CommDis1
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| What is stuttering? | An interruption to the forward progress of the speech signal - a fluency disruption. It is not a language problem. Folks with dysfluencies often develop large, compensatory vocabularies (substitution options).
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| Signs of Stuttering (4) | Repetitions (whole word, part word, whole phrase, part phrase), Prolongations, Tense Pauses/Blocks, Interjections
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| Demographics | Early childhood (~2.5 to 4 years of age). More boys than girls (3.5:1). Paternally linked. All ethnic, racial, and SES distinctions.
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| Etilogy | IDIOPATHIC. Genetics? Psycho-Social Factors? Hormonal Variables?. Neuro-motor Difficulties? (cluttering-childhood phon proc correlation) Demands/Capacity Model?
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| Diagnosis (6) | 1.Informal interview/formal speech sample 2.Case history 3.Identify severity and impact 4.Test for other underlying disabilities 5.Formal testing 6.Informal assessments
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| Informal asssessment | Note primary/secondary behaviors & pragmatic symptoms. Obtain sample representative of everyday speech - different contexts, with different people, in different environments.
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| Case history | Family history (attitudes?). Time since onset. Gender. Other speech/language problems. Motivation Present characteristics. Development course. Degree of awareness. Environmental influences. Parent/child or family relationship. Skills/interests.
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| Severity & impact | Some are going to plow through. Others will be defeated the event.
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| Formal testing | Artic test (required by some schools) may come back normal. SLP must describe pragmatic difficulties, latency issues, social-emotional impact on academic achievement (won’t even raise hand, can’t make friends, teasing/bullying).
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| Tests | Poor reliability - cyclical disorder: 1.Stuttering Prediction Instrument (SPI) (3-5 years of age) 2.Stuttering Severity Instrument (SSI-4) (adults and children) 3.Overall Assessment of the Speaker’s Experience of Stuttering (OASES) (adults)
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| Materials | Recorder (w/permission). Reading material (confrontational task). Standardized test (insurance likes #s). Parental/self-rating form (pre-/post-measure). Language test (distinguish dysfluency/apraxia)
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| Management | 1.Fluency-Shaping (Vocal Control) 2.Stuttering Modification 3.Contingency management
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| Fluency-Shaping | Slowed rate of speech movement, easy onset, light contacts, etc.
"Vocal Control" - better vocal tone, breath support, appropriate loudness.
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| Stuttering Modification | Reduce anxiety. Desensitization. Voluntary stuttering. Cancellations, pull-outs, acknowledgments, etc.
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| Contingency management | Non-aversive punishment for stuttering behaviors, successive approximation (shaping) toward fluent speech, use fluency-enhancement (mix of 2 main management techniques and seen in many intensive stuttering programs)
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| Parents/communication partners | Train slower speech rates. Lessen demand for rate matching (take breaths, exaggerate pauses). Don’t interrupt and don’t finish sentences. Don’t presume. Be mindful: don’t ask questions that require long, elaborate responses.
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| Transfer and maintenance | It’s not successful therapy if you can’t get similar results out in the parking lot or at a restaurant.
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Created by:
ashea01
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