Stuttering Intervention Techniques
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What is the main approach used by the Lidcombe Programme for treating children with stuttering?

  • Direct child-centered intervention through parent involvement (correct)
  • Group therapy focusing on peer interactions
  • Individual therapy sessions without parental involvement
  • Medication-based treatment

    • During therapy, what critical measure do parents use to guide treatment adjustments in the Lidcombe Programme?

  • General observations of behavior
  • Severity ratings of speech (correct)
  • Weekly feedback from therapists
  • Child's willingness to participate

    • What is the recommended duration for the median treatment time in the Lidcombe Programme?

  • 11 sessions (correct)
  • 30 sessions
  • 6 sessions
  • 20 sessions

    • Which of the following is NOT a component of the Lidcombe Programme?

    <p>Therapist-led group sessions</p> Signup and view all the answers

    What should parents do if there is no improvement observed within six weeks of starting therapy?

    <p>Consider implementing direct strategy work</p> Signup and view all the answers

    What is one of the basic objectives of fluency training programs?

    <p>Establish fluency</p> Signup and view all the answers

    Which technique involves training parents to manage a fluency program?

    <p>Lidcombe Program</p> Signup and view all the answers

    What is meant by 'desensitize and resist fluency disruptors' in fluency training?

    <p>To minimize the effect of interruptions to fluency</p> Signup and view all the answers

    What kind of complexity should fluency training build up?

    <p>Linguistic complexity</p> Signup and view all the answers

    Which of the following factors is NOT associated with a family history of chronic stuttering?

    <p>High linguistic complexity in speech</p> Signup and view all the answers

    What is the main goal of stuttering treatment for preschool children?

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

    Which technique is NOT mentioned as a form of fluency reinforcement?

    <p>Conversational Therapy</p> Signup and view all the answers

    Which factor may indicate less concern regarding a child's stuttering?

    <p>Strong speech/language skills</p> Signup and view all the answers

    In the context of fluency reinforcement for therapy sessions, what is the typical duration for the Lidcombe Program?

    <p>8-12 weeks</p> Signup and view all the answers

    What is a critical component of stuttering treatment for preschool children aside from improving fluency?

    <p>Developing healthy attitudes toward communication</p> Signup and view all the answers

    Which factor is NOT considered when assessing stuttering for therapy?

    <p>Age of the client</p> Signup and view all the answers

    What is the main focus of therapy for children who stutter?

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

    What is a significant difference in treating children compared to adults for stuttering?

    <p>Treatment for children is less direct</p> Signup and view all the answers

    Which component is NOT included in the long-term goals of therapy?

    <p>Immediate fluency achievement</p> Signup and view all the answers

    What does the self-determination aspect of therapy emphasize?

    <p>Clients must give permission for therapy.</p> Signup and view all the answers

    Which of the following is NOT a key aspect of managing stuttering?

    <p>Conducting therapy with minimal parental involvement</p> Signup and view all the answers

    What should the focus of therapy primarily depend on?

    <p>Phase of development</p> Signup and view all the answers

    Which strategy is least likely to be encouraged for effective communication in therapy?

    <p>Increasing speech complexity immediately</p> Signup and view all the answers

    What is the primary focus of indirect intervention for preschool children with stuttering?

    <p>Working primarily with parents to modify interaction</p> Signup and view all the answers

    Which technique is NOT recommended for helping reduce disruptions in a child's fluency?

    <p>Increasing pressure during speaking tasks</p> Signup and view all the answers

    What is one of the aims of the educational counseling provided to parents?

    <p>To understand the developmental nature of fluency</p> Signup and view all the answers

    Which of the following is NOT a focus of intervention for stuttering?

    <p>Increasing language complexity</p> Signup and view all the answers

    Which of the following is a correct method for facilitating communication with a preschool child?

    <p>Following the child’s lead in conversation</p> Signup and view all the answers

    What is one of the fluency enhancers recommended in therapy?

    <p>Slow, stretched speech with normal intonation</p> Signup and view all the answers

    What role do parents play in the context of stuttering therapy for preschool children?

    <p>They act as facilitators and observers in therapy sessions</p> Signup and view all the answers

    Parent training in stuttering therapy should aim to:

    <p>Educate parents to modify their behavior</p> Signup and view all the answers

    Which interaction factor contributes most significantly to improving a child's fluency?

    <p>Manner of interaction and turn-taking</p> Signup and view all the answers

    What is a demand that might affect a person who stutters?

    <p>Parent's communication style</p> Signup and view all the answers

    Which of the following strategies is designed to help parents identify communication difficulties?

    <p>Video analysis of interactions</p> Signup and view all the answers

    Which of the following reflects a social/emotional demand impacting stuttering?

    <p>Feeling of fear or anxiety</p> Signup and view all the answers

    What type of speech disruption is specifically recognized as a target for modification in parent interactions?

    <p>Excessive interruptions during conversations</p> Signup and view all the answers

    What is a typical characteristic of parent involvement in stuttering therapy?

    <p>Parents should support their child's lead in conversation</p> Signup and view all the answers

    Which statement best describes the 'demands and capacities' model?

    <p>It emphasizes the balance between capacities and communicative demands.</p> Signup and view all the answers

    How should therapy for stuttering be characterized?

    <p>Accountable and integrated</p> Signup and view all the answers

    Study Notes

    Stuttering Intervention

    • Therapy can be long-term or short-term.
    • Therapy can be weekly or intensive.
    • Therapy can be individual or group-based.
    • Intensity and severity of stuttering patterns, motivation to change, previous therapy, risk factors, and therapist-client relationships determine the therapy approach.
    • The client must consent to therapy.

    Introduction to Treatment

    • The intervention process is determined by the phase of development.
    • Evaluation and assessment is necessary.
    • Long-term, short-term, and session goals need to be set.
    • Client needs (what they want) are important to consider.
    • The presenting problem and priorities should be discussed.
    • Managing speech is the client's responsibility.

    Treatment Includes

    • Desensitization.
    • Addressing attitudes, emotions, and cognition.
    • Managing relapses.
    • Transferring and maintaining learned skills.
    • Self-determination.
    • Use of self-help groups.

    Treating Children vs Adults

    • Children are still developing, so therapists might initially focus on other developmental needs.
    • Children are more likely to be bullied compared to adults.
    • Parents, teachers, and other professionals play roles in supporting the child.
    • An asset-based approach can be beneficial.
    • Children tend to improve fluency more than adults.

    Management: Main Focus

    • Adapt the environment.
    • Involve the intervention team.
    • Guide parents and the child during intervention.
    • Use group therapy for parents.
    • Provide parents with relevant literature.
    • Model strategies for parents (similar to Hanen Program).
    • Focus on using slower speech rates with shorter utterances and less complex language.
    • Teach conversation strategies.

    Preschool

    • Describe developmental stages based on age, behaviors, and feelings/attitudes/awareness.

    Therapy Approaches

    • (1) Parent-centered/indirect approach.

      • Parents are the focus, allowing for indirect work on the child's speech.

    • (2) Child-centered/direct approach.

      • The child is the focus.

    • Awareness levels determine the focus in both approaches.

    Indirect (Parent-Centered) Intervention

    • Borderline: Child showing some word repetition, low tension, and generally unaware.

    • Parents are often counselled and provided with information about the developmental nature of stuttering.

    • Most work is done with parents vs. the child.

    • Techniques: Adjust environmental factors to reduce disruptions, decrease speech demands, reward fluency, and provide reassurance and encouragement.

    3 Stages of Parent Involvement

    • Educational counselling.
    • Facilitating communicative interaction.
    • Parents as observers and participants.

    Preschool Stuttering, Rustin's Family Interaction Therapy

    • Framework for intervention: The parent's interaction skills are targeted to modify them.
    • Techniques: following the child's lead, giving time to respond, and maintaining attention; improved interaction positioning, reinforcing, and supporting turn-taking; and addressing speech rate, intelligibility, etc.

    Video Analysis in Preschool Stuttering, Rustin's Family Interaction Therapy

    • Video analysis helps parents identify areas requiring modification.
    • Identifying areas to modify include rapid speech rate, interruptions, frequent questions without wait time, excessive parental direction during play/conversation, parental passivity, and non-verbal communication issues.

    Rustin's Therapy

    • Parents change specific behaviors during designated therapy times.
    • Improvements are expected within 6 weeks to enter the maintenance program.
    • If no improvement, direct intervention strategies may need to be implemented.

    Direct (Child-Centered) Intervention: Lidcombe Approach

    • Lidcombe approach is particularly helpful for children with speech and language issues.
    • Demands and capacities are assessed and addressed.
    • Therapists take into consideration the stage of development.
    • The prognosis with children and strategies for recovery, transfer, and maintenance are identified.
    • Relapses are addressed with warning and clarification.

    Lidcombe Programme

    • The Lidcombe Program typically works with the child and parents.
    • It's the treatment of choice for children under 6 years.
    • It focuses on a direct approach with self-monitoring.
    • It involves using behavioral techniques (operant conditioning, positive reinforcement).
    • It gently corrects speech to create a stutter-free environment.
    • It relies heavily on empirical data rather than theoretical support.

    Lidcombe Programme - Continued

    • Parents learn to identify stuttered and fluent speech.

    • Praising and correcting speech occurs naturally.

    • Treatment adjustments are based on daily severity ratings.

    • Severity ratings form the basis for all therapy decisions.

    • The typical treatment duration in 11 sessions (11 weeks).

    • Data exists regarding success using this model on over 2,000 children.

    Lidcombe Programme - Continued

    • Parents receive information regarding stuttering, treatment descriptions, and severity rating training.

    Demands & Capacities Model

    • Capacities: motor control, speech rhythm, language skills (syntax, semantics, phonology, pragmatics), cognitive development, and socio-emotional factors (emotional maturity, reactions to disfluency, ability to move on in spite of fears, anxiety, anger).

    • Demands: communication environment, articulation/phonological planning, parent's rate and communicative style, environmental demands, linguistic stressors, and social/emotional stressors.

    Demands & Capacities Model - Continued

    • Intervention focuses on reducing demands (with parent counselling, education, skill development) and increasing capacity (fluency shaping strategies, social/emotional development).

    Therapy

    • Fluency enhancers: slow, stretched speech with correct intonation, simpler sentences, and frequent silent periods.
    • Eliminate questions, interruptions, and verbal performance demands.
    • Using slowed conversation turn-taking style.
    • Employ self-talk and parallel play, following the child's lead in play, and producing disfluencies in conversation.

    Therapy Summary

    • Therapy should be accountable, effective, eclectic, efficient, short-term, integrated.

    • Parent training and involvement are vital.

    • Parents need education and information in order to change behaviours.

    • Parents should not be "stuttering police".

    Teachers - What Can They Do?

    • Teachers can provide a fun and encouraging environment.
    • They should avoid inadvertently disrupting fluency.
    • Teach parents how to manage the program successfully

    Each program has very specific objectives based on the theory or approach.

    • Stocker Probe Technique

    • Shine: Systematic Fluency Training for Young Children

    • Conture, Chapter 3: Stuttering, its Nature, Diagnosis, and Treatment

    • easy does it 1

    Different Therapy Techniques and Programmes

    • Guitar: Shapiro, Chapter 9 & 10 (integrated approach)
    • Lidcombe: Mark Onslow (tape, video, stopwatch)
    • SIP: Rebecca Pinzola (intervention program)
    • Smooth Talking: Nola Radford
    • Palin Child Intervention (PCI)
    • The school-aged child who stutters: Chmela, K.A., Rearden, N. (SFA).

    The Basic Objectives of These Programmes

    • Build up linguistic complexity
    • Experience fluency
    • Establish fluency
    • Desensitize and resist fluency disruptors
    • Work on personal constructs
    • Transfer and maintain

    Factors Potentially Associated with Childhood Stuttering

    • Negative responses to stuttering (e.g., fast-paced questions, interrupting).
    • Demanding questioning.
    • Competition for talking time.
    • Rapid conversation pace.
    • Major life changes and traumatic events.

    Achieving Communication Wellness

    • Achievements: "Normal" conversational fluency is achieved.
    • Therapy approach: easy talking for parents and child, conversational level direct model to question model.
    • Model and Practice for Parents: Reflecting/Rephrasing, reduced demands, increased pausing/reduced pace, easy talking.
    • Improve Communication Attitudes: modify communicative stressors, interpersonal stressors, different disfluency types.

    More Concern (in Preschoolers)

    • Family history of chronic stuttering.
    • Male gender.
    • Stable or increasing stutter-like disfluencies over 12 months.
    • Stuttering onset after 36 months.
    • Poorer speech/language performance.
    • No family history of recovered stuttering.

    Less Concern (in Preschoolers)

    • Decrease in disfluencies over 12 months.
    • Early onset of symptoms
    • Strong speech/language skills.

    Fluency Reinforcement

    • Process: conditioning/experiencing fluency.
    • Stimulus → Response → Reward.
    • Examples include Lidcombe Program, Stocker Probe Technique, and Smooth Talking.

    Fluency Reinforcement

    • These programs vary by age group, duration, follow-ups, target population.

    Stuttering Treatment Overview: Preschool Children

    • The goal is improving fluency, helping parents and teachers create a supportive environment and encouraging the child to develop normal speech patterns.

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    Related Documents

    Stuttering Intervention Lecture Notes PDF

    Description

    Explore various approaches to stuttering intervention, including the comparison between therapy styles, treatment phases, and considerations for both children and adults. Learn about the importance of client involvement, goal setting, and managing emotions in the therapy process.

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