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37 Cards in this Set

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goals
1. obtain sample of speech under normal circumstances
2. obtain sample under fixed circumstances
3. use samples to generate descriptions
4. find variables that affect client's fluency
5. obtain information about client's development relevant to fluency
6. obtain information about variables that affect outcome or prognosis
7. obtain information about relevant or non-relevant concommitant disorders
8. generate descriptions of assessment for other professionals and laypersons
process for goal 1: obtain normal speech sample
observe and record client:
- talking to friend or relative before interview
- during interview with clinician
- during daily activities (home, work, play)
process for goal 2: obtain generated speech sample
observe and record client:
- describing stimulus picture
- reading passage
- playing barrier game
- during structured interview
- describing something familiar
process for goal 3: generate descriptions
- administer standardized tests
- use protocols for coding samples
- transcribe samples
- find frequency, type and duration of disfluencies
- find speaking rate
- note physiological issues related to fluency
- describe secondary and attitudinal behaviors qualitatively
process for goal 4: find variables that affect fluency
- test different variables
- interview client/family
- tape client's interactions
- use trial treatment procedures (DAF, rate change, whispering)
process for goal 5: find information about client's development
- use questionnaires
- interview client/family
process for goal 6: find variables that influence outcome or prognosis
- read reports of other formal tests
- develop informal tests
process for goal 7: concommitant disorders
- read reports of or administer formal tests for other communication issues
- make informal observations
process for goal 8: describe assessments for others
- write reports of assessments for various audiences
- explain results to client, family and/or teacher
stuttering definition
an interruption in the forward flow of speech, characterized by primary core behaviors (repetitions, prolongations, interjections, blocks, etc.)
forms of intervention
- fluency shaping
- stuttering modification
fluency tools
- easy-onset for laryngeal tension
- soft articulatory contacts for oral motor tension
- stretching
- blending
cancellation
stutterer cancels out disfluency by repeating feared word using fluency tools
pull-out
stutterer "pulls out" of stuttering moment by using fluency tools
preparatory set
stutterer uses fluency tools when anticipating a feared word
laryngeal vs. oral-motor stuttering
- larnygeal: often consonantal
- oral-motor: often vowel oriented
normal adult speaking rate
150 wpm
capacities and demands
theory used to explain the phenomenon of normal childhood stuttering, states oral motor capacities are limited when it comes to linguistic demands (morphological inflections, MLU, increased speaking rate, etc.)
spontaneous recovery
outgrowing normal developmental disfluency
secondary behavior
way for a stutterer to break free from a stuttering moment, begins as deliberate behavior, becomes stronger and less controlled after repeated use, divided into two categories: escape and avoidance
escape vs. avoidance behaviors
escape: head nods, eye blinks, interjections, etc.
avoidance: circumlocution, substitutions, starters
anti-expectancy device
using high pitched voice, foreign accent, etc. to produce a feared word
prevalence/incidence/ratio
prevalence: 1-3% in children, estimated <1% in adults
incidence: 5%
ratio: 3:1
most frequently stuttered
- consonants
- sounds in word-initial position
- contextual speech (vs. isolated words)
- nouns, verbs, adjectives, and adverbs (vs. articles, prepositions, pronouns and conjunctions)
- longer words
- words at the beginnings of sentences
- stressed syllables
methods of empowerment
- bouncing back
- pseudo-stuttering
- freezing
core behaviors indicating stuttering per Guitar
- part-word repetitions
- monosyllabic whole-word repetitions
- sound prolongations
- blockages of sounds or airflow
SLD
- stuttering-like disfluency
- associated with within-word, part-word, single syllable repetitions, blocks and prolongations
- less than half of disfluencies in typical children are SLDS
- about two-thirds of disfluencies in stutterers are SLDS
speech sample
- ideally would obtain two samples: one clinic, one recorded in natural environment
- videotaping ideal, audiotaping essential
- length: 300-400 syllables of conversational and 200 of reading
assessing frequency
- percentage of syllables stuttered (perferred)
- percentage of words stuttered
- number of stutters per 100 words
assessing type
- count both types (typical and atypical)
- if <50% are SLDs, child is most likely to be normally disfluent (per Yairi)
- children who stutter have 3+ SLDs per 100 words
assessing duration
- record three longest disfluencies
- calculate mean
assessing severity
- use SSI
- examines sum of frequency, duration and physical concomitants
assessing speaking and reading rate
speaking rate thought to affect severity of stuttering
when to reassess
- after every 10 hours of treatment
- use diagnostic probe rather than full test
- take 5 minutes worth of data per session
good prognostic indicators
- decrease in SLDs during first 12 months
- female gender
- no stuttering in family history
- good language and articulation skills, no phonological problems
- good non-verbal intelligence scores
- good temperament
SSI-4
- use 150-500 syllable sample
- tests frequency, duration, and physical concomitants
- poor interjudge reliability due to subjective factors while assessing secondaries
- validity not convincingly demonstrated
- tests severity only, does not differentiate between normal disfluency and stuttering
how to score SSI-4
- count: sound or syllable repetitions, prolongations, blocks
- do not count: rephrasing, phrase or whole word repetition, pausing without tension