Fluency Ch. 9

Preassessment

the time before the formal assessment, in which the clinician gathers key information needed for the assessment

Parent-Child Interaction

Play-based conversation between parent(s) and child that is often used to assess and treat environmental influences on a child's stuttering

Parent Interview

A conversation with parent(s) in which parents are encouraged to describe their child's stuttering and their concerns about it. In this interaction, the clinician elicits and gives information relevant to the child's stuttering

Clinician-Child Interaction

Play-based conversation between clinician and child in which clinician observes child's speech and may seek information about child's feelings about his stuttering, as well as information about child's articulation and language skills.

Speech Sample

A segment of speech used to assess a client's stuttering. A sample may be limited to 300 syllables. It may be spontaneous conversation or written work that is read aloud. It is meant to be representative of a client's speech in general

Pattern of Disfluencies

The types of stuttering and/or typical disfluencies shown by someone who stutters. Examples are whole-word repetitions, part-word repetitions, and prolongations

Risk Factors for Persistent Stuttering

Characteristics within the child or within the environment that are hypothesized to increase probability that child will not overcome his stuttering naturally, that is, without intervention

Closing Interview

A conversation at the end of an evaluation session in which the clinician informs the client or family of her findings, makes recommendations for the future, and elicits questions

Individuals with Disabilities Education Act (IDEA '97)

A federal law that mandates the procedures for gathering information and deciding on treatment of children in public schools

Teacher Interview

A conversation with a child's classroom teacher(s) for the purpose of getting information about the child's speech and performance in the classroom. Such a conversation may also be used to enlist the teacher's help with the child's treatment

Classroom Observation

Time spent in the classroom by the clinician to assess how a child's stuttering may be affecting him in his class

Accepting Environment

Behavior by parents and other family members (and teachers and classmates where appropriate) that convey to the child that they accept his speech

Trial Therapy

A brief administration of one or more therapy strategies, used for the purpose of determining the effect on the client's speech in an evaluation

Fluency Skills

Ways of speaking designed to induce fluency. Examples are slow rate, easy onset of voicing, and light contact of articulators

Individualized Education Program (IEP)

A plan, mandated by the Individuals with Disabilities Education Act, that describes how a person with a disability will be educated to meet his individual needs

Stuttering Modification

Ways of managing stuttering that are designed to reduce struggle and tension. Examples are cancellations, pull-outs, and preparatory sets

When evaluating a preschool child, the clinician will try to determine:

a. the level of the parent's concern about their child's speech

b. if the child is stuttering or is normally disfluent

c. whether the child has any other speech or language difficulties

d. all of the above

e. none of the above

d.

Among the options after evaluating a preschool child are

a. watchful waiting

b. no treatment

c. parent-delivered treatment

d. all of the above

e. none of the above

d.

Between the time of a parent's call and the initial meeting with a preschool child

a. the parents should not do anything differently at home

b. the parents may begin keeping daily stuttering severity ratings

c. the parents and clinicians should talk on the telephone daily

d. all of the above

e. none of the above

b.

Video recording a parent and preschool child interacting

a. should only be done at the child's home

b. should only be done with the child's consent

c. should only be done after an initial assessment

d. all of the above

e. none of the above

e.

Talking with a parent about stuttering

a. should not be done if the parent is present

b. is initially done with the child absent

c. should begin with advice about what they can do

d. all of the above

e. none of the above

b.

When beginning an interview with parents of a preschool child, the clinician should

a. avoid "open-ended" questions

b. ask them to demonstrate how the child stutters

c. listen and be nonjudgmental

d. all of the above

e. none of the above

c.

One of the things a clinician might ask the parents of a preschool child is

a. what was the child's speech and language development like?

b. what do the parents believe caused the problem?

c. how do the parents feel about the child's disfluency problem?

d. all of the above

e. none of the above

d.

If a preschool child is entirely fluent during an initial interaction with the clinician,

a. the clinician can assume that he is not a stutterer

b. the clinician may find examples of the child's stuttering on the home video

c. the clinician can assume that this fluency is only temporary

d. all of the above

e. none of the above

b.

When talking with a preschool child, the clinician

a. can comment on her own disfluencies

b. should be direct and use the word "stuttering", rather than saying "getting stuck"

c. should not ask the child if he knows why he has come to the clinic

d. all of the above

e. none of the above

a.

When analyzing a preschool child's speech sample, the clinician

a. looks at frequency of disfluencies, but ignores types of disfluencies

b. looks for signs of tension during both prolongations and repetitions

c. doesn't look for word avoidances

d. all of the above

e. none of the above

b.

When evaluating a school-aged child, it is important for the clinician to speak with

a. the child's parents

b. the child's teachers

c. the child

d. all of the above

e. none of the above

d.

During an initial discussion with a school-age child, the clinician

a. can have the child draw pictures to elicit feelings

b. should engage in light teasing to see how the child responds

c. should suggest to the child that he not use "tricks" to get difficult words out

d. all of the above

e. none of the above

a.

Trial therapy with a school-age child

a. should begin at the first scheduled therapy appointment

b. should be conducted by the parent during the first week after an initial evaluation

c. can be conducted by the clinician during the evaluation

d. all of the above

e. none of the above

c.

Feelings and attitudes in a school-age child can be assessed

a. by looking at startle reactions

b. by using the A-19

c. generally a month after the initial evaluation

d. all of the above

e. none of the above

b.

Which of the following is unimportant when evaluating a school-age child?

a. cognitive development

b. physical development

c. social-emotional development

d. all of the above

e. none of the above

e.

The interview with an adult stutterer begins with

a. having him demonstrate how he stutters

b. having him talk about why he has come to the clinic

c. a description of when he began to stutter

d. all of the above

e. none of the above

b.

A clinician should ask an adolescent stutterer

a. if there are any words he expects to stutter on

b. if he avoids certain speaking situations

c. if he uses any "tricks" to get words out

d. all of the above

e. none of the above

d.

A clinician may refer an adult stutterer for psychotherapy

a. if the stutterer won't talk about his stuttering at the initial evaluation

b. if the stutterer shows shame about his stuttering at the initial evaluation

c. as an adjunct to ongoing stuttering therapy

d. all of the above

e. none of the above

c.

Besides measuring stuttering severity in an adult stutterer, the clinician should

a. calculate speech rate

b. look at dental records

c. consult with the stutterer's physician

d. all of the above

e. none of the above

a.

When evaluating an adolescent

a. the clinician should first meet with the stutterer and his parents together

b. parents should be asked about their fears, concerns, and frustrations

c. parents' questions should be answered before the clinician meets with the child

d. all of the above

e. none of the above

b.

In evaluating a client who may stutter, your task is to decide

1. if his disfluencies warrant treatment

2. if they do, you should also find out more about his history, current environment, speech behaviors, and reactions

3. what treatment seems reasonable given these findings

In assessing a preschool child, the important questions to answer are

1. whether the child is stuttering or is normally disfluent

2. what the probabilities are that he will recover without treatment

3. if treatment is warranted, you need to determine if indirect or direct is best

It is important to obtain some information prior to the formal assessment. This includes

a recording of the child's speech at home and a completed case history

Key elements of the assessment for a preschool child are

1. observation of parent-child interaction

2. parent interview

3. clinician-child interaction

4. analysis of child's speech

5. screening of language, articulation, and voice

6. determining risk factors

7. deciding on the child's need for treatment

8. making follow-up recommendations to family

In assessing a school-age child, the important questions are

1. how supportive the parents are of the child's problems

2. how the stuttering is affecting the child's performance in school

3. how the child feels about his stuttering

4. how motivated he is to work on it

5. how supportive the child's teachers are

The assessment of the school-age child may proceed differently if he

is being seen in a clinic or at school

What affects the process and mandates how assessment is carried out if the child is seen at school?

IDEA

If the child is seen in a clinic, the clinician will have

more contact with the family but needs to reach out to the school setting

Key elements of the assessment for a school-age child are

1. initial contact and formal interview with the child's parents

2. interview with the child's teachers

3. interview with the child

4. analysis of speech

5. trial therapy

6. assessment of other factors, including academic adjustment

7. determination of appropriate treatment

In assessing an adolescent or adult, the important questions are

- the client's level of motivation and ability to carry out assignments independently

- the severity of stuttering and degree of avoidance

- the client's feelings and attitudes about his stuttering

- whether the problem is typical "developmental" stuttering

- the appropriate type of treatment

Key elements of the assessment of an adolescent or adult are

1. obtaining preliminary case history, attitude questionnaires, and recordings make outside of the clinic

2. interviewing the client

3. analyzing the client's speech

4. conducting trial therapy

5. interviewing parents if client is an adolescent

6. determining appropriate treatment

7. summarizing findings and making recommendations in closing interview with client

Whether the person is to be treated as a normally disfluent speaker or as someone who stutters depends on your

interpretation rather than a score