SHS 716 Ch 10-14

Clinician Attributes (Van Riper)

Empathy , Warmth , Genuineness, preference for evidence-based practice

preference for evidence-based practice

valid and reliable measures; evidence for effectiveness of treatment

Empathy

the ability to understand the feelings, thoughts and behaviors of a person who stutters. You can develop empathy for your clients by being able to listen to your clients and accept them. another example in the book is when the clinician demonstrated a stutter in front of a cashier

Warmth

this is when the clinician is able to make the client feel nurtured. this will create an environment for the client that allows them to be comfortable with the challenges that are faced in attempt to change their speech.

Genuineness

this refers to honesty of the clinician, a genuine clinician will avoid sugar coating circumstances to their clients.

Evaluation procedures AND Treatment strategies

How a clinician's beliefs about the etiology affect their professional positions

Evaluation procedures

only with a detailed perspective about the onset and development of stuttering can the clinician effectively evaluate clients of all ages and counsel them and their families.

Treatment strategies

Treatment must be based on a good understanding of the dynamics underlying a particular client's stuttering. One size treatment does not fit all.

Cognitive Therapy

Used to reduce the negative thoughts and attitudes

Benefit of School-Age clients having group therapy

They could gain a sense of belonging and support from other group members and be open about experiences

Treatments for reducing avoidance behaviors

Help the client understand why they happen

Reducing negative emotions reduces need for avoidances

Client needs to reduce old behaviors before learning new one

Stuttering Modification definition

A therapy approach that helps the client to continue to stutter but in a way that is relaxed and easy and sounds like typical fluency and gives the client a feeling of being in control of their stuttering

Stuttering Modification purpose

Aim is to reduce or extinguish the threat and fear associated with the experience of stuttering or the anticipation of stuttering

Spontaneous fluency is increased

Reduces negative emotions

Teach client to stay in stutter; in a calm manner

Borderline Stuttering Treatment

Help family figure out how to make their environment fluency-facilitating

Indirect treatment:

Clinician counsels parent

Clinician models

Parents facilitate actions at home (Chapter 11)

Clinicians Methods:

Educate

Counsel

Collect

Modeling of Easy Stutters

a. Not done all the time, but enough to where the child notices them

b. Repetitions said slowly and the last one is eased into a slow production of the first part of the word

Catch Me

If the client is able to "catch" the stutter done by the clinician, they are rewarded.

///Clinician models a hard stutter, if the child is willing to catch the stutter the clinician changes the stutter to an easy one and tells the child

Beginning Stuttering/Attributes

interaction of sensory-motor deficits, vulnerable temperament, developmental factors, and environmental stress

Beginning Stuttering/ treatment

Treatment: focuses on caregiver (mother and clinician do session, mother and child practice session at home, mother and child natural convo at home)

Lidcombe Program

a. Parent delivered in home program, using praise every 5th utterance

b. Only correct every five praises

c. Parent collects daily severity ratings (SRS)

Severity Rating Scale

a. 1: typical fluency, 10:

extremely severe stuttering

b. Parents use this scale to report daily severity

c. Clinician may also use this

Treatment for Intermediate Stuttering

a. Explore goals, beliefs and feelings then explore and change core behavior then

openness then acceptance then transfer

b. Show the stutter who is boss

Fluency-shaping purpose

Purpose: teaches client

how to use controlled

fluency to eliminate or

significantly reduce

stuttering

Fluency-shaping definition

a speech restructuring method that requires individuals to change their speech patterns.

Shame and Intermediate Stuttering Population

a. Shame must be reduced by

openness

b. Show stutter who is boss

Light Contacts

Touching the articulators

very lightly without full stoppage so tension

doesnt occur

Treatment for Advanced Stuttering

Reduce negative emotions,

teach client to stay in stutter, when tension is

reduced finish smoothly

and slowly

Controlled Fluency

Skills to learn it: flexible

rate, pausing, easy onsets, light contacts, proprioception

Personal Aims Questionnaire

Helps determine clients goals