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Questions and Answers
What is one of the primary goals of a comprehensive assessment of a child who stutters?
What is one of the primary goals of a comprehensive assessment of a child who stutters?
The assessment of child who stutters does not involve gathering information from their teachers.
The assessment of child who stutters does not involve gathering information from their teachers.
False
What type of questions should be asked during the initial parent contact to gather information on concerns?
What type of questions should be asked during the initial parent contact to gather information on concerns?
Open-ended questions
A comprehensive assessment of stuttering includes a thorough case ______________.
A comprehensive assessment of stuttering includes a thorough case ______________.
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Match the assessment elements with their descriptions:
Match the assessment elements with their descriptions:
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Which of the following factors might indicate a child is at risk for persistent stuttering? (Select all that apply)
Which of the following factors might indicate a child is at risk for persistent stuttering? (Select all that apply)
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A child's awareness and concern about their speech do not impact their risk of stuttering.
A child's awareness and concern about their speech do not impact their risk of stuttering.
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What aspects should be included in a child's case history?
What aspects should be included in a child's case history?
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The process of gaining rapport with a child during therapy often starts with discussing their __________.
The process of gaining rapport with a child during therapy often starts with discussing their __________.
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Match the following resources with their relevance:
Match the following resources with their relevance:
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Which of the following are considered typical disfluencies and not types of stuttering?
Which of the following are considered typical disfluencies and not types of stuttering?
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The percentage of syllables stuttered (%SS) is calculated by dividing the number of syllables stuttered by the total number of syllables spoken.
The percentage of syllables stuttered (%SS) is calculated by dividing the number of syllables stuttered by the total number of syllables spoken.
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What is the recommended speaking sample length to assess stuttering?
What is the recommended speaking sample length to assess stuttering?
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An episode of stuttering may include ________ repetitions.
An episode of stuttering may include ________ repetitions.
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Match the following types of stuttering to their descriptions:
Match the following types of stuttering to their descriptions:
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Study Notes
Comprehensive Stuttering Assessment
- A comprehensive assessment acknowledges all aspects of stuttering, both overt and covert behaviours, and includes a thorough case history
- The assessment should consider the child's environment, including interactions with parents, teachers, and peers
- It should also factor in motoric, social, emotional, cognitive, and linguistic demands
- The assessment should inform a profile, severity rating, and prognosis for the individual
Understanding Stuttering
- Differentiate between normal disfluency and stuttering
- Analyze the stuttering (%SS, types, severity, speech rate)
- Understand the individual's feelings, attitudes, and avoidance behaviours
- Understand the impact of stuttering on the person's life, including home and school environments
Initial Parent Contact
- The primary goals of the initial contact with parents are to listen to their perspective, obtain preliminary information about their child's stuttering, educate them, and provide support
- Explain the origin and nature of stuttering in an understandable way to the parents
- Describe the assessment process, including case history and other assessments that will be conducted
- Ask open-ended questions to encourage open communication about the child's stuttering
Key Questions for Parents
- Is there a family history of stuttering?
- Did the family history of stuttering persist into adulthood?
- Are the parents worried about the child's speech?
- Has the child been stuttering for more than 12 months?
- Has the stuttering stayed the same or become worse?
- Does the child have any other speech or language difficulties?
- Has the child had any other speech and language difficulties in the past?
- Are the child's language skills advanced for their age?
- Is the child aware of their stuttering?
- Is the child worried about their speech?
Case History
- Recommended case history forms include those by Kelman & Nicholas and Guitar
- Both forms seek information on family life, developmental history, the onset and development of stuttering, communication skills, medical history, eating and sleeping habits, personality, genetics, education, and behaviour management
Child's Perspective
- Gaining the child's perspective provides information on their awareness and the impact of stuttering on their life
- It's important to build rapport with the child by discussing their interests and hobbies before transitioning to discussing their speech
- Use the child's words when talking about stuttering, such as "getting stuck" or "bumpy", to build rapport and begin the therapeutic process of identification and desensitisation
Home Environment
- Collect information about the home environment through detailed case history forms, discussions with parents, and interaction with the child
- Observe how other children react to the child's stuttering, whether there is any teasing or bullying, and how the teacher reacts to the child's stuttering
Assessment of Personal Factors
- Stuttering is inherently variable, so a speech sample may or may not represent the individual's functional speech
- Inquire with parents and the child about whether the speech sample is representative of their typical speech
- Aim for a speech sample of 300 to 400 syllables
- Record the speech sample for fluency analysis
Speech Disfluencies
- Analyze the frequency and type of stuttering, as well as the rate of speech.
- A reading sample can provide insight into the extent of word avoidance being used by the child
Typical Disfluencies
- Interjections (e.g. "um...uh...eh...")
- Phrase repetitions (e.g. "Mommy, David took my-took-took my DS")
- Multi-syllabic whole word repetitions (e.g. "because-because", "walking-walking")
- Phrase revisions/abandoned utterances (e.g. "The DS with the blue-with the pink Pokémon is mine")
%SS Calculation
- Calculate the total number of syllables spoken in the sample
- Calculate the total number of syllables stuttered in the sample
- Calculate the percentage of syllables stuttered (%SS) using the formula: (No. of syllables stuttered / No. of syllables spoken) x 100
%SS Analysis
- Listen to the entire speech sample while counting the number of syllables spoken and categorizing stuttering moments
- Note the duration of the three longest stutters
- Record clinical observations of any secondary behaviours
Clinical Observations: Physical Tension/Struggle/Movement
- These behaviours are considered part of stuttering, not secondary behaviours
- Examples include facial tension, body movements, and disrupted breathing
Rate of Speech
- Observe the rate of speech of both the child and the parent
- The rate of speech of either the child or parent may contribute to stuttering episodes
- Consider the rate of speech when differentiating between stuttering and cluttering
Calculating Stuttering Severity
- The SSI-3 and SSI-4 can be used to calculate stuttering severity, which considers factors such as frequency, duration, physical concomitants, and naturalness of speech
- In the absence of these tests, can use other severity rating scales to assess severity
Behavioural Reactions: Avoidance
- Avoidance behaviours may be observed or reported
- They start as reactions to feeling stuck or losing control and are often an attempt to avoid stuttering
- Over time, avoidance behaviours become an integral feature of stuttering
- Examples include word substitution, avoiding activities or participation
Affective/Cognitive Reactions
- Use standardized assessments such as the OASES-School Aged, Communication Attitude Test, and A-19 Scale to assess a school-aged child's affective/cognitive reactions to stuttering
Reactions to Stuttering
- Carefully observe and record the client's reactions to their own stuttering.
- Note any signs of self-consciousness, avoidance behaviors, or emotional responses such as blushing, whispering, or loss of eye contact.
- Analyze the parents' reactions to their child's stuttering, considering their level of sensitivity to the child's speech challenges.
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Description
This quiz explores the comprehensive assessment of stuttering, considering both overt and covert behaviors. It includes analysis of environmental factors, emotional aspects, and the stuttering severity in a child's life. Understanding the initial parent contact and the various interactions is crucial for effective assessment.
