DYSF. Ch. 12

Verbal contingencies for stuttered speech

A.) include pointing out a stutter B.) are introduced after a child's fluency has begun to show improvement C.) are given in a ratio of no less than five praises for one contingency D.) All

Edward Conture, Linda Louko, and Mary Louise Edwards

A.) believe that other speech problems should not be addressed until a child is fluent B.) use an indirect approach for articulation issues with a child who stutters C.) correct articulation errors at the same time they praise for fluency B.

Diane Hill

A.) believes that fluency treatment should begin before work on other speech disorders B.) does not involve parents in treatments C.) has not seen many stutterers who also have word-finding problems A

Unstructured Lidcombe sessions

A.) can take place in a car or at meals B.) can include a 1:1 ratio of praise to contingencies C.) should not take place if structured sessions are still being conducted A

Sheryl Gottwald

A.) does not involve parents in treatment B.) modifies child's speech as well as changes child's environment C.) uses perfect fluency as the criterion for success. B.

The Severity Rating Scale

A.) is a standardized test of stuttering B.) is used by the parent for weekly assessments C.) should be "calibrated" to see if the parent and clinician are in agreement

Outcome data about the Lidcombe Program

A.) is scarce B.) has only come from Australia C.) has not found negative psychological effects C

Treatment using the Lidcombe Program

A.) may be supervised by any SLP B.) may be conducted by any parent who has read the online treatment manual C.) is individualized for each stutterer within the parameters of the program C

If a child stutters more than occasionally during Lidcombe sessions,

A.) one-on-one sessions with the parents should be abandoned B.) the clinician can model how to help a child produce linguistically simpler speech C.) the parent should have the child use only one-word utterances B

In the Lidcombe Program,

A.) parents conduct daily treatment sessions B.) parents focus first on negatively reinforcing disfluencies C.) parents and the clinician discuss stuttering only when the child is not present A.

"Maintenance" begins in the Lidcombe Program after three weeks of

A.) severity ratings no higher than 3 B.) percentage syllables stuttered in the clinic no higher than 5 percent C.) perfectly fluent speech D.) none D.

Positive reinforcement of fluent speech

A.) should be verbal only B.) can include tangible rewards C.) is rarely as effective as specific fluency training for beginning stutterers B.

Lidcombe treatment sessions

A.) should maintain a linguistic level that enables the child to be mostly fluent B.) are conducted only in the clinic C.) include directions for how to produce fluent speech A.

Structured Lidcombe sessions

A.) should not be considered by the child as "fun" B.) can include both parents alternating C.) often include siblings B

Treatment for a beginning stutterer

A.) should only be conducted in a structured seeing rather than at home B.) includes daily practice of fluent speech C.) should focus first on reducing tension and frustration B

During "maintenance"

A.) the child comes to the clinic only on an "as-needed" basis B.) parents no longer give praise or verbal contingencies C.) parents continue to record severity ratings C

During weekly Lidcombe sessions

A.) the clinician demonstrates to the parents how to conduct daily sessions B.) the parent and clinician discuss the child's speech while the child is present C.) the clinician assesses the child's fluency D.) all of the above D.

If a child ignores a request to self-correct a stutter,

A.) the parent or clinician should model the correction B.) praise should be withheld from the next instance of fluent speech C.) it should be noted when determining a severity rating D.) NONE D.

Sheryl Gottwald

A.) uses treatment based on the "demands and capacities" theory of stuttering B.) begins treatment by counseling parents C.) believes parents and clinician should talk openly with the child about stuttering D. all D.

A beginning stutterer

A.) will not yet show tension B.) will not yet show secondary behaviors such as eye blinks C.) will have part-word repetitions as the predominant core stuttering behavior C.

Describe the basic philosophy behind the Lidcombe Program

Daily, structured practice of fluency reinforces neural pathways for fluent speech; this may happen best when treatment takes place at home; operant conditioning in the form of parental praise, acknowledgments of stutters and requests for corrections help the child learn how to speak fluently; open discussion about stuttering can take place with the child present

Describe Stage 2 of the Lidcombe Program and when it is implemented.

Stage 2 is the maintenance stage. It begins after severity ratings are consistently 1's and 2's. Clinic visits are gradually faded, as are the parent's verbal contingencies. Adjustments, such as reinstating weekly visits, may have to be made.

Describe differences and similarities between structured and unstructured treatment sessions in the Lidcombe Program.

Structured sessions are one-on-one sessions between the parent and child. They are conducted daily at home. The parent uses games and activities designed to elicit mostly fluent speech. Unstructured sessions take place in everyday situations, such as during meals, while driving in the car, shopping, or playing. In both structured and unstructured sessions, the parent responds to the child's speech with praise, acknowledgment, and requests for correction.

Describe how the parent's Severity Rating Scale is "calibrated."

The Severity Rating Scale rates the child's fluency on a scale of 1 to 10, with "1" representing no stuttering fluent speech and "10" representing extremely severe stuttering. The clinician asks the parent to rate the child's speech during the first visit to the clinic, and the clinician compares the parent's rating with her own. If there is disagreement by more than one point, the clinician will discuss with the parent how she came up with her rating and will try to determine whether the parent seems to understand her rationale and is likely to be accurate in future ratings. This process can be repeated while watching videotapes of the child's speech during the first few weeks of treatment.

What are three major goals that are accomplished at the first Lidcombe Program treatment session?

assessment of the child's stuttering, explaining severity ratings to the parent, teaching the parent how to conduct daily treatment sessions.