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treatment of beginning stuttering

Characteristics of the Beginning Stutterer. Usually between 3 and 6 years oldCore behaviorsPart-word repetitions most commonRapid, irregular rhythmSome prolongationsBlocks may be presentSecondary behaviorsEscapes , no specific word and or situation avoidances. Lidcombe approach. Operant conditioning approachDelivered by parents, guided by SLPRadical departure from previous therapies for beginning stutteringDeveloped in Lidcombe, AustraliaMark Onslow, et.al. .

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treatment of beginning stuttering

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    1. Treatment of Beginning Stuttering

    3. Lidcombe approach Operant conditioning approach Delivered by parents, guided by SLP Radical departure from previous therapies for beginning stuttering Developed in Lidcombe, Australia Mark Onslow, et.al.

    4. Two stages of the program Stage 1 Goal is for child to have no stuttering in everyday speaking situations Concludes when stuttering reaches pre-determined low criteria (near zero) Stage 2 Goal is to be certain child maintains treatment benefits

    5. Stage 1 Weekly clinic visits Clinician trains parent to do treatment Parent provides verbal contingencies in structured conversations and in unstructured conversations Clinical measurements procedures implemented within and beyond the clinic

    6. Stage 2 Parent assumes responsibility for treatment in the long term and achieves independence from the clinician Time between clinic visits increases Parents continue with treatment in unstructured conversations as required Any departure from criterion speech performance, clinic visits increase

    7. Key concepts Treatment agents include praise for stutter-free speech and acknowledging and asking for self-correction of stuttered speech Parental verbal contingencies are not constant, intensive, or invasive Treatment is done by parents in everyday life situations Clinician trains the parent

    8. Treatment time Median treatment time for Stage 1 is 11 weeks 50% of children will take less than 3 months; 50% will require more than 3 months 90% will complete Stage 1 within 6 months

    9. Data collection Stuttering rate measured in percentage of stuttered syllables (%SS) counting only the number of unambiguous stuttered syllables Button press counter device Stuttering severity is measured using a Likert-type 10 point scale Severity ratings 1= no stuttering; 2=very mild stuttering; 10= extremely severe stuttering

    10. Verbal response contingenciesstutter-free contingencies 5:1 over unambiguous stuttering contingencies! CHILD’S Stutter-free Speech Unambiguous RESPONSES Stuttering Praise Acknowledge Request PARENTAL self-correction VERBAL Request CONTINGENCIES self-evaluation

    11. Stutter-free speech contingencies Low-key acknowledgement That was smooth No bumps in that Praise Great smooth talking Good job keeping smooth Request self-evaluation Was that smooth? Bumpy?

    12. Unambiguous stuttering contingencies Low key acknowledgement There was a little bump there I heard a stuck word Requesting self-correction See if you can say “dog” without the bump You had a stuck word. Try it again.

    13. Stage 1 Clinic visits once per week for 45 minutes to 1 hour Count syllables stuttered using 300 syl www.truetalk.com.au Assign daily structured conversations (p. 327) and gradually move to unstructured conversations after 2-3 weeks

    14. Stage 2 Two criteria must be met: parent severity rating are only 1’s or 2’s, with at least 4 being a “1” for 3 weeks %SS at the clinic is below 1% for 3 weeks 30 minute clinic visits at greater intervals Clinician trains parents to decrease verbal contingencies Clinician monitors data Takes about a year to complete

    15. Example http://www3.fhs.usyd.edu.au/asrcwww/downloads/LP_manual_English_Oct2002.pdf

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