Stuttering Treatment in Older Preschool Children

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Questions and Answers

What is the age range typically associated with older preschool children who may exhibit stuttering?

2.5 to 7 years

5 to 8 years

3.5 to 6 years (correct)

2 to 4 years

Which of the following is NOT considered a core behavior of stuttering?

Part-word repetitions

Eye blinks (correct)

Excessive tension

Prolongations

What feeling is commonly experienced by children who stutter but has not yet developed into fear or shame?

Anger

Frustration (correct)

Annoyance

Embarrassment

What is a key aspect of effective treatment for stuttering in children?

Reinforcing fluency in structured situations Signup and view all the answers

What is the primary goal of the Lidcombe Program?

To shape fluency in preschoolers younger than 6 years Signup and view all the answers

Which behaviors are classified as secondary behaviors in stuttering?

Avoidance devices Signup and view all the answers

What approach helps to reinforce fluent speech in children who stutter?

Daily structured practice Signup and view all the answers

Which treatment model begins treatment of fluency simultaneously with other speech disorders?

Concurrent model Signup and view all the answers

What does the cyclic model primarily provide to the child in treatment?

Initial concentrated learning of new skills Signup and view all the answers

Why is it unnecessary to focus directly on feelings and attitudes during therapy for children who stutter?

Family influences these feelings Signup and view all the answers

What type of fluency goal is aimed for in the treatment of stuttering?

Spontaneous, normal fluency Signup and view all the answers

For which of the following approaches is certification necessary to implement?

Lidcombe Program Signup and view all the answers

What is emphasized during the maintenance phase of stuttering therapy?

Continued data collection and systematic fading contact Signup and view all the answers

How does the blended model support fluency treatment?

By treating fluency and other disorders together Signup and view all the answers

What should parents do regarding their child's stuttering?

Discuss it openly in the child's presence Signup and view all the answers

Which treatment approach focuses on fluency practice using mastered language structures?

Concurrent model Signup and view all the answers

Study Notes

Treatment of Stuttering in Older Preschool Children

Older preschool children are between 3.5 and 6 years old, sometimes 7 or 8 years old.
A presentation on stuttering treatment in older preschool children was given by Dr. Fauzia Abdalla.
The presentation involved a fluency disorder, CDS 432.

Beginning Stuttering: An Integrated Approach

The approach to stuttering is integrated.
A mother and child are pictured in both clinic and structured/unstructured home conversations.
A Child's Stuttering Severity Rating Chart is mentioned as a tool in the process.

Core Behaviors

Part-word repetitions happen quickly and irregularly.
Prolongations of sounds may also be present.
Stuttering involves excessive tension in the voice with abrupt endings and increases in vocal pitch. Blocks may also be present but aren't the main characteristic.

Secondary Behaviors

Escape devices include eye blinks, head nods, and increases in pitch.
Avoidances include starting sentences with extra "uh" sounds.

Feelings

Children experience frustration in their difficulty speaking.
Some children avoid speaking.
Fear of stuttering or shame of their speech might be present. (Not fully developed yet).

Nature of Stuttering

Basic sensory-motor difficulties interact with temperament and developmental and environmental influences impacting repetitions, prolongations and blocks.
Daily structured fluency practice reinforces neural pathways for fluent speech, resulting in more robust and automatic speech that is more resistant to stress.

Lidcombe Program (LP)

An operant conditioning treatment for stuttering administered by a parent or caregiver, guided by weekly meetings with the clinician.
Operant conditioning uses rewards/punishments to either increase or decrease the frequency of a behavior.
Verbal contingencies, such as remarks made immediately after events (e.g., fluent speech, stuttering), are used to modify behavior frequency.
Stage 1 goals are to reach normal speech fluency.
Criteria for completing Stage 1 include three consecutive weeks where:
- Weekly parent scores average less than 2, with most of sessions rating as 1s or 2s
- Clinician's sessions rating are mostly 1s-2s.
Stage 2, focuses on maintaining fluency and gradually decreasing clinic visits.
The schedule of sessions are spaced out across two-two-four-four-eight-eight- and finally 16-week intervals. The child must consistently meet fluency criteria.

Clinical Procedure

The initial focus is eliciting fluency in extremely structured situations, and then transferring that to more real-life situations where stuttering occurs.
Effective treatment helps children gain/regain spontaneous fluency.

Feelings and Attitudes

Occasional frustration and concerns about talking are normal.
Conditions fears and avoidance of stuttering are not usually issues to be addressed immediately.
Families are helped to view the child's speech objectively, whether “smooth” or “bumpy”.
Open family discussion about the child's stuttering is encouraged.
Feelings and attitudes are a secondary aspect in the treatment.

How Do We Help Young Children Who Stutter?

The presentation was delivered by Nina Reeves and J Scott Yaruss.
Resources are available.

Clinical Procedure-Maintenance

Continue careful data collection and contact schedule tapering.
Stress appropriate fluency contingency maintenance at the beginning of treatment.
Return to meetings to address any potential relapses.

Clinical Methods - Lidcombe Program

The presentation has a website mention for the 'Australian Stuttering Research Centre (ASRC)'.
The program is an operant conditioning treatment delivered by a parent or caregiver, guided by weekly meetings with the clinician.
The parent is educated to consistently give positive feedback mostly when the child is speaking fluently.

Lidcombe Summary

The approach is direct, focusing on fluency shaping.
Intended clients are typically preschoolers under 6 years of age.
The program involves two stages.
Training/certification is necessary to administer this treatment approach successfully.

Treatment Activity #2b: Changing Stuttering

The activity encourages the child to prepare for changing stuttering tension through a fist analogy exercise.
The child is getting instruction on changing stuttering tension using a non-speech analogy.

Treatment of Co-occurring Speech and Language Problems

Sequential model: Language/articulation issues are addressed first to hopefully remove stuttering issues.
Concurrent model: Fluency treatment is implemented simultaneously with tackling other issues. Fluency practice is restricted to language structures that have been previously mastered.
Blended model: Addresses both fluency and other speech/language problems simultaneously.
Cyclic model: Fluency treatment and language/phonology treatment alternate throughout the year. Concentrated learning sessions are followed by opportunities for spontaneous generalization.

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Description

This quiz explores the treatment of stuttering in older preschool children, focusing on core and secondary behaviors. It highlights integrated approaches to addressing fluency disorders, using tools like the Child's Stuttering Severity Rating Chart. Understanding these concepts is essential for effective intervention in early childhood settings.