Fluency RAP 1

What are the differences between core and secondary behaviors in stuttering?

Core: repetitions, prolongations, blocks

Secondary: reactions to stuttering (avoidance and escape behaviors)

• Avoidance: learned when person anticipates a stutter (eye blinks or filler words)

• Escape: when a person is stuttering and attempts to terminate the stutter (eye blinks, head nods, interjections)

What are some feelings and attitudes people who stutter might have, and what is their origin?

Initial excitement from children then frustration begins the more it occurs

- Origins come from ICF (functioning and disability)

- Environmental and personal factors contribute

What is the age range for the onset of stuttering (the youngest and oldest ages at which onset is commonly reported)? What is going on at that time in typical speech-language development?

Age range: 3-12; 3-5 = most common

• Rapid growth in words, longer utterances, increased conversational skills

Why might the ratio of male-to-female stutterers change with age?

Because boys recover more frequently than girls, and lack of research

What happens to children’s fluency when they produce longer, more grammatically complex utterances?

Fluency becomes worse

What are the risk factors for stuttering persistence?

• Family history (whether recovered or not)

• Gender: boys persist more

• Age of onset: After 3.5 = higher risk

• Trend: Stuttering isnt decreasing in frequency or severity

• Duration: Longer than year

• Duration of stuttering moments: Continued more than one rep unit

• Below avg phonological skills

What does it mean to suggest that a clinician must play two different roles during an evaluation?

• Show empathy and understanding to the client to make them feel heard

• Show expertise in evaluation and treatment

What factors can affect the process of measuring stuttering?

Reliability: making sure you are consistently and non-biased when assessing stuttering

• Intrarater: Individual makes the same judgement repeatedly on the same sample

• Interrater: Checking judgement with second observer

Why is it important to obtain several samples of speech from a client when assessing stuttering, whereas a single sample might be adequate for assessing a phonological disorder?

• Stuttering varies by location, pressure, and familiarity with people.

• Must assess outside of therapy room through video recording or audio recording

Give two reasons why assessment of reliability of measurements of stuttering is important?

• To accurately determine if the client actually stutters

• To make sure our bias doesn’t influence their calculations for the sample

Describe five dimensions or aspects of stuttering that may be assessed in an evaluation of a client who stutters?

• Duration

• Speech naturalness

• Secondary behaviors

• Speaking/reading rate

• Feelings/attitudes

Why is it relevant to assess speech rate for a person who stutters?

• Slow or fast speaking rate is common in stutterers

• Communication is affected, and listeners may be inpatient with listening

Why is it useful to obtain audio/video recordings of a preschool child’s stuttering before the evaluation?

• To preview the child’s speech before their eval. Also ,in case a child’s stuttering disappears by the eval.

• Helps learn about the family interactions.

What do you tell the parent of a preschool or school-age child who asks you what causes stuttering?

Children have slight differences in their neurological organization of speech, which reveals as stuttering when children experience normal stress or life changes.

What are the variables assessed in the speech of a preschooler to determine his developmental/treatment level?

Frequency of disfluencies

• Types of disfluencies

• Nature of repetitions and prolongations

• Starting and sustaining airflow and phonation

• Physical concomitants

• Word avoidance

What characteristics suggest treatment deferral for a preschool-aged child is appropriate?

Decrease in stutter like disfluencies during the 12 months after onset

• Female, no relatives who stutter

• Good language and articulation skills, good nonverbal intelligence scores

• Outgoing, carefree temperament

What are the advantages and disadvantages of talking to a child about his stuttering?

Advantages: makes children express feelings they may not have before, helps them become more aware, provides good info for SLP

Disadvantages: Child may become mad/sad, may not participate in activities or be scared

In what various ways do we assess the impact of the school environment on the school-age child who stutters?

By assessing:

• behaviors associated with stuttering

• how it impacts their education

• consider social environments

• their understandability

• emotional well-being

• participation in activities

What are the major questions to be answered in the evaluation of an adult?

Tell me about the beginning of your stuttering and how it has changed over the years?

• What do you believed caused your stutters?

• Does anyone else in your family stutter?

• Have you ever had therapy for it? What did it consist of? How effective?

• Has your stuttering changed recently or caused more problems recently? Why did you come in at this time?

• Are there times where you stutter more or less?

• Do you avoid situations where you expect to stutter?

• Do you avoid certain words you expect to stutter? Do you substitute words if you expect it coming?

• Do you have any special movements or sounds to get words out?

• Has your academic or vocational choices been affecting your stutter?

• Have your relationships been affected since you stutter?

• What are your feelings/attitudes of your stuttering? What do you think other people think?

• What are your family’s reactions/attitudes/feelings towards it and towards beginning therapy?

• Any additional info or questions?