Fluency Ch. 13

Therapy Protocol

a detailed plan for carrying out treatment

Empathy

ability to put oneself in another's place and to identify with the feelings that the other person has

Warmth

a feeling of positive regard for another person, often conveyed by tone of voice or body language

Genuineness

honesty about life, oneself, and other people; a sense that the individual is comfortable with herself and speaks in a straightforward manner in which actions are congruent with thoughts, beliefs, and attitudes

Evidence-Based Practice

a commitment to use research evidence, client goals, and clinician expertise when choosing assessment and treatment tools

Critical Thinking

an attitude of mind that encourages questioning; in the current context, the questioning is about whether a treatment will be effective for a particular client

Clinician's Belief

the perspective a clinician takes on the nature and development of stuttering that leads to her choices of assessment and treatment strategies

Abnormality of Stuttering

characteristics of an individual's stuttering that make it stand out or be distracting to the listener. Examples are facial tension and facial grimacing, body movements used to release the stutter, and avoidances that make it difficult for the listener to follow what the individual is saying such as "well, um, you see, that is..."

Fluency-Facilitating Enviornment

a climate in one or more situations that makes it easier for an individual who stutters to speak more fluently

Emotions Related to Stuttering

physiological responses and conscious feelings that arise in a person who stutters, in regard to the act of stuttering or the fact of being someone who stutters

Cognitive Behavior Therapy (CBT)

treatment based on the notion that persons' perceptions of and thoughts about situations and themselves determine their feelings and behavior. CBT aims to help the persons see situations and themselves more realistically and more compassionately

An important attribute for a clinician to have is

a. empathy

b. warmth

c. genuineness

d. all of the above

e. none of the above

d.

A clinician should

a. never say anything negative about a client's speech

b. try to never stutter when working with a client

c. be aware of her own strengths and weaknesses

d. all of the above

e. none of the above

c.

When deciding on a treatment plan, a clinician should

a. look for data that supports a treatment's effectiveness

b. only use treatment that has lots of data

c. let the client or family choose which treatment to use

d. all of the above

e. none of the above

a.

A clinician might decide to

a. use some aspects of a treatment approach that is otherwise ineffective

b. adjust goals so that some stuttering is acceptable

c. adapt a treatment approach to be successful in a particular enviornment

d. all of the above

e. none of the above

d.

A clinician's belief about the etiology of stuttering can affect:

a. how she approaches treatment

b. what she might say to a young stutterer's parents

c. what she might look for in assessing a stutterer

d. all of the above

e. none of the above

d.

Regardless of her beliefs about something, a clinician should

a. examine a child's feelings and attitudes about stuttering

b. discuss treatment goals with a stutterer or his parents

c. use an approach based on modification of stutters

d. all of the above

e. none of the above

b.

A clinician who believes that stuttering is related to the way the brain processes speech:

a. should enlist the parents' help in managing a child's stuttering

b. should not discuss with parents ideas about the nature of stuttering

c. should tell parents that the cause of stuttering has been determined

d. all of the above

e. none of the above

a.

A treatment goal should be to reduce the frequency of stuttering:

a. even if it leads to other behaviors that might be distracting in conversation

b. to zero in preschool children

c. only in structured enviornments

d. all of the above

e. none of the above

b.

Treatment for advanced stuttering:

a. should always focus on achieving complete fluency

b. should attempt to reduce negative feelings about stuttering

c. should focus only on fluency before dealing with escape behaviors

d. all of the above

e. none of the above

b.

Avoidance behaviors:

a. include saying "um" before attempting a feared word

b. include not talking on the telephone

c. help keep a stutterer from learning how to stutter more easily

d. all of the above

e. none of the above

d.

Environments that facilitate fluency

a. include parents using a slow speech rate with the child who stutters

b. are almost impossible to achieve in a regular classroom situation

c. should be the only places a young stutterer is exposed to

d. all of the above

e. none of the above

a.

Operant conditioning to reduce the frequency of stuttering

a. can include a request to try a stuttered word again

b. is not used when using "fluency shaping" treatments

c. should include verbal, but not tangible, rewards

d. all of the above

e. none of the above

a.

"Stuttering modification"

a. includes attempting to change tense stutters into more relaxed ones

b. does not target escape and avoidance behaviors

c. is another name for "fluency shaping"

d. all of the above

e. none of the above

a.

Ways to deal with negative emotions about stuttering include:

a. voluntary stuttering

b. counseling for a stutterer and his family

c. using humor when discussing stuttering

d. all of the above

e. none of the above

d.

Because school children often feel fear or shame when asked to speak at school,

a. they should be treated only with a "fluency shaping" approach

b. they should not participate in school plays

c. during "circle" they should sit slightly apart from everyone else

d. all of the above

e. none of the above

e.

Cognitive Therapy

a. should never be used as the sole treatment

b. helps a stutterer examine his thought processes

c. is not recommended for dealing with negative attitudes about stuttering

d. all of the above

e. none of the above

b.

Treatment for reducing avoidance behaviors:

a. is most important when working with younger children

b. should begin by having the stutterer speak in a difficult situation

c. includes voluntary stutters

d. all of the above

e. none of the above

c.

Basic communication skills

a. should be addressed only in group therapy

b. include turn-taking, staying on-topic, and speaking intelligibly

c. should be part of every stutterer's treatment

d. all of the above

e. none of the above

b.

The ability to communicate easily can be affected by

a. stuttering

b. temperament

c. a family's communication style

d. all of the above

e. none of the above

d.

A school-age stutterer

a. should talk about stuttering with his family, but not peers

b. is often helped by group therapy

c. should not view a video of himself stuttering

d. all of the above

e. none of the above

b.

What are a vital ingredient in treatment success?

the clinician's attributes

What are the three clinician attributes that have been considered important by Van Riper

- empathy

- genuineness

- warmth

An important component of best clinical practice is

choosing evaluation procedures and tools that have been shown to be valid and reliable

Best clinical practice dictates becoming aware of

evidence of effectiveness for treatment procedures that you use and adapting treatment procedures to fit clients' needs, as well as continuous assessment of improvement in attributes that have been chosen as goals for treatment

What is vital to keep abreast of new approaches and new evidence of effectiveness of current approaches?

continuing education

It is important for clinicians to develop an informed set of beliefs about

the nature of stuttering and to fit assessment and treatment procedures to those beliefs

Goals for treatment and for continuing assessment should come from not only the clinician's beliefs but also from

the client's (or family's) informed choices

Treatment procedures for meeting goals can include

- methods of reducing frequency and severity of stuttering and secondary behaviors

- reducing negative emotions and thoughts that interfere with fluency

- increasing communication abilities

- developing environments which facilitate fluency