Introduction to Stuttering Therapy
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Questions and Answers

What is the main focus of the Lidcombe Programme?

  • Parent-centered treatment involving the child (correct)
  • Medications for speech disorders
  • Directly teaching children speech techniques
  • Focus on group therapy for children

    • Parents trained in the Lidcombe Programme do not influence the therapy process.

    False

    What type of approach does the Lidcombe Programme utilize for treatment?

    Behavioristic approach using operant conditioning and positive reinforcement.

    The median treatment time for the Lidcombe Programme is __ weeks.

    <p>11</p> Signup and view all the answers

    Match each aspect of the Lidcombe Programme to its description:

    <p>Severity Ratings = Daily assessment to guide therapy decisions Parent Training = Educating parents to monitor and correct speech Direct Intervention = Working closely with parents and children Stuttering Indicators = Indicators to assess recovery potential</p> Signup and view all the answers

    Which approach focuses indirectly on the child during therapy?

    <p>Parent-centered approach</p> Signup and view all the answers

    Therapy for stuttering is only effective if it is intensive and conducted individually.

    <p>False</p> Signup and view all the answers

    What is a primary focus of the 3 P's in stuttering management?

    <p>Adapt the environment</p> Signup and view all the answers

    The client must give _______ for therapy to proceed.

    <p>permission</p> Signup and view all the answers

    Match the stages of development with their respective aspects:

    <p>Age = Demographic stage of growth Stage = Developmental milestone Core behaviours = Observable actions related to speech Feelings/Attitudes/Awareness = Emotional responses to stuttering</p> Signup and view all the answers

    Which factor does NOT influence the therapy process?

    <p>Therapist's age</p> Signup and view all the answers

    Self-help groups are included in the therapy process for stuttering.

    <p>True</p> Signup and view all the answers

    What is a common emotional response that can accompany stuttering?

    <p>Teasing</p> Signup and view all the answers

    What is one of the basic objectives of fluency programs?

    <p>To establish fluency</p> Signup and view all the answers

    The SHINE program aims to eliminate fluency disruptors.

    <p>True</p> Signup and view all the answers

    Name one technique mentioned for managing fluency.

    <p>Stocker Probe Technique</p> Signup and view all the answers

    The Palin Child Intervention (PCI) is focused on ____ in children who stutter.

    <p>working with attitudes and emotions</p> Signup and view all the answers

    Match the following fluency programs with their focus area:

    <p>Lidcombe = Parent-managed program SMOOTH TALKING = Resist fluency disruptors SIP = Comprehensive intervention Palin Child Intervention = Attitudes and emotions</p> Signup and view all the answers

    Which technique is NOT associated with fluency shaping?

    <p>Cancellations</p> Signup and view all the answers

    Fluency shaping focuses primarily on changing attitudes towards stuttering.

    <p>False</p> Signup and view all the answers

    Name one technique involved in stuttering modification.

    <p>Pullouts</p> Signup and view all the answers

    In fluency shaping, the aim is to totally eliminate all __________ events.

    <p>stuttering</p> Signup and view all the answers

    Match the following therapy techniques with their descriptions:

    <p>Easy voice onset = A technique to begin speaking without tension Light articulatory contact = Minimizing physical tension in speech Continuous phonation = Maintaining a flow of speech with no breaks Prolonged speech = Extending vowel sounds to enhance fluency</p> Signup and view all the answers

    What is the first step in self-management?

    <p>Identification</p> Signup and view all the answers

    Which of the following is a goal of stuttering modification?

    <p>To understand and accept stuttering</p> Signup and view all the answers

    Children who stutter often feel no fear of being teased.

    <p>False</p> Signup and view all the answers

    Desensitization is a key component in both fluency shaping and stuttering modification.

    <p>True</p> Signup and view all the answers

    What is the purpose of pseudostuttering?

    <p>To desensitize and advertise stuttering</p> Signup and view all the answers

    What technique is used to prepare ahead for stuttering?

    <p>Preparatory Sets</p> Signup and view all the answers

    Teachers should maintain _____ contact when interacting with a child who stutters.

    <p>eye</p> Signup and view all the answers

    Which of the following is NOT a behavior to help desensitize stuttering?

    <p>Avoiding the situation</p> Signup and view all the answers

    It is encouraged for teachers to finish a child’s sentence when they stutter.

    <p>False</p> Signup and view all the answers

    Name one situation where newly learned modification skills should be practiced.

    <p>Telephone calls</p> Signup and view all the answers

    Match the stuttering modification techniques with their descriptions:

    <p>Cancellation = Stutter-Pause-Control Pullouts = Stutter-Catch-Use technique Easy onset = Starting speech with a soft sound Light contact = Gentle contact during speech</p> Signup and view all the answers

    Study Notes

    Introduction to Treatment

    • Stuttering therapy can be long or short term, weekly or intensive, individual, or in a group.
    • Therapy is determined by a detailed assessment that looks at the intensity and severity of the stuttering pattern, the phase of development, client motivation, previous therapy, risk factors, and the relationship between the therapist and the client.
    • The client must give permission for therapy.
    • The process and approach of intervention are determined by the phase of development.
    • Refer to evaluation and assessment.
    • Therapy includes long-term goals, short-term goals, and session goals.
    • The therapist considers the client's needs and presenting problems when choosing priorities.
    • The client is responsible for learning to manage their speech.
    • Strategies used in therapy include desensitization, management of attitudes, emotions, and cognition, and awareness of relapses, transfer, and maintenance.

    Treating Children vs Adults

    • Children are still developing conceptual, linguistic, affective, and neuro-physiological skills.
    • Therapy might focus on other concomitants first, such as teasing and bullying.
    • The approach to therapy is less direct compared with adults.
    • Parents, teachers, other professionals play a role in therapy and use an asset-based approach.
    • Children are more likely to obtain fluency.

    Management: Main Focus

    • Focus on the 3 P’s:
      • Adapt the environment
      • Involve the team
      • Intervention with the parents and child
    • Groups for parents are helpful.
    • Parents benefit from literature, models, and strategies to implement at home (similar to Hanen Programme).
    • Strategies include slower speech rate, shorter utterances, less complex sentences, and appropriate pauses.
    • Teach conversation strategies through pamphlets, videos, books, and websites.

    Preschool: Stages of Development

    • In preschool, the therapist describes the stages of development according to:
      • Age
      • Stage
      • Core behaviors
      • Feelings/Attitudes/Awareness

    Two Approaches to Therapy

    • Two approaches to intervention:
      • Parent-centered/Focused
      • Child-centered/Focused
    • The level of awareness determines which approach to use.
    • Parents are trained to change specific aspects in therapy and to implement strategies at home during designated "special times."

    Rustin's Therapy

    • Improvements should be noted within six weeks and the child should enter a maintenance program.
    • If no improvement is seen, the therapist may implement a direct strategy.

    Direct Intervention

    • Direct or Child-Centered Intervention includes the Lidcombe Approach.
    • The Lidcombe Approach focuses on the child's demands and capacities, especially for children with speech and language problems.
    • The therapist works with the child and parents through the Lidcombe Programme.
    • The Lidcombe Programme is parent-centered.
    • The Lidcombe Programme is the treatment of choice for children under six.
    • The Lidcombe Programme includes a direct approach with self-monitoring, but does not teach a specific technique.
    • This program is based on behavioristic operant conditioning and positive reinforcement.
    • The program involves gently correcting, eliciting smooth/stutter-free speech, and parent training.
    • The Lidcombe Programme is not theoretically based but has extensive empirical data.

    Lidcombe Programme

    • The Lidcombe Programme advises against non-involvement of the child.
    • Parents learn to:
      • Identify stuttered and fluent speech in their children.
      • Praise and correct in a natural way.
      • Take severity ratings every day.
      • Adjust treatment based on severity.
    • Severity ratings, which include speech measures, determine all therapy decisions.
    • The median treatment time is 11 sessions, or 11 weeks.
    • There is data on over 2,000 children treated using this approach.
    • The program should be fun but not overshadow its aims, such as eliminating fluency disruptors.
    • Parents must be trained to manage the program.

    Teachers and the Lidcombe Programme

    • Teachers play an important role in the Lidcombe Programme.
    • The Stocker Probe Technique can be helpful for a child stuttering.
    • Other therapy programs include SHINE (Systematic Fluency Training for Young Children), EASY Does it 1, GUITAR (Stuttering an Integrated Approach), and SIP (Stuttering Intervention Programme).

    Objectives of Programs

    • The basic objectives of programs are to:
      • Build up linguistic complexity and experience fluency.
      • Establish fluency.
      • Desensitize and resist fluency disruptors.
      • Work on personal constructs.
      • Transfer and maintain skills.
      • Weigh the odds of success based on factors such as family history, gender, and pattern of stutter-like disfluencies.

    Fluency Shaping

    • Fluency-shaping manages surface features of stuttering.
    • The goal is to totally eliminate all stuttering events.
    • There is little or no focus on attitudes.
    • The approach distinguishes fluency from stuttering.
    • Strategies include desensitization, establishing fluency, transfer, and maintenance.
    • Fluency is first established in the clinical setting.
    • Fluency is reinforced with structured therapy.
    • Fluency is gradually modified towards a natural sound.
    • New fluency is generalized across tasks.
    • Fluency is generalized outside the clinical setting.

    Fluency Shaping Techniques

    • Therapy techniques include:
      • Slow, rate controlled speech.
      • Prolonged speech.
      • Easy voice onset.
      • Light articulatory contact.
      • As close to natural sounding speech as possible.

    Stuttering Modification

    • Stuttering modification modifies moments of stuttering.
    • It reduces and manages fear and avoidance.
    • It encourages clients to be motivated, aware, and to discuss and plan aims with the therapist.
    • Clients explore, identify, and learn to control their stuttering pattern.
    • The approach includes desensitization and working on attitudes and emotions with a focus on the environment.
    • The approach works with clients to modify their stuttering pattern through control techniques such as:
      • Pullouts
      • Cancellations
      • Intentional, open, smooth, and relaxed stuttering
      • "Acceptable" stuttering
      • "Pseudostuttering" (desensitizes and advertises)

    Stuttering Modification: Feelings and Attitudes

    • The goal is to:
      • Decrease shame and fear.
      • Talk about stuttering.
      • Think about stuttering.
      • Express feelings about stuttering.
      • Learn about stuttering.
      • Teach others about stuttering.
      • Own stuttering.
      • Accept stuttering.

    Stuttering Modification: Identification

    • The first step in self-management is identification of stuttering behaviors such as repetitions, sound blocks, and "things I do because I stutter" such as avoidances, anxieties, and fears.

    Stuttering Modification: Desensitization

    • Desensitization involves:
      • Behaviours such as watching in the mirror, describing stuttering in detail, and having the SLP model it.
      • Word avoidances such as saying words and competing to use words the most during sessions.
      • Situation avoidances such as talking about feared scenarios, role playing, and experiencing feared situations.

    Stuttering Modification: Modification

    • Modification focuses on learning easier ways to stutter in an "acceptable" manner:
      • Cancellations: Stutter-Pause-Control (bounce)
      • Pullouts: Stutter-Catch-Use Technique (easy onset, light contact)
      • Preparatory Sets: Prepare ahead and use techniques

    Stuttering Modification: Stabilization

    • Stabilization involves practicing newly learned modifications under more stressful conditions such as:
      • Telephone calls.
      • Public speaking.
      • Social introductions.
    • Through practice, techniques become overlearned and can withstand increased pressure.

    Stuttering in the Classroom

    • Children who stutter may exhibit fear of being teased, reading aloud, and presenting orally.
    • These children may pretend to be disorganized, ill, lack knowledge, or indifferent.

    Encouraging Teachers

    • Teachers are encouraged to maintain eye contact, pause before responding to children’s statements or questions, and rephrase the child’s remarks to affirm that the message was delivered.
    • Teachers should routinely:
      • Reduce the length and complexity of sentences when a child is stuttering.
      • Speak at a normal to slow-normal rate.
      • Resist the urge to speak quickly or rush their speech.
    • Teachers should never:
      • Finish a child’s sentence or fill in a word.

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    Description

    Explore the different approaches to stuttering therapy, including the assessment processes that inform therapy choices. This quiz covers strategies, client responsibilities, and distinctions between treating children and adults. Learn how effective treatment hinges on understanding both the client's unique needs and therapy goals.

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