Final Exam - Fluency

therapy techniques

* fluency enhancing: increase fluent speech
* stuttering modification: target the stuttering behavior

specific goals for advanced stuttering

* controlled fluency: conscious monitoring of speech
* acceptable stuttering: noticeable stuttering but speaker is comfortable with it

phases in treatment

1. education
2. identification
3. desensitization
4. modification
5. maintenance

Education

* teaching clients basics of speech production
* dispelling myths about stuttering
* info about stuttering
* make sure you and your client are on the same page with definitions of stuttering/concepts

Identification

* client recognizes and examines the core behaviors, secondary behaviors, and feelings/attitudes associated with their individual nature of stuttering
* therapy strategies used to identify behaviors:
* oral reading
* discussion
* modeling stuttering behaviors
* self observation

identification helps clients explore:

* the physiology of speech
* what happens during stuttering:
* identify types of stuttering
* pseudo stuttering
* identify moments of stuttering and what happens during stuttering

Identification: discussion for advanced stuttering

* name 5 difficult speaking situations
* name 5 easy speaking situations
* name 3 difficult people to talk to
* name 3 easy people to talk to

Identification: discussion for early stuttering 

* clients may assume all types of disfluency is stuttering
* less direct than in advanced stuttering


1. how your client feels when stuttering?
2. what do your clients do when they stutter? (speech behavior & emotions)

Desensitization

* clients learn strategies to reduce negative feelings and anxiety associated with stuttering
* therapy strategies are to confront the disorder and desensitize the individual to stutter behaviors and listener reactions

desensitization is mainly…

the reduction of negative emotion

component/steps in desensitization: Van Riper’s Adult stuttering therapy

1. Time pressure


1. Plan scenarios where clients feel rushed but have to resist the urge to rush through speech.


1. Stuttered speech


1. Pseudostuttering


1. Negative Emotion


1. Discuss worse case scenario and how to deal with the emotions
2. Eye contact


1. Depends/May be over-rated

general guidelines for teaching techniques

1\. Clinician models and client observes

2\. Clinician and client practice together

3\. Client practices technique with clinician feedback

4\. Client tries to teach the clinician how to use the technique

5\. Client practices and rates own production with clinician guidance.

6\. Client practices the behavior and self-monitors.

controlled fluency techniques (fluency shaping)

1. Slower rate
2. Soft starts/Easy Onset
3. Soft contact/light articulatory contact

speech rate (before stutter): goals

1. Overall slower speech i.e. fewer words per minute
2. Smooth connected speech
3. Increase fluency


1. Stretching sounds and syllables and/or
2. Pausing
3. Proprioception (overarticulation)