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Fluency (Points to consider (Family history: increase risk of persistence…
Fluency
Points to consider
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Age at onset: Later onset, increased risk of persistence, but can occur at any point in your lifespan
Stuttering freq, severity
Duration since onset: longer child stutters beyond 1y post onset, increased risk of persistence
More repetition units= increased risk, severity increased
Ongoing prolongations, blocks. Impt for no., types of stuttering behaviours
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Chars stuttering
Abnormally high freq, duration of stoppage in forward flow of speech
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Blocking
stoppage of airflow (forced release of air, but sometimes can be silent) , no sound comes out. Anatomy: VF closed, flow of air stopped (tension)
client attempts to speak, struggle to get words out
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Prolongations
stretching sound- NO TENSION, usually in fricatives, some vowels
occurs on sounds anywhere in word/sentence, can vary in length
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Emotions
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Avoiding situations
Fear of telephone, ordering, shopping, making enquiries
Loss of self-esteem
shame, guilt, failure, so DO NOT try to draw attention to child's stuttering behaviour
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Age of onset varies
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Yariri Ambrose: 41% sudden, 32% intermediate, 27% gradual
In adolescents, adults: usually psychogenic, neurogenic
Incidence vs. prevalence
I: how many ppl have stuttered at some point in our lives, 5% children,1-2% adults
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Suggest that most people who stutter at some point recover from it eg. using maturity, aspects of growth, treatment
Recovery w/o treatment
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70-75% children who stutter, recover spontaneously in first 2-6y of suttering
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Causes of stuttering
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Might be: Breakdown (motor issue) neural processing related to area of brain responsible for speech production, genetic, begins in children b/w 2-4 y/o (combining words, vocab explosion), physical disorder
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Gender
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Females who X recover have stronger predisposition to stuttering. May lack recovery factor, inherited additional factors that inhibit recovery
Stuttering
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No: smooth speech
Increase self confidence, esteem
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Increase career, promotional prospects
Assessments, treatment
Assessments
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Stutter types, severity, behaviours, speech rate, variability across tasks
Interviews, questionnaires
Case history: dev, educational, medical history
Stuttering history: family, evolution, variability, triggers, strategies, what words they stutter more on
Impact on indv, participation
Attitudes towards speech, stuttering
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Treatments
Lidcombe program
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Simple operant conditioning, best evidence practice
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Parents give verbal response contingent stimulation in everyday situations, speaking env
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Stage 1: 4 sessions, child's SR reduce by 30%
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Good bcos
No overlearning of stuttering, emphasises on neuroplasticity
Adults are potent reinforcers for their children, want to receive that praise
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Treatment occurs where problem occurs (online, at home)
1.Speech restructuring: smooth, prolonged speech. Slow down rate, breathing, how to ease into the word, work on naturalness
- Cognitive based therapies: cognitive restructuring, anxiety, avoidance training
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- Assistive device: delayed auditory feedback, within-ear devices
- Pharmacotherapy on the side
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*Simplify speech-motor act, stabilise an unstable speech motor system
Defn stuttering
Disorder in rhythm, coordination, timing of speech such that pt knows exactly what they want to say. At that time, X move forward in speech bcos involuntary repetition, blocking or prolongation of sounds/words
Normal vs. stuttered dysfluencies: most are unaware of their stutterring but 2;0 boy stopped talking about turtles, garbage trucks RED FLAG- awareness and avoidance
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