csds 115 exam 4 Unit 6 School Age Children; Intermediate Stuttering

School-Age Children; Intermediate Stuttering; Core Behaviors

Increased blocks/broken words/Repetitions + prolongations

School-Age Children; Intermediate Stuttering; Secondary Behaviors

Escape behaviors/Avoidance behaviors

School-Age Children; Intermediate Stuttering; Feelings & Attitudes

Fear before stuttering/ Embarrassment during stuttering/ Shame after stuttering/ Frustration

School-Age Children; Intermediate Stuttering; Underlying Processes

Increase in muscle tension + tempo/ Operant conditioning/ Avoidance conditioning

Intermediate stuttering treatment approach; Nature of stuttering

neural pathways anomalies supporting speech production, combined with child's vulnerable temperament, interact with developmental + environmental factors to prevent natural recovery + produce/exacerbate core behaviors; repetitions, prolongations, blocks/responds with increased tension; stutter worsens

Intermediate stutteirng treatment approach; Speech behaviors targeted for therapy

begins with a focus on stuttering behaviors that are first approached, explored, accepted, and then changed. But for those children who are hardly bothered by their stuttering, fluent speech is the target

Intermediate stuttering treatment approach; Fluency Goals

acceptable stuttering, that is, fluency mixed with mild or very mild stuttering/Very young students may be able to develop spontaneous fluency.

Intermediate stuttering treatment approach; Feelings and attitudes

Give a lot of attention. When child frustrated, embarrassed, afraid of stuttering + speaking, clinician must help him feel okay abt his speech. let them talk about whatever they want (advice)"he child may then let go of some of his or her nonconscious defensive responses.

Intermediate stuttering treatment approach; Maintenance procedures and relapse

treatment must include strategies designed to keep extinction of old fear active for the long term/"tapered off gradually/maintain intermittent contact with child/encoruage mentoring to increase self-esteem + reinforce what they learned

Intermediate stuttering treatment approach; Clinical methods (1)

listening acceptingly as we talk together about student's stuttering, incl feelings abt being seen as someone who stutters

Intermediate stuttering treatment approach; Clincial methods (2) join student

playing with stuttering; make therapy fun, reduce anxiety, reward hard work, approach fear associated with stuttering; learn reduce tension + struggle.

Intermediate stuttering treatment approach; Clinical methods (2) When less afraid/ less shame

introduce modeling + coaching to teach different response to anticipation + stuttering experience/ work with parents+teachers create stuttering friendly envrionment

Exploration of Stuttering

Decrease the negative emotions/Reduce the threat and fear of the moment of "stuckness" in stuttering and decrease tension/tension is decreased, the client finishes the word slowly and easily/continue rescue fear + avoidance/transfer to other activies

Explore Stuttering;Reduce the threat and fear of the moment of "stuckness" in stuttering and decrease tension

Talk abt it/if not then draw abt it/Staying in the stutter is okay/You may still stutter after therapy

Explore Stuttering;Continue to reduce fear and avoidance

Being open about stuttering/ Accepting the stuttering/Learn use voluntary stuttering/Become desensitized to stuttering in a variety of situations

Explore Stuttering;Transfer to other activities

Example;Practice ordering "What do we want for lunch?" (in cafeteria)

Superfluency

A style of speaking that incorporates fluency-shaping components such as slow speech rate and gentle onset of phonation/Few negative emotions

Fluency-shaping components

Flexible rates/ Pausing/ Easy+Gentle onsets/ Light contacts/ Proprioception to enhance and manage stuttering/ Transfer to real-world situations

Flexible rates

slowing down word production, especially first syllable/only syllables with expected stuttering are slowed, not the surrounding speech/thought to be effective in reducing stuttering, allows more time for language planning + motor execution

Pausing

use pausing when using flexible rate to downshift in preparing to say a feared word a little more slowly

Easy/Gentle onsets

refers to an easy or gentle onset of voicing. Easier to begin a feared sound with voicing gently vibrating rather than rapidly/vowels in word-intial position easier to use than consonants

Light contacts

producing a stop consonant by just brushing the articulators together, keeping airflow going as the stop is produced/better because hard articulatory contacts can trigger stutter

Proprioception to enhance and manage stuttering

sensory feedback from mechanoreceptors in lips, jaw, + tongue muslces/ex;" pick word from list + closing their eyes + silently moving articulators for this word + being rewarded when clinician guesses word

Transfer to real-world situations

setting up a hierarchy with the child of easy to difficult situations, clinician supports them by listening to progress while having parents be supportive too

Working with parents rationale in intermediate stuttering treatment

explain treatment program and the parent's role/explain possible stuttering causes/Identifying + reducing fluency disrupters/Increasing fluency-enhancing situations/Eliminating teasing

Working with teachers rationale

Explain treatment program and teacher's role/Teachers' talking with child about his stuttering/Coping with oral participation/Reduce teasing

OTHER TREATMENT APPROACHES; SCHOOL-AGE CHILDREN; INTERMEDIATE STUTTERING

Treating the entire disorder/Lidcombe program for school-age children/Fun with fluency for the school-age child

Treating the entire disorder (Yaruss, Pelczarski, Quesal, Reeves)

Incorporates cognitive behavioral therapy/ Goal is to become the most effective communicator

Lidcombe program for school-age children (Harrison, Bruce, Shenker, Koushik, Kazenski)

Two stage program

Fun with fluency for the school-age child (Patty Walton)

Fluency shaping/ Works with attitudes and emotions/ Parent counseling/ Working with teachers