SH732 FLUENCY DISORDERS

Boston University - Spring, 2009

 

Diane Parris, MS CCC/SLP, BRS-FD

dparris@bu.edu  (617) 353-7479.

 

SYLLABUS

 

Course Description     (2 credits)

This course presents the theory, diagnosis and treatment of fluency disorders in children, adolescents, and adults. As a teacher-clinician, my goal is to develop your understanding and practice knowledge about individuals with stuttering and related fluency disorders so that you can provide quality services to these clients.  In this course, we will review the symptomatology of stuttering, survey theories of stuttering, and examine normal versus abnormal fluency development.  Then we will focus on diagnosis of fluency disorders and differential diagnosis of stuttering and related disorders of fluency.  A central focus will be placed on the design and application of appropriate treatment programs for young children, school-aged children and adults.  This will include knowledge in related areas necessary to treat this multidimensional disorder holistically, i.e. motor skills re-training, family involvement, and counseling. Throughout the course, I will involve you in practical experiences to enhance your clinical understanding; this will include discussion of clinical cases, videos of clients and master clinicians, opportunity to meet with individuals who stutter, and classroom experiences as well as assignments.

 

 

Required Text and Readings

1.      Conture, E. & Curlee, R. (2007) Stuttering and Related Disorders of Fluency, 3rd Edition. New York, NY: Thieme Medical Publishers, Inc.

2.      Journal articles specified on Courseinfo.   

 

Other Recommended Resources

Bennett, Ellen M. (2006) Working with People Who Stutter, Prentice Hall Publishers.

Bloom, C. & Cooperman, D. Synergistic Stuttering Therapy: A Holistic Approach, MA:

Boston Butterworth-Heinemann.

Bothe, A. (2004) Evidenced Based Treatment of Stuttering, Mahwan, New Jersey:

              Lawrence Erlbaum Associates.

Guitar, B. (2006) Stuttering An Integrated Approach to Its Nature and Treatment, 3rd

Edition. Baltimore, MD: Williams & Wilkins.

Manning, Walt (2001). Clinical decision making in fluency disorders (2nd ed.) Vancouver:                

           Singular Thompson Learning.

Shapiro, D.A. (1999). Stuttering intervention: A collaborative journey to fluency freedom.

           Austin,TX: Pro-Ed.

VanRiper, C. (1982).The nature of stuttering.  Waveland Publishers.

 

Suggested on-line resources:

Journal of Fluency Disorders:  http://www.sciencedirect.com/science/journal/0094730X

Judith Kusterís Website: http://www.stutteringhomepage.com

Stuttering Foundation of America: http://www.stutteringhelp.org

Course Objectives

ASHA Standard (2005)

Assessment Method & Criterion

1. To develop an understanding of speech fluency and factors which interfere with it.

ASHA Standard III-B: The applicant must demonstrate knowledge of basic human communication and swallowing processes, including their biological, neurological, acoustic, psychological, developmental, and linguistic and cultural bases.

Reflection paper:

Students will list ways in which own fluency fluctuates and factors influencing degree of fluency.

2. To describe specific behaviors associated with the disability known as stuttering.

Standard III-C: The applicant must demonstrate knowledge of the nature of speech, language, hearing, and communication disorders and differences and swallowing disorders, including the etiologies, characteristics, anatomical/physiological, acoustic, psychological, developmental, and linguistic and cultural correlates.

Students will describe and demonstrate behavioral characteristics of stuttering in pseudostuttering exercise.

3. To review various theoretical models concerning the etiology of stuttering and the development of the disorder as well as variables that contribute to its maintenance.

Standard III-C: Same as above.

 

Classroom quiz.

4. To develop assessment practices through examining interviewing methods, various diagnostic measures and instruments used in the assessment of those who stutter.

Standard IV-G-1 b &e: The applicant for certification must complete a program of study that includes supervised clinical experiences sufficient in breadth and depth to achieve the following skills outcomes: 1. Evaluation:
b. collect case history information and integrate information from clients/patients, family, caregivers, teachers, relevant others, and other professionals
e. interpret, integrate, and synthesize all information to develop diagnoses.

Diagnostic homework assignment: students will be able to code fluency behaviors in order to complete an SSI-3 severity rating accurately. In addition, students will participate in discussion of case studies including identifying behavioral observations and results of attitudinal surveys.

 

Final Project.

5. To understand various therapeutic procedures and programs for the treatment of stuttering with consideration of age and cultural issues, including skill development in motor speech modification strategies and counseling skills.

Standard III-D: Same as above.

Classroom exercises;

Reflection paper for speech change exercise; Final Project

6. To develop a clinical approach to the treatment of stuttering and the potential handicap it presents in individualsí lives, including for those clients with issues related to concomitant phonology and/or language impairments.

Standard IV-G-2-a: The applicant for certification must complete a program of study that includes supervised clinical experiences sufficient in breadth and depth to achieve the following skills outcomes: 2. Intervention: a. develop setting -appropriate intervention plans with measurable and achievable goals that meet clientsí/patientsí needs. Collaborate with clients/patients and relevant others in the planning process.

Final project: Develop a Fluency handbook for future clinical practice that includes appropriate evidence-based integrated treatment assessment and tx procedures including tools to be used with preschoolers, school-age children, and adults.
Course Requirements

Your course grade is based on completion of each of the following assignments. A total of 200 points can be achieved:

1. Assignments.  60 points (20 points per assignment)

  1. The first is a reflection on your own communication challenges, the events that lead to fluency breakdown as well as speech or formulation breakdowns, the context in which these breakdowns occur, the stressors that are operative, and your responses and reactions to these stressors and the dysfluencies. 
  2. Homework assignment following the diagnostics class re: scoring disfluencies.
  3. Participate in direct experiences of stuttering and what it takes to modify speech for prolonged periods of time.  This is a valuable assignment for anyone planning to treat individuals who stutter and will entail writing up your reactions to 1) producing pseudo-stuttering in three distinct speaking situations, and 2) altering your speech, e.g., producing targets (motor speech skills that we train our clients to use) daily over the period of one week. 

 

2. Classroom Quiz – Etiology and development of stuttering. 40 points

 

3.       Final Project: My Fluency Handbook. 100 Points

Compile a course handbook throughout the semester that will contain materials related to the assessment and treatment of stuttering for preschoolers, school age children, and adults who stutter. Notebooks that are well organized, contain at least three pertinent journal articles, and that contain a wide variety of materials to assist you on the job will receive the highest grades.  A notebook that is well organized and includes materials available from class and courseinfo only will receive a ëBí range grade.  Notebooks that also include a variety of resources/materials you collect/compile outside of class to assist you in the assessment and treatment of stuttering will receive an ëAí range grade.  You will be asked to explain the significance of artifacts you include in this notebook and the thoughtfulness of your significance statements will also be considered in your notebook grade. The final section of the handbook should include resources related to one of the following topics – your choice: cluttering, neurogenic stuttering, assessment and intervention in bilingual speakers, the neurology of stuttering. Notebooks can be hard-copy or stored on CD or flash drive. You may leave them in the box that will be outside my door on the due date: May 6.

 

Important Dates and B.U. Policies

 

 

Office Hours

Wednesdays:     1:00 – 2:00 p.m. Room 329.

 

Teaching Assistant

The TA for this course is Nicole Ellis who can be contacted at nicanne@bu.edu.

 

Class Topics, Assignments, and Readings

 

March 18           Introduction to the course: purpose and goals, requirements

Characteristics of stuttering; the Development of Stuttering

 

                              Assignment:     Reflection Paper 1 – The Experience of Normal Disfluency

              

                              Readings for next weekís class:

Guitar – Chapter 4 (on reserve in Makechnie Study Center)

Andrews article – All articles are on Courseinfo under ìAssignmentsî

 

March 25           Etiological Theories of Stuttering

 

                              Assignment:      Paper due; discuss in class.

 

                              Readings for next time:

                              Conture & Curlee text – Section I

                              Yaruss & Healy article

                             

April 1                Clinical Assessment of Fluency Disorders

              

Assignment:     Quiz – Etiology and Development of Stuttering

Scoring Disfluencies

 

Readings for next time:

                              Bernstein-Ratner on EBP

                              Bothe – Review of Stuttering Therapy Research 1970 – 2005 (optional)

 

April 8                Guest Speakers

Motor Speech Behaviors                                    

                             

                              Assignment:     Scoring Disfluencies due.

                                                            Reflection Paper 2 – Pseudostuttering & Speech Modification                        

Readings for next time:

                              Conture & Curlee text – Section II

                              Gottwald on Intervention for Preschoolers

 

April 15              Treating Preschool Age Children Who Stutter

Parent Training

 

                              Assignment:     Paper due; discuss in class.

 

Readings for next time:

                              Conture & Curlee text – Section III

                              Ramig & Bennett article

                              Murphy articles (2) – Reducing Negative Emotions, Reducing Bullying

 

 

April 22              Treating School-Aged Children Who Stutter

 

Assignment: Final Project due in two weeks.

 

Readings for next time:

                              Conture & Curlee text – Section IV

                              Daly on Working with Adolescents

                              Floyd on Stages of Change

 

 

April 29              Treating Adolescents and Adults Who Stutter

 

Assignment: Final Project due on Wednesday May 6 at 9:00 a.m.