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Adult stuttering Tx (3) - Coggle Diagram

- - - - Overview of program
      - 8 point stut severity scale
      - Learn to control stut using training model w fluency technique of 7-8 during spontaneous speech
      - B/w 3-5 x 45-60 minute individual consultations
      - Progression criteria to enter Stage II
      - Assign self scores w stuttering severity scale that are similar to the clinician's scores
      - Consistently use fluency technique that approximates training model to control stut, with severity score of 0 and fluency technique score of 7-8. Feel in control of their stuttering. Recognise various fluency technique scores when demonstrated by clinician or from recordings
      - Anxiety measures
        
        Speech-related anxiety is common for adults who present with stut. Tx
        
        Useful to have clinical measures of speech-related anxiety to inform clinical decision making or referral to psychologist if needed
        
        0-10 scale anxiety. Cients can record this on situations measurement chart along with SR, fluency technique scores
    - - Consolidate their info of training model fluency technique
      - Work w clinician to dev. an individualised, natural sounding fluency technique that they find acceptable for stut. control
      - Practise self-eval skills for stut. severity and fluency technique
      - Dev. problem-solving skills to assist later generalisation of stut. free speech to everyday speaking situations
    - - Criterion to enter this: indv fluency technique to control stut. in conversation has been dev, commences when clients can speak w clinician for entire session at SR0-1 and fluency technique score acceptable to client
      - Generalisation: confirm that they can use a fluency technique to control stut, compare their speech measures w those of clinician, review and revise their fluency technique practice routine, report their stut severity, fluency technique, speech related anxiety scores from everyday speaking situations.
      - Present and discuss recordings of their speech w speech measures in various everyday situations
      - Interpret those speech measures w clinicians and plan strategies to resolve any problems, devise hierarchy of everyday speaking situations to assist transfer of fluency technique, plan Tx changes for coming week based on speech measures, modify measurement procedures if required, summarise Tx changes for coming week
    - - Stut and fluency technique goals are met for 3 consecutive weekly consultations
      - Goals for stut severity scores are to be 0-1 in most everyday speaking situations w no situation avoidance and fluency technique scores that the client finds acceptable
      - Maintenance of Tx gains
        
        Maintain stutter free speech throughout the consultation
        
        Present acceptable stuttering severity fluency technique scores for representative everyday speaking situations
        
        Confirm those scores w several audio recordings
        
        Demo how variations of stut severity have been dealt w appropriately
        
        Booster programs
        
        Self-help groups
        
        Problem solving more independently
        
        Clients are discharged if they complete the program criteria, do not comply w program requirements, withdraw from Tx program
        
        Discharge from whole program will be negotiated b/w clinician, client when they can demonstrate: skills for monitoring their speech, controlling their stut., ability to address fluctuations in stut. severity. Achievement of personalised goals for stut treatment.
- - - - Motivation level
      - Decrease self awareness
      - Dislike drawing attention which influences practice
      - See SLPs as figures of authority
    - - Use of diff materials
      - Reward systems
      - Appropriate apps on iphone, ipad
      - Normalise the process-don't make it a big deal
      - Use adolescent exemplars so they can better relate
      - Contracts
      - Let them be in the room, do monologue to check pre and post test to let them see the difference