Stuttering

Characteristics

100

What is disfluency? 

Overt disruptions in a spoken word

200

NSD

Interjections,Revisions,phrase repetitions

300

SLD

Sound, Pw, Monosyllablic word repeition, blocks, prolongations, Dysrhythmic phonation

400

Percent of Family history of stutterin

30-60%

500

Physical Concominents are also known as..

Secondary Characteristics

Theories

100

Lee Travis

Central Dominence Theory

200

How did Wendall Johnson think stuttering developed? 

The slippery slope (Diagnosogenic theory)

300

Who is the father of stuttering? 

Charles Van Riper

400

Phases of Charles Van Riper's theory

Preschool-little concern

Elementary Aged-little more concerned

Late-Childhood-Complex stuttering and negative reactions 

Adolescence and Adulthood-Circumlocutions, shame and avoidence

500

Incidence Vs Prevalence

Incidence: only the number of new cases that arose in the current period (5%)

Prevalence: the number of cases in the current period, both old and new cases (1%)

Assessment

100

Why should we treat a child? 

By the time the child is referred to an SLP, they have likely already stuttered for a year or more.

200

Young Child Checklist: 

-Case History-Observable disfluencies (duration, frequency, type)

-CWS’s  awareness, reactions, struggle

-Environmental impact, other’s reactions

-Speech/language development

300

Adolescence Checklist

-Case History-History of Tx, knowledge of Stuttering and Treatment-Perception of both-Presumed etiology

-Observable disfluencies (duration, frequency, type)-CWS’s  awareness, reactions, struggle

-Secondaries

-Environmental impact, other’s reactions

-Assess Temperament, Attitude and Emotional Reaction

-Assess Impact to School/Work

400

Case History

•Exact time/age of onset

•Manner of onset (gradual or sudden)

•Changes to stuttering since onset  (use rating scale 0-10)

•Family history

500

Risk Factors 

•Severity

•Phonology

•Language skills 

•Secondary  characteristics-   Presence may indicate greater risk.

•Concomitant disorders,

Assessment Tools

100

Parameters of the SSI

Frequency, Duration, Secondary Behaviors

200

Parameters of Verbatim Transcription

Frequency, Type, Duration, Severity 

300

Four Sections of the OASES

General Information, Speaker’s Reaction, Daily Communication, and Quality of Life.  

400

Advice to Parents Handling Home Environment 

Decrease various time pressures (interruptions, question bombardment)

•Monitor emotional and physical excitement

•Present a slower pace of daily activities

•Speak slower, especially to child 

• Promote child’s self confidence.

500

Assessing Emotions 

KIMS, OASES, MAAS

Interventions

100

Stuttering Modifications

• Cancellation 

• Pull out/slide out/ease out  

• Easy stuttering 

• Catching the stutter 

• Relaxing the stutter 

200

Fluency Enhancement 

• Decreasing rate 

• Easy onsets 

• Light contacts 

• Modified breathing 

• Pausing 

• Modified rate and stretched speech 

300

Indirect Therapy

1. EDUCATE PARENTS

2. IDENTIFY AND MANAGE  ENVIRONMENT

3. MODEL EASY CONVERSATION STYLE

4. TRAIN PARENTS TO USE EASIER CONVERSATION STYLE5. PROVIDE COUNSELING TO PARENTS

400

Direct therapy

1. reduce signs of physical tension in speech mechanism

2. modify rate to account for language complexity and formulation

3. demonstrate and teach how to stutter easily without tension

4. address child’s feelings and attitudes about stuttering

500

Lidcombe Method

1. PARENT LED, CLINICIAN GUIDED

2. PARENTS PRAISE DESIRED BEHAVIOR

3. OCCASIONAL ACKNOWLEDGMENT OF STUTTERED LIKE DISFLUENCY FOLLOWED BY A REQUEST FOR REPETITION WITH EASY FLUENCY*POSITIVE PRAISE IS 5 TIME MORE FREQUENT THAN REQUEST FOR SELF CORRECTION