csds 115 exam 4 Unit 5 mutlicultural/lingual assessment considerations, interjudge and intrajudge ability, problems in stuttering assessments

Eye contact

in some cultures inappropriate. SLP may encourage eye contact improvement but need to be culturally sensitive

Physical contact

in some cultures, touching a client (even their arm/hand) is invasion of personal space. SLP may need to ask/explain need for physical guidance when working with stuttering.

Nature of reinforcers

maybe a family prefers use of special symbols rather than just saying "great job"

Family interactions

some families talk over each other/or dont. Some stuttering children have benefited when family dynamic changes. Ex) family speech slows down, client's speech slows down, less opportunity for error.

Intentional stuttering

some cultures perceive stutter as negative. During some treatment we may ask client to stutter on purpose to reduce stutter due to fear. Requires educating family on why we would ask client to stutter.

Conversational style

other cultures may be offended by clinician asking many personal questions we are required to investigate. So being aware/culturally sensitive is key to building rapport/effective treatment.

Modes of address

determine respectful way to address client and client's family "how would you like me to address you?"

Behaviors of interest should be assessed

ex) core stuttering behaviors, secondary behaviors, respiration, phonatory and laryngeal aspects

Assessment of stuttering involves

measurement of disfluencies

Disfluencies should be measured in

Clinical and nonclinical settings/ In oral reading and conversational speech/

Reliability

is the degree to which repeated measures are consistent

Measurements should be repeated to

establish reliability

interjudge reliability

Degree to which measures taken by two or more individuals agree/2 individuals measure same event and measures are evaluated to establish degree the measures agree

The greater the agreement between the two measures

the higher the reliability

intrajudge reliability

Degree to which two or more measures taken by the same observer agree

Intrajudge reliability; Same clinician measures: the same event two or more times and evaluates the degree to which the measures agree

The greater the agreement

the higher the intrajudge reliability

Variables contributing to difficulty in measuring stuttering

Varied definition of stuttering, Lack of clinician training, Variability of stuttering within

Lack of clinician training in stuttering measurements

Early SLPs are overwhelmed with first stuttering client, overtime easier to identify

Variability of stuttering within, in stuttering measurements

Different speaking conditions/Oral reading vs. conversation