Fluency Final

Front 1

What are the 4 approaches to therapy for preschool, school-aged children, and adults?

Back 1

Preschool:
-Indirect treatment: through the parents; child not aware of the treatment
-Direct treatment

School Age/Adults:
-Stuttering modification
-Fluency shaping

Front 2

What is fluency shaping?

Back 2

Teach methods to change the time/tension of productions to prevent moments of stuttering (e.g., easy onsets)
Highly structured
Goal: Complete speech fluency (either spontaneous or controlled)

Front 3

What is stuttering modification?

Back 3

Teach methods to change the time/tension of productions to change during moments of stuttering (e.g., pull-outs)
Loosely structured
Goal: Controlled stuttering and decreased anxiety leading to spontaneous fluency

Front 4

What are the overarching treatment goals?

Back 4

1. Increase fluency
2. Improve ability to communicate
3. Develop autonomy

Front 5

Ways to decrease temporal demands when speaking.

Back 5

-Reduce speech rate
-Prolong initial syllables (just to establish fluency)

Front 6

Ways to decrease tension when speaking.

Back 6

-Easy onset of voicing and pre-voiced exhalation
-Light articulatory contacts
-Pull-outs and cancellations
-Purposeful stuttering – desensitization

Front 7

What are ways to improve overall communication skills?

Back 7

-Turn-taking
-Public speaking (if desired)
-Advertising

Front 8

How do you develop autonomy?

Back 8

-Help the client to feel in control
-Reduce avoidance behaviors

Front 9

What are ways to modify a stutter?

Back 9

1. Cancellation (post-event)
2. Pullouts (mid-event)
3. Preparatory sets (pre-event)

Front 10

Good candidate for fluency shaping...

Back 10

-Stutters openly
-Does not avoid speaking
-Perceives annoyance or interference but no personal penalty for stuttering’
-Feels positive about self as a communicator
-Demonstrates a positive response to fluency shaping trial therapy

Front 11

How are children who stutter different from adults who stutter?

Back 11

-Still maturing, less developed
-More likely to have other developmental deficits
-Teasing and bullying more likely
-Less experience with stuttering
-May be easier to change
-Fewer learned reactions
-Role of family and other adults

Front 12

Major focus of treatment with children

Back 12

-Make speech enjoyable
-Increase speech fluency
-Increase the ability to communicate

Front 13

Facilitating communication

Back 13

-Model communication that facilitates fluency with the child
-Slow the rate of speech and lessen complexity of language (Mr. Rogers)
-Modify verbal and nonverbal responses to fluency breaks
-Reduce interruptions, increase turn taking, and response-time latency

Front 14

Parent-Child Interaction Therapy

Back 14

We education parents so that they can make their own educated decision about what to do.

Front 15

Fluency shaping techniques

Back 15

-Flexible rate: slow production of initial syllables
-Easy onsets: gradual onset of voicing rather than sudden glottal attack
-Light contacts: modeling easy articulatory postures
-Proprioception: change feedback loop by having child close eyes, using masking noise, exaggerated or slow movements

Front 16

What are some self-help groups?

Back 16

-NSA
-Friends

Front 17

What do you do you say to parents?

Back 17

Your child is exhibiting stuttering. This isn't something that you caused. It may be aggravated by ______ (concominant language issue). Based on the following risk factors--__________--I would/wouldn't expect the stuttering to go away on its own. At home I would try waiting one second after your child finishes speaking to respond, not interrupting, and not asking the child to stop and start again. 7/10 children will significantly improved within 6-24 months. You can refer to the NSA for more information. Do you have any questions.