Fluency Final Exam

Front 1

Fluency Enhancing Skills

Back 1

For Factor 1
-Collection of somewhat varied treatment procedures emphasizing the learning of fluency producing skills
GOAL: natural sounding speech

Front 2

Behavior Modification

Back 2

Collection of approaches: cancellation, pull-out, preparatory sets
GOAL: less severe stuttering, extinction of coping behaviors, positive attitude and speech positive emotion

Front 3

Cancellation

Back 3

Complete the stuttered word, pause for 3 seconds, repeat the word in a relaxed way

Front 4

Pull out

Back 4

Reduce the tension at the onset on stuttering, pull out of the stuttering by slowing down and reducing tension at articulatory contact

Front 5

Preparatory Set

Back 5

Prior to saying the word on which stuttering is anticipated, the client prepares production by using soft contact and easy onset

Front 6

Reality testing

Back 6

Using masking, choral reading, shadowing, whispering
GOAL: show client they are capable of fluent speech, they are not able to produce perfectly fluent speech, rid of their negative empotion and false beliefs about speech

Front 7

Counseling

Back 7

Collection of varied approaches that provide information, change attitude, lead to rational emotional reactions
-can be used with direct TX methods
-Done with the client and the parents

Front 8

Attitude change

Back 8

Discuss the clients irrational beliefs that others are always fluent and that he/she will always stutter

Front 9

Fluency Reinforcement

Back 9

Positive reinforcement is delivered for an increase in the frequency of fluently spoken words or the duration during which speech is fluent

Front 10

Fluency enhancing skills

Back 10

relaxation
airflow mngmnt
gentle phonatory onset
soft artic contact
reduction in artic rate
continuous vocalization

Front 11

Airflow management

Back 11

PURPOSE: reduce laryngeal tension by initiating phonation at a moment when the vocal folds cannot be completely adducted.

Front 12

Gentle phonatory onset

Back 12

GOAL: easy, slow relaxed speech
- client learns to use as little laryngeal tension as possible when initiating voicing

Front 13

Soft articulatory contact

Back 13

GOAL: to reduce muscular tension during speech production
-light contact prevents the occurence of prolonged atric postures associated w/ the inability to make the transition to the artic position of the next sound

Front 14

Rate reduction

Back 14

reduction of articulatory rate by using within-word prolongation (extended sound and syllable duration)

Front 15

Prolonged articulation

Back 15

trained through instruction, modeling, differential reinforcement

Front 16

Continuous Vocalization

Back 16

using modeling, imitation, and reinforcement to habituate articulatory movement throughout an utterance

Front 17

Response cost

Back 17

client earns tokens when using the appropriate fluency enhancing skills and loses them if the skill being trianed is not used
-used when reindorecment and non/reinforcement does not produce the desired skills

Front 18

Counter conditioning of targeted speech sounds and situations

Back 18

sounds, words and situations that elicit negative emotions should be rank ordered (ocassion the least concern, occur most frequently, client motivation)

Front 19

Transfer

Back 19

*goes with maintanence
Behavior rehearsal in settings similar to real life setting; transfer clinic Tx to outside settings

Front 20

Maintanence

Back 20

When therapy is reduced enough to dismiss, use client follow-up, counsel the client and family, ask client to contact you if fluency decreases

Front 21

Delayed Auditory Feedback (DAF)

Back 21

Hearing one's own speech after a delay introduced by a mechanical device
-effect is to slow down rate of speech

Front 22

Metranome-Paced Speech

Back 22

speech regulated by beats of a metronome
-used to change rate of speech
-used for stuttering and cluttering

Front 23

Monterey Fluency Program

Back 23

Operant approach
-to establish, transfer, maintain fluency
Two methods: DAF or Increase in length and complexity of utterances (younger)

Front 24

Stutter-Free speech TX program

Back 24

Shames & Florance
- used DAF to induce stutter-free speech
-uses operant procedures to shape normal sounding fluency
GOAL: speech of person contains little or no stuttering

Front 25

Stuttering Prevention: clinical method

Back 25

Starkweather
-Early Tx program for children
-based on Demands and Capacities Model
GOAL: to reduce demands made on child's fluency and increase fluency capacities

Front 26

Lidcombe Program

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Tx for young children
-parent and child visit the clinic once a week
-parent does the tx every day
-two stages

Front 27

Cortical dysfluency producing disorders:

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Palilalia
cluttering
expressive aphasia
parkinsons
closed head injury
tumor
drug abuse
apraxia

Front 28

Non-cortical dysfluency producing disorders:

Back 28

encephalitis
spinal meningitis
wilson's disease
soto's disease
down syndrome
spasmodic dysphonia
tourette

Front 29

Order for initial "extinction" of factor II behaviors:

Back 29

1. those that are most debilitating
2. involve the largest muscle group
3. are not specific to the mouth
4. the ones the client is most motivated to reduce

Front 30

Target awareness

Back 30

Factor II tactic to initiate identification of a target response to move towards 95%

Front 31

Target omission

Back 31

DRO
Used after awareness (which will decrease some of the behavior)to stabalize and carry-over to different situations

Front 32

D.R.O.

Back 32

Differential Reinforcement of Other Behaviors

Front 33

Negative Practice Gamma

Back 33

For factor II behaviors
GOAL: to eliminate the response after successful awareness training

Front 34

Non-Aversive Response Reduction

Back 34

Factor II behaviors
GOAL: After successful awareness training and base-rate determination, the client is informed whenever the targeted behavior occurs

Front 35

Time out from speech

Back 35

Apprx. 10 seconds of stopped speech when the target response occurs

Front 36

Negative practice beta

Back 36

Factor II
GOAL: same as gamma, but if target repsonse occurs the client stops and then repeatedly and rapidly produce the target until it is fatigued and greatly decreased in liklihood of occuring, then return to omission training procedures

Front 37

Chaining

Back 37

Factor II
The target response that has been omitted must be chained to another target. The client must omit the previously worked on target while the new one is being dealt with.