Treatment of Stuttering in Older Preschool Children PDF

TREATMENT OF STUTTERING IN OLDER PRESCHOOL CHILDREN CDS 432 Fluency Disorders Dr. Fauzia Abdalla  2 OLDER PRESCHOOL CHILDREN ARE BETWEEN 3.5 AND 6 YEARS SOMETIMES 7 OR 8 YEARS  BEGINNING STUTTERING An Integrated Appro...

TREATMENT OF STUTTERING IN OLDER PRESCHOOL CHILDREN CDS 432 Fluency Disorders Dr. Fauzia Abdalla  2 OLDER PRESCHOOL CHILDREN ARE BETWEEN 3.5 AND 6 YEARS SOMETIMES 7 OR 8 YEARS  BEGINNING STUTTERING An Integrated Approach  4 AN INTEGRATED APPROACH Guitar Text  MOST COMMON BEHAVIORS 5 CORE BEHAVIORS o Part-word repetitions that are produced rapidly, usually with irregular rhythm. Some prolongations may also be present. o Stutters contain excessive tension (heard as abrupt endings, increases in vocal pitch). Blocks may be present but not predominant core behavior. SECONDARY BEHAVIORS o Escape devices (eye blinks, head nods, increases in pitch). o A few avoidance = starting sentences with extra "uh". Guitar Text  MOST COMMON BEHAVIORS 6 FEELINGS o frustrated with their difficulty in talking –not yet developed fear of stuttering or learned to be ashamed of their speech. o Some children may momentarily avoid talking. Guitar Text Page 253 NATURE OF STUTTERING 7 o Basic sensory-motor difficulty interacts with their temperament and other developmental and environmental influences to produce or exacerbate repetitions, prolongations and blocks. o Daily structured practice of fluency reinforces neural pathways for fluent speech so they can become more robust, more automatic and more resistant to stress. Guitar Text TERMINOLOGY 8  9 CLINICAL PROCEDURE Fluency Goal o Elicit fluency in highly structured situations → systematically reinforce → carefully transfer to more and more real-life situations in which stuttering is occurring. o Effective treatment → can gain or regain spontaneous, normal fluency. Guitar Text  10 CLINICAL PROCEDURE Feelings and Attitudes o Occasional frustration and intermittent concern about talking. No conditioned fears or avoidances of stuttering. o Unnecessary to focus directly on feelings and attitudes in therapy. Feelings and attitudes are influenced by family – teach family member to be matter- of-fact about child’s “smooth” and “bumpy” speech. o Openly discuss with family child’s stuttering in his presence Guitar Text  11 For SLPs: Early Childhood Stuttering Therapy  12 CLINICAL PROCEDURE Maintenance o Systematic fading contact and continued careful data collection. o Stress maintenance at outset of treatment. o Return to weekly meetings to discuss appropriate contingencies for fluency & stuttering if relapse occurs. Guitar Text  CLINICAL METHODS 13 LIDCOMBE PROGRAM Guitar Text  14 https://www.youtube.com/watch?v=JVz42q8U8zg  LIDCOMBE SUMMARY 15 Direct approach based on fluency shaping Intended clients preschoolers younger than 6 years It consists of two stages You need training/certification to apply this approach https://www.youtube.com/watch?v=hh2Vg74_2oU&t=52s  16 https://www.youtube.com/watch?v=4z6YUeEp4IM&t=205s  17 https://www.youtube.com/watch?v=_Hyl-BSyJCc TREATMENT OF CONCOMITANT 18 SPEECH AND LANGUAGE PROBLEMS Sequential model = treats language or articulation problem first with the hope that once this problem is resolved stuttering will no longer be a problem for the child. Concurrent model – begin treatment of fluency simultaneously with treatment of other disorder. Child practices fluency only with language structures that have been mastered. TREATMENT OF CONCOMITANT 19 SPEECH AND LANGUAGE PROBLEMS Blended model –works on both fluency and other disorder at the same time which provides extra support of fluency. Cyclic model – alternates fluency treatment with language or phonology over the course of the year. Provides child with initial periods of concentrated learning of new skills, followed by opportunities for spontaneous generalization of these skills to other settings.