measure?

disfluencies

2

When will fluency shaping techniques be the most effective?

If they are intensely practiced everyday at a live-in program.
Repetition

3

Bober and Kully was established what year?

1994

4

What are the 8 techniques of Boberg and Kully?

1. baseline
2. Identify Patterns
3. Modify using 5 fluency shaping techniques
-easy onset
-soft contact
-continuous phonation
-short phrases
-slowed rate
4. Length of utterance
5. prolonged rate (slowed rate)
6. normalize rate
7. self monitor
8. Transfer

5

Boberg and Kully 1994
Step 1

Establish Baseline: Figure out how much stuttering the client does. This is the measure of performance at this moment in time. (this can change, fluency alters as a natural course of the disorder)

6

Boberg and Kully 1994
Step 2

Identify Stuttering Patterns: People will have typical patterns

7

Boberg and Kully 1994
Step 3

Teach Fluency Shaping Techniques
-Easy Onset
-Soft Contact
-Continuous Phonation
-Short Phrases
-Slowed Rate

8

Boberg and Kully 1994
Step 4

Length of Utterance:
Start at one word/syllable length and after client achieves 75% accuracy then move onto two word/syllable and so on. This is called easy speech
Apply this step to each of the 5 fluency shaping techniques.

9

Boberg and Kully 1994
Step 5

Prolonged Speech- slowed rate:
Master of prolonged speech (connected speech) with 75% accuracy. Connected speech at a slowed rate.

10

Boberg and Kully 1994
Step 6

Normalize Rate:
Normalize the rate of speech. When the rate increases, teach cancellations and pullouts for the stutter.

11

Boberg and Kully 1994
Step 7

Self Monitor: Move from clinician monitoring to client monitoring

12

Boberg and Kully 1994
Step 8

Transfer: Learn to carryover out in the real world.

13

What is the criteria to move into step 7 (self monitor)?

Produce connected speech at a syllable rate of about 190 syllables per minute with 1% or less disfluencies.

14

What technique does Boberg and Kully 1994 emphasize?

eye contact

15

What year was Dahm established?

1997

16

What is Dahm's program called?

Speech Processing Therapy

17

What is the goal of Dahm's Program?

fluent speech and the focus is vf vibration

18

Is Dahm's a computer program?

yes it requires hours of repetition. While it monitors vf vibration.

19

Dahm 1997 6 step program

1. simple to complex processing
2. short to long utterances
3. slow to normal rate
4. intentional behaviors to habitual
5. low anxiety situations to high
6. clinician evaluated to self

20

Dahm 1997
Step 1

Simple to complex processing: practice pre set phrases first because they are easiest cognitively.

21

Dahm 1997
Step 2

Short to long utterances

22

Dahm 1997
Step 3

Slow to normal rate: working from extended/ continuous phonation, where the computer times the length of cessation, to normal rate.

23

Dahm 1997
Step 4

Intentional Behaviors to Habitual: working toward automaticity, habitual, automatic behaviors.

24

Dahm 1997
Step 5

Low anxiety situations to high: for example sitting at the computer practicing to talking on the phone (high anxiety)

25

Dahm 1997
Step 6

Clinician evaluated to self evaluated:

26

Very famous fluency shaping program

Ronald Webster's program 1966

27

What is the name of Ronald Webster's program 1966?

Precision fluency shaping

28

This is a three week live in program

Ronald Webster's program 1966

29

Based on controlled gentle onset of voicing

Ronald Webster's program 1966

30

Ronald Webster's program 1966
What are the 5 steps?

1. Vowels
2. Voiced Continuants
3. Voiceless Continuants
4. Plosives
5. voice Monitor

31

Ronald Webster's program 1966
Step 1

Vowels: Start vowels with easy onset in progression

32

Ronald Webster's program 1966
Step 2

Voiced Continuants: Voiced consonants

33

Ronald Webster's program 1966
Step 3

Voiceless fricative continuants

34

Ronald Webster's program 1966
Step 4

Plosives: stops

35

Ronald Webster's program 1966
Step 5

Voice Monitor: measures continuous phonation by airflow. This is measured on a computer that provides feedback on gentle onset. Computer monitors you and then you monitor yourself in the group sessions.

36

Ronald Webster's program 1966

-uses group sessions
-therapy is hours per day
-people do achieve greatly improved fluency
-it is built in that you come back

37

Onslow and Packman 1997

This is a basic fluency shaping program but with 5 pretreatment issues you must consider before treatment begins.

38

Onslow and Packman 1997
What are the 5 pre- treatment issues?

1. Quality of life change?
2. Drive?
3. Anxiety or stuttering?
4. Sufficiently organized?
5. Self motivation?

39

Onslow and Packman 1997
Step 1

Can the client identify that his quality of life will improve? Client has to know this to be true.

40

Onslow and Packman 1997
Step 2

Does the client have drive and determination to succeed?

41

Onslow and Packman 1997
Step 3

Is the problem anxiety or stuttering? A fluency shaping program may cause even more anxiety because meeting the criteria is very hard. You can refer the client out for different therapy.

42

Onslow and Packman 1997
Step 4

Is the client sufficiently organized enough to leave daily life/ organize lifestyle in order to commit to duration of treatment.

43

Onslow and Packman 1997
Step 5

Is the client wanting to come to treatment or is someone asking them to go? Is the motivation internal?

44

What are the commonalities between all of these programs?

1. baselining
2. they all teach fluency shaping techniques
3. start small and get harder
4. transition from comfortable to out in the world
5. transition from clinician monitor to self monitor
6. may/may no use slowed rate/ normalizing component (but many do)