Treatment of Stuttering in Preschool Children
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Questions and Answers

What is the first step in evaluating family interaction patterns?

  • Monitor speech rate of all family members.
  • Observe family interaction in a clinical setting.
  • Record a 10-minute conversation typical of the child. (correct)
  • Transcribe past interactions with the child.
  • What should be quantified during the evaluation of family interactions?

  • Behavioral changes in the clinician.
  • The emotional responses of the parents.
  • The number of stutters made by the child.
  • Eight specific variables related to interaction. (correct)
  • What family interaction patterns may negatively impact a borderline stutterer?

  • Positive reinforcement during conversations.
  • Encouragement during speech practice.
  • Busy household interactions that create pressure. (correct)
  • Slow and clear speech rates.
  • Which technique is recommended for parents to help a child who stutters?

    <p>Model interaction with slower speech and pauses. (C)</p> Signup and view all the answers

    What is the purpose of the clinician modeling interaction with the child?

    <p>To demonstrate changes in conversational patterns. (C)</p> Signup and view all the answers

    How long should the family observe the clinician's interaction before participating?

    <p>5-10 minutes. (B)</p> Signup and view all the answers

    What ratio of positive to corrective comments is suggested for giving feedback to families?

    <p>5:1 ratio. (C)</p> Signup and view all the answers

    What should families consider changing in their interactions to aid a child who stutters?

    <p>Strategies that improve communication patterns. (B)</p> Signup and view all the answers

    What is a key characteristic of children with mild borderline stuttering?

    <p>They are mostly fluent and can develop normal fluency. (C)</p> Signup and view all the answers

    In the treatment for severe borderline stuttering, what is essential to address without delay?

    <p>The child's negative feelings about stuttering. (A)</p> Signup and view all the answers

    What is the primary aim of indirect treatment for borderline stuttering in younger preschool children?

    <p>Change the environment to foster fluency (C)</p> Signup and view all the answers

    Which approach is emphasized for parents of children with mild borderline stuttering?

    <p>To use praise for fluency during daily one-on-one time (D)</p> Signup and view all the answers

    At what age range are children typically considered to have borderline stuttering?

    <p>2 to 3.5 years (B)</p> Signup and view all the answers

    What frequency should parents use positive reinforcement for fluency in a session?

    <p>1 for every 5 utterances (C)</p> Signup and view all the answers

    How often should sessions with a clinician occur for children with severe borderline stuttering?

    <p>Once a week (A)</p> Signup and view all the answers

    Why should direct treatment be approached cautiously in children with borderline stuttering?

    <p>It could interfere with natural recovery (D)</p> Signup and view all the answers

    What is an important focus during interactions with children with mild borderline stuttering?

    <p>Encouraging a relaxed environment. (B)</p> Signup and view all the answers

    What is a common characteristic of stuttering in younger preschool children within the borderline category?

    <p>Loose and relaxed repetitions (D)</p> Signup and view all the answers

    What should be included in daily logs for parents of children with mild borderline stuttering?

    <p>Overall fluency severity ratings from 1 to 10. (B)</p> Signup and view all the answers

    What is the main goal of achieving spontaneous fluency in treatment?

    <p>To promote natural speech patterns (A)</p> Signup and view all the answers

    What does the treatment hierarchy for severe borderline stuttering involve?

    <p>Advancing to the next step when the child feels competent. (D)</p> Signup and view all the answers

    What two principles guide the treatment of borderline stuttering?

    <p>Decrease stress and enhance fluency (B)</p> Signup and view all the answers

    What happens if there is no progress after six weeks of indirect treatment?

    <p>Direct therapy is implemented (A)</p> Signup and view all the answers

    What assumption does direct therapy make regarding the child's awareness?

    <p>The child is somewhat aware of their stuttering (A)</p> Signup and view all the answers

    What is one significant motivator for changing a child's stuttering?

    <p>Significant change in child's stuttering (A)</p> Signup and view all the answers

    What is a recommended duration for one-on-one time between a parent and child each day to help with fluency?

    <p>15 to 20 minutes (A)</p> Signup and view all the answers

    Which approach is suggested to maintain a child's fluency during periods of stress?

    <p>Help the family view stuttering more objectively (C)</p> Signup and view all the answers

    What type of play is suggested to facilitate fluent interactions with a child?

    <p>Child-directed and attentive play (C)</p> Signup and view all the answers

    When should families ideally implement fluency-facilitating verbal interactions?

    <p>In the morning for daily carryover (C)</p> Signup and view all the answers

    What approach involves having the child produce intentional stutters?

    <p>Non-Lidcombe direct treatment (D)</p> Signup and view all the answers

    What is the purpose of praising and rewarding the child during treatment?

    <p>To build their confidence (C)</p> Signup and view all the answers

    What should families do in response to periods of increased stress related to a child's stuttering?

    <p>Develop a problem-solving plan (A)</p> Signup and view all the answers

    Which technique involves parents witnessing and accepting the child's stutter?

    <p>Desensitization (D)</p> Signup and view all the answers

    How often should families meet to continue assessing and supporting their efforts in managing stuttering?

    <p>Once every two weeks (A)</p> Signup and view all the answers

    Which of the following represents a common misconception about stuttering management?

    <p>Once fluency is achieved, no further effort is needed (D)</p> Signup and view all the answers

    What method is used to shape the child's stuttering into a slower and more relaxed style?

    <p>Positive reinforcement (B)</p> Signup and view all the answers

    What initial step should be taken if a child has not benefited from previous treatments?

    <p>Modify their own stutters (A)</p> Signup and view all the answers

    What should parents learn to do to support their child's treatment?

    <p>Stutter themselves under guidance (A)</p> Signup and view all the answers

    How can spontaneous generalization of easier stutters be encouraged?

    <p>By celebrating success in therapy sessions (B)</p> Signup and view all the answers

    When should modeling of slower stuttering be introduced?

    <p>When the child is ready to modify their stutters (D)</p> Signup and view all the answers

    What is a key component of modeling easy stutters during play?

    <p>Providing models of easy stuttering in speech (B)</p> Signup and view all the answers

    How should a clinician respond if a child expresses dislike towards modeled easy stuttering?

    <p>Reassure the child about the process slowly (A)</p> Signup and view all the answers

    What is the purpose of the 'catch me' activity?

    <p>To encourage the child to participate actively (A)</p> Signup and view all the answers

    What might a clinician do during the 'catch me' activity to help the child?

    <p>Change a fast, tight repetition to a slow, loose one (D)</p> Signup and view all the answers

    In the context of play, how can clinicians help a child become desensitized to their disfluencies?

    <p>Playfully imitate disfluencies similar to the child's (D)</p> Signup and view all the answers

    What role do tangible rewards play in the 'catch me' activity?

    <p>They reinforce the child's sense of competence (D)</p> Signup and view all the answers

    What is one approach clinicians might use to help a child express their frustration with stuttering?

    <p>Allowing the child to vocalize their feelings (A)</p> Signup and view all the answers

    What technique is suggested for introducing easy stutters during a play session?

    <p>Inserting easy stutter models every two to three sentences (C)</p> Signup and view all the answers

    Flashcards

    Family Interaction Pattern Analysis

    The recording and analysis of family interactions to identify patterns that may contribute to stuttering. This includes observing and quantifying variables such as interruptions, turn-taking, and overall communication style.

    Slower Speech Rate with Pauses

    A technique used to help children who stutter by teaching them to speak more slowly with pauses. This involves modeling and practicing slower speech rates with intentional pauses during natural conversations.

    Modeling Interaction

    The process of showing a child how to communicate with a slower speech rate and pauses. This can involve modeling desired communication patterns, then having the family engage in similar interactions.

    Positive Feedback Ratio

    Positive feedback given during therapy to encourage and reinforce desired communication behaviors. The therapist should focus on providing five positive comments for every one corrective mention.

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    Borderline Stuttering

    Stuttering in children between 2 and 3.5 years old, characterized by loose and relaxed repetitions. Often a temporary phase.

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    Indirect Treatment

    Treating stuttering in young children by focusing on changing the environment instead of directly teaching the child ways to change their speech.

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    Direct Treatment

    Directly teaching a child to change their stuttering behaviors.

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    Spontaneous Fluency

    The ability to speak fluently without stuttering. This is the goal of treatment.

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    Educate Family and Reduce Stress

    Educating the child's family on ways to reduce stressful communication interactions and promote fluency.

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    Changing Repetitions and Prolongations

    Changing the child's repetitions and prolongations to make stuttering less noticeable or impactful.

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    Constitutional Predispositions

    The child's tendency for stuttering, often related to their individual personality and sensitivity.

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    Developmental Demands

    The pressures of learning and growing up, which can influence stuttering.

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    Family Routine Changes

    Changes in family routine are a key part of indirect treatment, helping families identify stressors that may contribute to a child's stuttering.

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    Parent-Child Interaction (One-on-One Time)

    Dedicated, one-on-one time with a child is crucial for their self-esteem and can positively affect their stuttering.

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    Non-Directive Play

    These interactions can be non-directive play, where the child leads, or attentive play that eventually evolves into conversations as the child gets older.

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    Fluency-Facilitating Verbal Interactions

    This dedicated time provides valuable practice for the child to use fluency-facilitating verbal interactions.

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    Maintenance Strategies

    Maintenance strategies help families navigate stressful periods that may lead to an increase in stuttering. These strategies help families manage stress and reduce anxiety about the child's disfluencies.

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    Objective View of Stuttering

    Parents can learn to view their child's stuttering more objectively, reducing anxiety and guilt they may feel. This helps them foster a calmer and more supportive environment.

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    Confidence in Problem-Solving

    Families gain confidence in their ability to use problem-solving skills they've learned to manage increases in stuttering. It's important to remember that relapses are normal and can be addressed with continued support.

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    Lidcombe Program

    A program designed to help young children who stutter, focusing on parent training and early intervention.

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    Mild Borderline Stuttering

    A type of stuttering where the child has mild awareness of their disfluencies and doesn't show extra effort to avoid stuttering.

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    Severe Borderline Stuttering

    A type of stuttering characterized by increased awareness of disfluencies and potential negative emotions about stuttering, but without physical tension or escape behaviors.

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    Positive Reinforcement for Fluency

    Using praise and positive reinforcement to encourage fluent speech in children with mild borderline stuttering.

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    Daily Fluency Logs

    Tracking the overall fluency of a child with mild borderline stuttering, using a scale from 1 to 10.

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    Gradual Reduction of Praise

    Gradually reducing the frequency of praise for fluency, using it only occasionally during different activities.

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    Weekly Therapy Sessions

    Weekly sessions with a clinician, focusing on providing support, demonstrating techniques and discussing progress.

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    Supportive Environment

    Creating a supportive environment for the child, addressing emotions, and using games and activities to casually address stuttering.

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    Intentional Stuttering

    A technique where the therapist intentionally stutters to show the child it's okay. They'll pretend to struggle with a word and ask the child to show them how to do it.

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    Desensitize to Stuttering

    This technique helps the child and parent get used to the sound of stuttering. The therapist models acceptance and encourages the child to do the same.

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    Changing Real Stutters

    When a child is ready, the therapist helps them change their own stutters. This involves accepting the child's stutter, modeling a smoother way to stutter, and rewarding their attempts.

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    Opportunity for Modification

    The therapist identifies opportunities to help the child modify their stutters when they're ready. This includes observing and responding to their natural stutters in a positive and encouraging manner.

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    Modeling a Slower Stutter

    The therapist may imitate the child's stutter to help them feel more comfortable with it. The therapist also comments positively on the stutter and encourages the child to try a slower, easier way of saying the word.

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    Positive Reinforcement

    Positive feedback is used to encourage the child to use slower and easier stutters. The therapist may praise the child's efforts and reward them for making progress.

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    Generalization of Stuttering

    The goal is to help the child generalize their ability to stutter more easily in different situations. The therapist may work with the family to encourage this at home and teach them to use positive reinforcement.

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    Family Stuttering Training

    The therapist may teach the child's family to stutter in a controlled setting to help them better understand and support the child. This can involve role-playing and practicing different scenarios.

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    Modeling Easy Stutters

    A technique where a therapist models easy stuttering, such as slow repetitions or brief prolongations, during play activities with a child who stutters. This helps the child see stuttering as normal and less threatening.

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    Active participation in "catch me"

    In this technique, the therapist actively stutters during play activities and the child is encouraged to 'catch' the therapist's stutter. When the child identifies a stutter, the therapist demonstrates how to slow down and make the stutter easier. This gives the child a sense of control over stuttering.

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    Active participation in play

    A technique where a child actively imitates disfluencies (stuttering) in a playful way. This helps the child become comfortable with stuttering and reduces the anxiety associated with it.

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    Expressing frustration

    When a child expresses frustration with stuttering, the therapist acknowledges and supports their feelings. This helps the child feel accepted and understood.

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    Praise and rewards

    During 'catch me' activities, the therapist uses various rewards, such as small snacks or turns in a game, to encourage the child's active participation in identifying stutters. This reinforces the child's success and builds their confidence.

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    Matching stuttering style

    The therapist chooses stuttering patterns that closely resemble the child's own to make the therapy feel more relatable and less intrusive.

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    Playfully imitating disfluencies

    A therapist uses activities like repeating sounds or phrases to help the child become comfortable with the idea of stuttering and reduce its emotional impact.

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    Normalizing stuttering

    The therapist helps the child understand that stuttering is a common and normal part of language development. By normalizing stuttering, the child is less likely to feel ashamed or embarrassed.

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    Study Notes

    Treatment of Stuttering in Younger Preschool Children

    • Younger preschool children are aged between 2 and 3.5 years.
    • Treatment for borderline stuttering should be indirect, focusing on changing the environment.
    • Treating children who are more advanced in their stuttering with tension may be less effective as direct intervention may only increase their awareness and frustration.
    • Most children stuttering for less than a year between ages 2 and 3.5 have a high likelihood of natural recovery. Intervention should thus avoid hindering recovery and instead facilitate it.
    • Younger preschool children are not cognitively ready for direct treatment strategies aimed at altering their speech patterns.

    Borderline Stuttering (Integrated Approach)

    • This approach utilizes an integrated approach focused on the interaction of clinician with parents and the interaction with the child.
    • Clinicians counsel parents on facilitating communication and interaction skills.
    • Clinicians model appropriate interaction techniques for parents to practice at home.
    • Key principle is to decrease stress in the environment to aid in increasing fluency and address constitutional predispositions.

    Terminology

    • Indirect treatment: Therapy aimed at alleviating stressors related to communication in various situations.
    • Direct treatment: Therapy focusing directly on speech and fluency, possibly involving techniques to modify stuttering patterns.

    Clinical Procedures (Indirect Treatment)

    • Indirect approach: Focuses on educating families about communication strategies to reduce stress, and improve fluency.
    • Includes demonstrating effective interaction styles, and guiding families to enhance their child's communication.
    • Measures the severity of stuttering employing a rating scale.
    • Baseline Speech Measures: Analyzing the child's environment to document situations that hinder fluency and understanding.
    • Using assessment tools such as rating scales for stuttering severity to evaluate, and record findings regarding speech patterns, considering how factors in the child's environment contribute to disfluencies.
    • Family Interaction Patterns: Recording and quantifying family's interaction patterns by focusing on speech rate with pauses and changes in family routines.
      • Family interaction patterns are documented to help identify aspects needing modification, to facilitate fluency.
      • Methods include slower speech rate with pauses, teaching slower speaking rate, trying slower rate in clinics, using slower rate at home, monitoring parental practice of slower rate, working on other parent/child aspects, and changes in family routines.

    Clinical Procedures (Indirect Treatment)

    • Guidelines: Using materials to understand stuttering and the family's role (possibly through video-tapes). A key component is to gather data on a child's speech, families' perceptions of stuttering, and supporting the family as the child learns and masters better communication skills.

    Clinical Procedures (Direct Treatment)

    • Clinical Procedures: The section discusses different treatment approaches tailored to different severity levels of borderline stuttering, distinguishing between mild and more severe cases.
    • Lidcombe Program: A recognized program for treatment detailing procedures involved in the program.
    • Non-Lidcombe Direct Treatment (Mild Borderline): A treatment approach for mild borderline stuttering that emphasizes fluency.
      • Focuses on having parents praise fluency, ignoring stuttering unless the child is distressed, using praise for smooth talking.
      • Involves daily log keeping of fluency with 1-10 severity ratings by parents, weekly sessions to review progress, and concurrent interaction/family style changes.

    Clinical Procedures (Direct Treatment)

    • Non-Lidcombe Direct Treatment (Severe Borderline): An approach for severe borderline stuttering, including procedures such as modeling easy stutters, child's active participation, producing intentional stutters, and changing child's real stutters.
    • Initially involves modeling fluent speech in play, gradually progressing to incorporating more complex strategies for intentional communication modifications.
    • There's also a detailed description of incorporating play elements into the therapy.

    Maintenance

    • Strategies to maintain therapy gains include helping parents view stuttering objectively, reducing anxiety and panic, and building confidence in applying problem-solving skills during periods of increased stress.
    • Relapse is a possibility and should be expected.

    Treatment Course

    • Indirect treatments take a longer course of actions before transitioning to direct strategies.

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    Description

    This quiz focuses on the treatment approaches for borderline stuttering in younger preschool children aged 2 to 3.5 years. It discusses the importance of an indirect treatment strategy that emphasizes environmental changes and parental involvement to facilitate natural recovery. Explore key concepts in stuttering management within this age group.

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