Podcast
Questions and Answers
What is the main approach used by the Lidcombe Programme for treating children with stuttering?
What is the main approach used by the Lidcombe Programme for treating children with stuttering?
During therapy, what critical measure do parents use to guide treatment adjustments in the Lidcombe Programme?
During therapy, what critical measure do parents use to guide treatment adjustments in the Lidcombe Programme?
What is the recommended duration for the median treatment time in the Lidcombe Programme?
What is the recommended duration for the median treatment time in the Lidcombe Programme?
Which of the following is NOT a component of the Lidcombe Programme?
Which of the following is NOT a component of the Lidcombe Programme?
Signup and view all the answers
What should parents do if there is no improvement observed within six weeks of starting therapy?
What should parents do if there is no improvement observed within six weeks of starting therapy?
Signup and view all the answers
What is one of the basic objectives of fluency training programs?
What is one of the basic objectives of fluency training programs?
Signup and view all the answers
Which technique involves training parents to manage a fluency program?
Which technique involves training parents to manage a fluency program?
Signup and view all the answers
What is meant by 'desensitize and resist fluency disruptors' in fluency training?
What is meant by 'desensitize and resist fluency disruptors' in fluency training?
Signup and view all the answers
What kind of complexity should fluency training build up?
What kind of complexity should fluency training build up?
Signup and view all the answers
Which of the following factors is NOT associated with a family history of chronic stuttering?
Which of the following factors is NOT associated with a family history of chronic stuttering?
Signup and view all the answers
What is the main goal of stuttering treatment for preschool children?
What is the main goal of stuttering treatment for preschool children?
Signup and view all the answers
Which technique is NOT mentioned as a form of fluency reinforcement?
Which technique is NOT mentioned as a form of fluency reinforcement?
Signup and view all the answers
Which factor may indicate less concern regarding a child's stuttering?
Which factor may indicate less concern regarding a child's stuttering?
Signup and view all the answers
In the context of fluency reinforcement for therapy sessions, what is the typical duration for the Lidcombe Program?
In the context of fluency reinforcement for therapy sessions, what is the typical duration for the Lidcombe Program?
Signup and view all the answers
What is a critical component of stuttering treatment for preschool children aside from improving fluency?
What is a critical component of stuttering treatment for preschool children aside from improving fluency?
Signup and view all the answers
Which factor is NOT considered when assessing stuttering for therapy?
Which factor is NOT considered when assessing stuttering for therapy?
Signup and view all the answers
What is the main focus of therapy for children who stutter?
What is the main focus of therapy for children who stutter?
Signup and view all the answers
What is a significant difference in treating children compared to adults for stuttering?
What is a significant difference in treating children compared to adults for stuttering?
Signup and view all the answers
Which component is NOT included in the long-term goals of therapy?
Which component is NOT included in the long-term goals of therapy?
Signup and view all the answers
What does the self-determination aspect of therapy emphasize?
What does the self-determination aspect of therapy emphasize?
Signup and view all the answers
Which of the following is NOT a key aspect of managing stuttering?
Which of the following is NOT a key aspect of managing stuttering?
Signup and view all the answers
What should the focus of therapy primarily depend on?
What should the focus of therapy primarily depend on?
Signup and view all the answers
Which strategy is least likely to be encouraged for effective communication in therapy?
Which strategy is least likely to be encouraged for effective communication in therapy?
Signup and view all the answers
What is the primary focus of indirect intervention for preschool children with stuttering?
What is the primary focus of indirect intervention for preschool children with stuttering?
Signup and view all the answers
Which technique is NOT recommended for helping reduce disruptions in a child's fluency?
Which technique is NOT recommended for helping reduce disruptions in a child's fluency?
Signup and view all the answers
What is one of the aims of the educational counseling provided to parents?
What is one of the aims of the educational counseling provided to parents?
Signup and view all the answers
Which of the following is NOT a focus of intervention for stuttering?
Which of the following is NOT a focus of intervention for stuttering?
Signup and view all the answers
Which of the following is a correct method for facilitating communication with a preschool child?
Which of the following is a correct method for facilitating communication with a preschool child?
Signup and view all the answers
What is one of the fluency enhancers recommended in therapy?
What is one of the fluency enhancers recommended in therapy?
Signup and view all the answers
What role do parents play in the context of stuttering therapy for preschool children?
What role do parents play in the context of stuttering therapy for preschool children?
Signup and view all the answers
Parent training in stuttering therapy should aim to:
Parent training in stuttering therapy should aim to:
Signup and view all the answers
Which interaction factor contributes most significantly to improving a child's fluency?
Which interaction factor contributes most significantly to improving a child's fluency?
Signup and view all the answers
What is a demand that might affect a person who stutters?
What is a demand that might affect a person who stutters?
Signup and view all the answers
Which of the following strategies is designed to help parents identify communication difficulties?
Which of the following strategies is designed to help parents identify communication difficulties?
Signup and view all the answers
Which of the following reflects a social/emotional demand impacting stuttering?
Which of the following reflects a social/emotional demand impacting stuttering?
Signup and view all the answers
What type of speech disruption is specifically recognized as a target for modification in parent interactions?
What type of speech disruption is specifically recognized as a target for modification in parent interactions?
Signup and view all the answers
What is a typical characteristic of parent involvement in stuttering therapy?
What is a typical characteristic of parent involvement in stuttering therapy?
Signup and view all the answers
Which statement best describes the 'demands and capacities' model?
Which statement best describes the 'demands and capacities' model?
Signup and view all the answers
How should therapy for stuttering be characterized?
How should therapy for stuttering be characterized?
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.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
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.
