SLP 561: Advanced Fluency Disorders

Spring Semester, 2004

SCHEDULE: M-W: 11:00 -12:15

LOCATION: Room 2330 UCOM Speech Pathology and Audiology

CREDITS: 3 semester hours

INSTRUCTOR: Stephen B. Hood, Ph.D., CCC-SLP

UCOM, Office 2102

Office: 380-2628

Home: 342-3927

Email: sbhood@JAGUAR1.USOUTHAL.edu

OFFICE HOURS: M-W: 10:00 - Noon

T-Th: 9:00-11:00

Subject to change depending upon clinic schedule.

***Also available by appointment.

CATALOG DESCRIPTION: Study of theories, research and contemporary treatment procedures in the area of disfluency.

COURSE PURPOSE:

SPA 561 is designed to bridge the gap between theory, research and clinical applications. The course is intended to investigate current trends and to determine common strengths and weaknesses among them.

For students with a strong academic background in stuttering, parts of this course may seem like a quick review; for others, the challenge may appear extreme. It is my strong hope that the class will develop a unity of curiosity that will lead to provocative class discussions, arguments and attempts at better understanding. But I cannot do this alone. Letπs all work together to make class meetings more of a dialog among us than a monolog from me. This is not to imply a desire to all arrive at the same conclusions, for this would be unrealistic. Let us strive to come to an understanding based on an appreciation of various theoretical positions, with which we can feel comfortable, and from which we can provide optimum clinical services for our clients.

FEAR NOT -- The reading list!!! It looks more lengthy than it really is. Redundancy is built into the readings to aid in learning. The major highlights will be stressed in class, and will be the foundation upon which examinations are built. No attempts will be made to be "tricky."

I am well aware of the cost of textbooks and have tried to limit the number of textbooks for this course. Many books have been published in recent years, and there really is no "single best book." With respect to the supplemental readings, we can develop a system wherein copies can be checked out as needed.

REQUIRED TEXTS:

Barry Guitar. (1998). Stuttering: An Integrated Approach to its Nature and Treatment. Williams and Wilkins

Stuttering Foundation of America. Memphis, TN. Series of Pamphlets and books.

Stuttering Foundation of America Series

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Ainsworth: If Your Child Stutters: A Guide for Parents

Starkweather: Therapy for Stutterers

Conture: Stuttering and Your Child: Questions & Answers

Hood: Stuttering: Words.

Hood: Advice to Those Who Stutter Stutterer

Gruss: Stuttering Therapy: Transfer & Maintenance

Gruss: Counseling Stutterers

Fraser: Do You Stutter: A Guide for Teens

Fraser: Self Therapy for the Stutterer

Dell: Treating the School Aged Stutterer

Guitar: Stuttering: Integration of Therapies

Gregory: Stuttering Therapy: Prevention & Intervention

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SUPPLEMENTARY READINGS: Class Handouts and handouts of Power Point slides will be available.

For students who seek additional information about the various topics to be covered, I have a number of personal resources that may be borrowed.

Bloodstein, O. (1995). A Handbook on Stuttering. San Diego, CA: Singular Publishing.

Hood, S. (1978). The Assessment of Fluency Disorders. In S. Singh and J. Lynch (Eds.) Diagnostic Procedures in Hearing, Language and Speech. Baltimore, MD: University Park Press.

Starkweather, C. W. and Givens-Ackerman, J. 1997 Stuttering. Austin, TX: Pro-Ed

Van Riper, C. (1982). The Nature of Stuttering. (2nd Edition). Englewood Cliffs, NJ: Prentice Hall.

Van Riper, C. (1973). The Treatment of Stuttering. Englewood Cliffs, NJ: Prentice Hall.

Class Handouts will be available. Those who were USA undergraduates will note that most of these are identical to what you received in the undergraduate course. In this class, we will go into more depth.

I wish that I could assume that some sections of this course will represent a review of materials presented at the undergraduate level. But this assumption is increasingly dangerous because more and more universities have stopped offering courses in specific topics such as voice and stuttering. In recent years, this class has become increasingly heterogeneous with respect to commonality of background.

For those who feel they have a weak background, I will hold additional ≥catch-up≤ meetings. For those interested, we can determine a time for this later. Supplemental additional readings are shown later in this handout, and I can provide additional material, as well.

STUDENTS WITH SPECIAL NEEDS: It is the policy of USA to accommodate students with disabilities. Any student with a qualified disability that requires accommodations should see the instructor during the first week of classes. A student must verify that he/she has a qualified disability through Disabled Student Services (460-7213), Student Center Room 270, Ms. Bernita Pulmas, director.

POLICY ON ACADEMIC MISCONDUCT: Any dishonesty related to academic work or records constitutes academic misconduct. Academic misconduct is incompatible with the standards of the academic community. Such acts are viewed as moral and intellectual offenses and are subject to investigation and disciplinary action through appropriate University procedures. Penalties may range from the loss of credit for a particular assignment to dismissal from the University. (See The Lowdown, Student Academic Conduct Policy.)

PROGRAM ACCREDITATION: The Council of Academic Accreditation (CAA), under the auspices of the American Speech Language Hearing Association (ASHA), has certified the Department of Speech Pathology and Audiology at USA as an authorized educational facility. This means that credentials obtained by graduates in Speech-Language Pathology or Audiology will automatically be accepted by ASHA when these graduates apply for certification. If students wish to contact CAA for additional information, they may do so at the following address:

Council of Academic Accreditation

The American Speech Language Hearing Association

10801 Rockville Pike

Rockville MD 20852

BEHAVIORALLY-DEFINED COURSE OBJECTIVES FOR STUDENT KNOWLEDGE AND SKILL:

Upon completion of the course, the student will:

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1. Demonstrate understanding of the affective, behavioral and cognitive aspects of fluency, disfluency and stuttering

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2. Be able to identify the risk factors that make certain children more vulnerable to the development of stuttering

3. Describe the similarities and differences between normal nonflunecies, stutter-like disfluencies, and stuttering

4. Know the core features of stuttering, secondary features of stuttering, and related attitudes and feelings

5. Comprehend the development of stuttering in terms of behavioral, emotional and attitudinal components

6. Be able to apply the principles of learning theory to the onset, development and maintenance of stuttering

7. Understand the parameters of diagnostic assessment to the overt and covert features of stuttering

8. Be aware of the general principles of prevention and early intervention in preschool children

9. Be able to identify the general principles of treatment for borderline stuttering

10. Demonstrate an understanding of the general principles of treatment for mild, intermediate and advanced stuttering

11. Describe the similarities and differences to stuttering therapy programs based on ≥fluency shaping≤ and ≥stuttering modification≤ techniques.

12. Perform disfluency analyses on fluent and stuttered speech in order to determine the overt features of frequency, intensity, duration and type.

13. Enter selected speaking situations wherein students will assume the role of a person who stutters, and wherein the student will perform fluency shaping and stuttering modification strategies such as: easy onset, gradual release, cancellation, pull out, preparatory set

Objectives 1 through 11 directly address ASHA Standards III-B, III-C and III D. Knowledge of basic human communication processes, Communication Differences and Disorders, and Prevention, Assessment and Intervention.

14. Write narrative summaries of objectives 12, and 13, above

15. Write narrative summaries of Web Site searches to sites such as: the Stuttering Home Page, Stuttering Foundation of America and the Stuttering Foundation of America

Objectives 14 and 15 Address Standard ASHA III-A, Skill in written communication.

EVALUATION AND GRADING:

Listed below is the projected time from for assignments, and the projected grading scale. These are subject to modification, if necessary.

20 % Examination 1 February 18

25 % Examination 2 May 5. 10:00 AM

5 % Project I January 28

10 % Project II February 25

10 % Project III March 10

25 % Project IV. April 14

5 % Project V April 28

Projected Grading Scale:

A: 90 - 100

B: 80 - 89

C: 70 - 79 ---- Iπm struggling

D: 60 - 69 ---- Iπm sinking

F: < 60 ---- Iπm Downing

Attendance

Since attendance is important to learning, students are expected to attend class. However, the class is operated on the assumption that university students are responsible for their own behavior, including attendance, so formal attendance will not be taken for the purpose of computing your final course grade. You are responsible for the material presented in class, and unless there is sufficient reason, time spent during office hours is not designed for individual tutoring of materials missed due to absences.

Students must be in class on the day of examinations. Absences not previously granted by the instructor must be accompanied by a formal university or medical excuse. This will be discussed in class. Hopefully, members of the Mobile Chapter of the National Stuttering Association will visit class. This will be announced well in advance. Attendance on this date will be mandatory.

Tentative Course Outline

This year's group of students will again be heterogeneous. Much of what we will be covering will involve reviewing and expanding upon things you should already know (assuming your long term memory cells are functioning) as well as getting into some things that are new and different. If you find yourself getting confused, please see me as soon as possible.

We will watch a number of video tapes. These tapes will highlight things that cannot as easily be presented via straight lectures or through reading assignments. In order to do this, there may be a delicate balance between how much time we can spend with various modes of presentation. (In past years, most students found the tapes to be very helpful, but some students found them to be dull and boring. I will need your feedback on this. How much time is spent on lecture and how much time is spent with supplemental video tapes will depend upon you as a class.)

Changes in Course Requirements:

Should the requirements for completing this course change, students will be notified, and with consideration for time restrictions and student load.

Class Outline and Projected Time Frames

Unit I. The Nature of Stuttering: Models of Stuttering

Jan 12, 14, 21 Intro and Orientation to SPA 561.

Models of Stuttering:

Behavioral and Emotional Dimensions

Sheehanπs Iceberg of Stuttering

Temporal Sequencing and Episodic Variation

Core Features, Secondary Features, Attitudes & Feelings

Required Readings

Guitar, Chapters 1and 4

Hood, SFA Booklet.

Stuttering Words. Definitions Pgs. 9-12

Class Handouts

Unit II. Application of Learning Theory to Stuttering

Jan 26, 28, February 2. Classical and Operant Conditioning

Brutten and Shoemaker Model

Van Riper

Sheehan

Required Readings:

Guitar: Pages 89 - 100.

Handouts

Review of Learning Theory

Brutten and Shoemaker Model

Sheehanπs Model: Approach-Avoidance Conflict

Van Riperπs Models: PGAGH, and MIDVAS

Unit III. ≥Normal Nonfluencies,≤ ≥Stutter-Like Disfluencies≤ and the Onset and Development of Stuttering

February 4, 9

Required Readings

Guitar: Chapter 5

Class Handouts

Van Riperπs 4 Stages

Douglass and Quarrington: Interiorized/Exteriorized

≥Schematic Portrayal of the Moment of Stuttering≤ (again)

Unit IV. Assessment of Stuttering

Feb 11, 16.

Case History – Predisposing, Precipitating and Perpetuating Factors

Parent Interview, Client Interview, Collecting Speech Samples

Disfluency Analysis

Stuttering Severity Instrument

Cooper Assessment of Stuttering Severity

Modified Erickson Scale

Perceptions of Stuttering Inventory

Communication Attitude Test

Required Readings:

Guitar: Chapter 7

Handouts

Hood, Disfluency Analysis Worksheet

Riley, SSI

EXAM I: February 18

The next units will deal with (a) working with older teens and adults who stutter, (b) working with school aged children, and (c) with the prevention and early intervention in young children, The text and lectures will be heavily supplemented by video tapes designed to show examples of therapy procedures.

Since SPA 561 is now being taught in the spring rather than the fall semester, more of you will have had experiences working in stuttering clinic. I hope that those of you who have had, or are now having clinical experiences with stuttering, will bring examples of your experiences to the class for group discussion.

This section of the course will be far more meaningful to you if you, and your fellow classmates, become highly involved in class discussions. This is especially true for those of you who had stuttering clients in the fall, or who have them this spring.

Class participation will be both encouraged and appreciated!

Unit V. Therapy for Older Teens and Adults

February 23 - March 29

Required Readings: Guitar Chapter 8 and 9

Handouts

Skim through these SFA Booklets for general overview of information.

Therapy for Stutterers

Self-Therapy for Stutterers

Advice for Those Who Stutter

Do You Stutter? A Guide for Teens

February 23-25 Fluency Shaping and Stuttering Modification

March 1 ASHA Video– Recovery from Stuttering

Recovery Tapes: Manning, Murphy, Others: on your own

March 3 SFA: Van Riper and Jeff -- Diagnosis and Identification

March 8 SFA: Van Riper and Jeff. -- Desensitization

March 10 SFA Van Riper and Jeff -- Variation

March 22 SFA Van Riper and Jeff -- Cancellation

March 24 SFA Van Riper and Jeff -- Monitoring

March 20 SFA Van Riper and Jeff - 20 Years Later