What should you consider as part of the assessment of adults with any disorder?
Thing about the 5 pre-treatment issues from Onslow and Packman
What can be considered to be predictive of clinical success?
Having a good prognosis based on Onslow and Packman’s 5 pre-treatment issues.
What causes stuttering?
We don’t know.
What are some ideas that are being considered as a cause of stuttering?
- genetics
2. neurological difference
What are the 10 myths of stuttering?
The ghost of Wendell Johnson…
- personality disorder
- nervousness
- low self esteem
- shyness
- thinking faster than you can talk
- highly demanding and critical parents
- anxious parents
- asking the child excessive questions
- parents speech rate
- emotional trauma
What is a good statement about stuttering that you can use to tell parents?
Stuttering is a complex interaction between the child’s inherent abilities and his/her internal/external environment.
What is internal environment?
What the child thinks and feels. We are born with our own internal environment (personality).
Why can treatment be effective?
Because we understand people better than ever, and we know how they can change.
What is the best strategy for fluency?
Early Intervention and Early Assessment
How should you assess a child?
Have the child tell a story, or have a conversation. You have to get a connected speech sample.
What is the number 1 and 2 best tools for assessment?
- Clinicians ears
2. clinicians eyes
What is a valid/reliable test for assessing disfluencies?
There is not one. The best tool is the clinicians ears.
What is one test that will assess a client who stutters quality of life?
OASES
What 3 things should you have in your report?
- syllable or word count
- the primary disfluencies
- rating of the clients disfluencies
What are the 3 “wh”s you need to assess?
- What
- Where
- When
- What
- The nature of stuttering itself. What is happening? Is the stuttering happening on vowels or consonants. Are they repetitions, prolongations, or blocks.
- What is the severity? How much and how long? If it is more than 1 disfluency in a sentence or more than 5% then the person is disfluent.
- Are there any concomitant features? For kids it might be blinking or a funny voice. Also check the child’s reaction.
1. What is happening?
2. What is the severity
3. Are there any concomitant features?
- Where
- Where in the word? What is the loci of the disfluencies?
- Developmental stuttering is in the word initial
- And initial, medial and final positions are indicators of brain damage or a neurological disease.
- When
When is the stutter happening? All the time? In certain situations?
- normally stuttering variable, and cyclical - Ask the client about his/her opinion on their stuttering variability and cycles?
A child must stutter during an assessment. If they do not what can you do to get them to stutter?
- Change activities
- Add tension
- Reading
- Conversation
- Telephone
Need to Assess:
5 Questions to ask in the interview.
After what, when, where
- How handicapping is the stuttering?
- Case history
- Family history
- Parent reactions
- Motivation
- How handicapping is the stuttering?
academically socially emotionally work what is a child's reaction
2 & 3. Case history and family history?
when did it start?
family health
- What are the parents reactions?
Is the family emotionally distraught? Do you need to refer them to SH groups or therapy?
- Ask about motivation…
Is the child and family willing to dedicate time and energy into completing and sticking with a program that could be very intense?
