Precision Fluency Shaping Programs

1. Precision Fluency Shaping Programs

2. Precision Fluency Shaping Programs • Common Features • Teach skills, all teach • easy onset • prolongations • other skills • Skill progression • May or may not deal with attitudes/anxiety • May or may not include a transfer program

3. Fluency Shaping Programs ALLPrograms Focus on RETRAINING SPM Some programs focus on Attitudes and Anxiety DAF Stop Watch Work books Operant Conditioning Cooper Daly Shames & Florance

4. Text information (ch. 5) • 1. • 2. • 3. • 4. • 5. • 6. • 7. • 8. • 9. • 10

5. Selected Fluency Shaping Programs • Webster, Precision Fluency Shaping program • Cooper, Personalized Fluency Shaping Program • Daly, Freedom of Fluency • Shames and Florance, Stutter Free Speech • Easy Does It

6. Training Paradigm • Format: • 1. Read about the skill, comprehend it, learn vocabulary • 2. Clinician demonstrates (Example-NON- Example-Example) • 3. Client demonstrates on same paradigm • 4. Client practices under observation • 5. Client practices with periodic monitoring

7. Skill Progression • Principles according to Webster • build from -bottom up-respiration first • start at syllable level and continue progression • Steps • 2 second syllable stretch • Diaphragmatic Breathing • Easy Onsets • Articulatory Focus • prolongations • light contact for plosives • Combine in words • Loudness Contour • continuous phonation ‘ • Increase Rate to Slow Normal

8. Sound Classes • Prolong or Hold first sound • equals no articulatory movement • Practice Organized Systematically • IV Classes • Class I All Vowels • Class II All Voiced Continuants • prolong voiced continuant • Class III All Voiceless Continuants • brief prolongation on voiceless consonant, moving to voiced sound • Class IV All Plosives • light contact on plosive

9. Equipment for PFSP • Trainer’s Manual • Client’s Workbook • Voice Monitor • Stop Watch • Diaphragmatic Breathing Belt

10. Practice Sequence for Classes • Base 5, % correct 80-100 (4/5, 5/5) • Sequence • Class I ALL Vowels • Class II Voiced Continuants • Class III Unvoiced Continuants • Class IV Plosives • Items: • one syllable words • two-syllable words • RULE: HOLD THE FIRST SOUND, • except Class IV, then the second sound

11. Rate Progression • 2 second Syllable Stretch= 30 wpm • 1 second Syllable stretch=60 wpm • 1/2 sec Syllable delay=90 wpm • Slow Normal • within normalcy range • rate at which you can monitor targets of • breathing • easy onset • continuous phonation • articulatory control • concern for Speech Naturalness Rating

12. How to SLOW DOWN • RATE DAF Stop watch • 30 wpm 250msec 2 sec. Syl Str • 45 wpm 200msec • 60 wpm 150msec 1 sec Syl Str • 75 wpm 100msec • 90 wpm 50 msec 1/2 sec Syl Str

13. Therapy Paradigm • 1 hour session • 20 minutes instruction, independent practice • 10 minutes transfer • 20 minutes instruction, independent practice • Home Assignment • practice on same schedule • 20/10 • transfer skill with someone

14. Precision Fluency Shaping Transfer and Maintenance • Transfer • 1. Within Establishment program • within sessions • home assignments • 2 Transfer PHASE • specific assignments • variables: 3 of interchanges • need to record event and report • # of itransfers increases as progress dictates

15. Telephone Transfer • Progression • dial • after listener responds, take a comfortably full breath of air • begin your message using appropriate monitoring rate • use for 1 exchange • “What time do you close?” • record feelings • continue increasing frequency and # of exchanges

16. Maintenance Instructions • 1. Fluency depends on MONITORING • Therefore, NEED to practice for at always 1 year • 2. PRACTICE EVERY DAY • 3. There may be some decline in fluency • 4 Keep in contact through post cards • 5. If regression, come back for a “miniprogram”

17. Cooper’s Freedom From Fluency • Based on Webster’s program • 3 Parts to Program • 1. Comprehensive Evaluation which can be used alone • 2.Fluency Shaping • multiple worksheets • 3.Added Attitudinal Component • “Monkey’s On My Back”

18. Notes

19. Notes

20. Stutter Free Speech • Shames and Florance • Program Goal: Stuterer is responsible for his fluency through self-regulation and reinforcement • Uses DAF • starts at 250 msec. Delay and progresses • uses 3 modes • monitored and unmonitored • Addresses feelings and attitudes

21. Stutter Free Speech • Transfer • uses Contracts

22. Notes

23. Daly’s Freedom of Fluency • Addresses BOTH Attitudes and retrains the Speech Production Mechanism • Separate discussion

24. A Fluent end to the discussion!