Fluency Exam 2

How does the client feel about change during the preparation stage of change?

have made decision to change, but have unresolved ambivalent feelings.

What is the fifth stage of change?

maintenance

What is the consolidation period of Palin PCI?

period of treatment at home using strategies and methods.

the results of Lidcombe v Restart DCM study imply that at 18 months ________-___________ onset both treatments are roughly ________ in treating developmental stuttering in ways that surpass expectations of natural recovery.

post-treatment, equal

What is the third stage of change?

preparation

When is direct treatment introduced in the family-focused treatment approach?

stage 3

What are the three components of EBP?

- Current best practice - Clinical Expertise - Client/Patient Values

What are some parent communication modifications in the family-focused treatment approach?

- Easy Talking Model - Increased pause time - Reduced Demands - Reflecting/Rephrasing

How should a therapist respond during the precontemplation stage of change

- Empathy - Active Listening - Give info - provide choices - give hope - remove barriers - validate lack of readiness.

How should a therapist respond to clients in the Preparation stage of change?

- Help clients concretize plans for change - Help clients brainstorm small steps they can begin to take - Discuss potential roadblocks and help them develop strategies in advance

How should a therapist respond to a client in the Contemplation stage of change?

- Help clients concretize reasons for changing. - help clients articulate a vision of their wants - recognize ambivalence - Give time and encourage evaluation of pros and cons of behavior change

What are some factors that the SLP need to take into account when deciding whether to recommend therapy or not?

1. Does the child stutter? 2. if so, is the parent concerned?

What are three treatment goals in indirect therapy?

1. Educate the parents 2. Identify Fluency Stressors 3. Introduce the concept "Fluency-facilitating environment"

Lidcombe v Restart DCM study found that at ____ ________ clinical outcomes for direct and indirect treatment were _______________.

18 months, comparable

How long is the consolidation period of Palin PCI?

6 weeks

What happens during stage 2 of Lidcombe?

Maintenance, interval clinic visits to reinforce parent contingencies.

What factors influence a client's readiness for change?

Self Efficiency

How does the common factor of technique contribute to similar treatment outcomes?

factors or strategies unique to different therapy approaches

How many weeks does Palin PCI last?

12

What are some stressful communication interaction patterns?

- High rates of speech - Rapid-fire conversational pace (lack of pauses) - Interruptions - Frequent open ended questions?? - Many critical or corrective comments - Inadequate or inconsistent listening to what the child says - Vocabulary far above the child's level - Advanced levels of syntax

What are some helpful communication interaction patterns.

- Positive comments - Listening time - Pauses - Slow rate - Fewer questions

What do parents do during the consolidation period of Palin PCI?

- Special Times and log. - Praise log - send sheets to slp - contact therapist if fluency worsens.

How should a therapist respond to clients who are in the maintenance stage of change?

- Use of toolbox - Relapse prevention plan - If relapses occur, encourage early recognition and rapid responses, discuss coping with relapse and potentially go back to using skills for preparation and action stages

What are the basic components of the Palin PCI model?

- multifactorial assessment - stage 1 in clinic sessions - stage 2 home based period - stage 3 review session - monitoring only phase.

How is parent and child understanding and acceptance of stuttering achieved in the family-focused treatment approach?

- parent counseling and education about stuttering - identify stressors - communication wellness - education and speaking and stuttering - desensitization

What happens during stage 1 of Lidcombe?

- parent learns how to have structured conversations encouraging fluent speech and correcting nonfluent.

What are the 7 tips for talking with your child (presented by stuttering foundation)

- reduce the pace - full listening - ask questions - turn-taking - building confidence - special times (from palin PCI) - normal rules apply

What are the common factors in therapy?

- technique - extra therapeutic change - hope/expectancy - therapeutic relationship

What is the fourth stage of change?

Action

What could you use to assess your patient's readiness for change?

Decisional Balance Worksheet

What questionnaire taps on the stages of change and readiness for change in adults who stutter?

Final Stages of Change Scale (SOC scale)

What is the 2nd question on the readiness ruler?

How confident are you that you can make this change?

What is the first question on the readiness ruler?

How important is it for you to make this change?

What is the second question of the SOC Scale questionnaire?

How ready are you right now to change your negative thoughts and feelings about stuttering?

What is the first scale of the SOC Scale questionnaire?

How ready are you right now to get help to learn and use speech techniques for speaking more fluently or stuttering with less tension and struggle?

What is the third question of the SOC Scale questionnaire?

How ready are you right now to say what you want to say without avoiding sounds, words, or situations

What is the 3rd question on the readiness ruler?

How ready are you to make this change?

How do you work towards spontaneous fluency?

Indirect treatment (lessening environmental factors)

What theory of stuttering is Palin PCI based on?

Multifactorial theory

How should a therapist respond to a client in the termination stage of change?

No therapy needed.

How ready is someone to change at the contemplation stage of change?

Not quite ready, but begins to think about what to do about the difficulty.

What is the main difference between Lidcombe and Palin PCI?

Palin PCI is indirect, Lidcombe is direct.

What is the first stage of change?

Pre-contemplation

What does "Without substantial evidence" is not the same as "without substantial value." mean?

Some treatments that are shown to be efficacious are not effective in clinical settings

What is the ideal fluency-related goal when working with preschool-age children who stutter? Spontaneous fluency or controlled fluency using speech tools?

Spontaneous Fluency

What kind of contingencies are used in Lidcombe?

Verbal contingencies for the child's stutter-free speech and stuttering.

What are "Special Times" in palin pci?

at least five minutes of caregiver giving their child their undivided attention, listening to the child without focus on how it is said.

Describe the maintenance stage of change

behavior changed has become a habit and confident that change can be maintained.

What are the demands in the demands and capacities model of stuttering?

challenges confronting the child when speaking with others, (automatic and unconscious demands)

How does the common factor of Extra-therapeutic Change contribute to similar treatment outcomes?

characteristics of the client and his/herenvironment (e.g. temperament, social support)

How does the common factor of Therapeutic Relationship contribute to similar treatment outcomes?

characteristics of the clinician/client that facilitate change are present regardless of clinician's therapy orientation

How does the common factor of Hope or expectancy contribute to similar treatment outcomes?

client and clinician hope and expectancy will likely lead to change. (placebo)

Describe the action stage of change

clients are active in making changes (behavior, awareness, emotions, and thinking)

Describe the termination stage of change

clients are confident in maintaining changes in all situations.

Parent counseling

clinician listens, eases concerns, shows understanding

Parent education

clinician provides info and explanations

Parent training

clinician shows and teaches how to interact with child.

What is the second stage of change?

contemplation

What is the dodo effect?

different therapies can achieve similar change and progress.

What is the difference between indirect and direct treatment?

direct treatment aims to change speech whereas indirect aims to change environment.

What does the Demands and Capacities model of stuttering suggest?

each case of stuttering is a unique combination of speech, language, and motor limitations, and environmental demands.

What is a decisional balance worksheet?

table that displays the factors that influence their readiness to change by considering the pros and cons of changing or not

What are the 2 aspects of the speech production that most direct therapy techniques try to modify?

tension and timing

What is the 6th stage of change?

termination

What are the capacities in the demands and capacities model of stuttering?

the skill and abilities required to speak fluently. (being able to choose correct word, arrange sentences, etc)

Lidcombe v Restart DCM study showed that there is basically no significant difference between.....

the two treatments.

Lidcombe v Restart DCM study found that decreased stuttering more quickly during the first _______ ________ of treatment.

three months

How is video recording of parent-child interaction used in Palin PCI?

to identify what the child needs to help their fluency, what is helpful from the parents and what they could do more to help.