NORTHERN ILLINOIS UNIVERSITY DEPARTMENT OF COMMUNICATIVE DISORDERS


COMD 544: STUTTERING MANAGEMENT AND TREATMENT
FALL SEMESTER 1996 HOWARD D. SCHWARTZ Ph.D.
TUESDAY 12:30 P.M. - 3:14 P.M.
ADAMS 20 NORTHERN (815) 753-1429 NAPERVILLE (630) 357- 5540

PURPOSES:

REQUIRED TEXTBOOKS

Conture, E. (1990 2ND EDITION). Stuttering. Englewood Cliffs, NJ.:Prentice-Hall, Inc.

544 COLLECTED ARTICLES/PAPERS AVAILABLE AT BOOKSTORE

RECOMMENDED PAMPHLETS/BOOKLETS

Ainsworth, S. (1989). If Your Child Stutters-A Guide for Parents. Memphis,Tenn.: Speech Foundation of America, Revised Edition.

Conture, E.G. & Fraser, J. (1990). Do you stutter: A guide for Teens, Speech Foundation of America

Conture, E.G. (1992). Stuttering and your child: Questions and Answers, Speech Foundation of America

Guitar, B. & Conture, E.G. (1992). To the Pediatrician, Speech Foundation of America

Peters, T.J. & Guitar, B. (1991) Stuttering an Integrated Approach to its Nature and Treatment. Baltimore: Williams and Wilkins.

COURSE ORIENTATION

The majority of students enroll in this class because they want to learn how to do stuttering therapy. You can be taught the technical aspects of stuttering therapy in a five hour period. As this course is 48 hours in duration, we are left to fill in 43 hours with something meaningful. I believe that you need to understand a number of concepts including consistent identification of stuttering and the methodology of a comprehensive evaluation. In addition, it is my intention to help to shape your perspectives on stuttering so that you consider yourself to be a problem solver rather than a technician. Anyone can follow a recipe and be a technician. Strive for more.

REQUIREMENTS

Your final grade will determined by four written projects that will be turned in during the semester. You will receive these projects in one package so that you can start working on each paper at your leisure. Each project will be unique to the topics under discussion. It is my intent to keep the length of these projects to four to five typed pages. Papers that exceed the maximum will lose at least 1/2 letter grade for failing to following directions. Your work on these projects will serve to prepare you for future in-class discussions and possible presentations. Your final grade will be an average of your written projects.

You will also have the opportunity to complete an extra credit project. The grade for the extra credit project can be substituted for your lowest grade on any of the other projects.

ACADEMIC DISHONESTY

There is no excuse for academic dishonesty. You are expected to prepare your own papers, use original thinking and provide appropriate references when referring to material that is written by other authors. When a paper appears to be plagiarized or misrepresents material in a dishonest manner, the student will receive a zero grade for the paper.

TOPICS

8/27 DIAGNOSING STUTTERING
9/ 3 DIAGNOSING STUTTERING
9/10 DIAGNOSING STUTTERING
9/17 ONSET AND DEVELOPMENT OF STUTTERING
9/24 ONSET
10/1 ONSET
10/8 OVERVIEW STUTTERING MODIFICATION VERSUS FLUENCY SHAPING
10/22 ADULT THERAPY PROGRAMS
10/29 PRESCHOOL THERAPY PROGRAMS
11/5 PRESCHOOL THERAPY PROGRAMS
11/12 TEACHING SPEECH FLUENCY
11/19 NO CLASS
11/26 OLDER CHILDREN AND ADOLESCENTS
12/3 INTENSIVE FLUENCY THERAPY
12/10 ADULTS
12/17 COUNSELING ADULTS WHO STUTTER

READING ASSIGNMENTS

PLEASE NOTE: In order to get the most out of this seminar, it is to your advantage to do all the readings, not just the readings that you will be presenting in class. It is my hope that the readings will help you to generate questions and comments during our class meetings.

(1) STUTTERING AND ITS DIAGNOSIS

Conture, E. pp. 35-84

Andrews, G. Introduction: A tutorial on stuttering (1987). in Rustin, L., Purser, H. & Rowley D (Eds). Progress in the treatment of stuttering. New York, Taylor & Francis pp. xvii-xix ON RESERVE

Zebrowski, P. (1994). Stuttering. in J.B. Tomblin, H.J. Morris, & D.C. Spriestersbach (Eds.), Diagnosis in communication sciences and disorders. San Diego: Singular Publishing. CHAPTER ON RESERVE UNDER COMD 424 STUTTERING

(2) ONSET AND DEVELOPMENT OF STUTTERING Johnson, W. Et al. (1942). A study of the onset and development of stuttering, Journal of Speech Disorders, 7, 251-257 RESERVE

Bloodstein, O. (1993). The Diagnosogenic Theory in Stuttering: The Search for a Cause and Cure. Boston: Allyn and Bacon, pp. 56-70, COLLECTED

Silverman, F. (1990). The monster study. Journal of Fluency Disorders. COLLECTED v Yairi, E. (1983). The onset of stuttering in two and three year old children: A preliminary report. Journal of Speech and Hearing Research. pp. 171-177 COLLECTED

Yairi, E., and Lewis, B. (1984). Disfluencies at the onset of stuttering, Journal of Speech and Hearing Research, 24: 154-159. COLLECTED

Yairi, E. (1993) Epidemiologic and other considerations in treatment efficacy research with preschool age children who stutter. Journal of Fluency Disorders, 18, 197-220. COLLECTED

Yairi, E., Ambrose, N.G., Paden, E.P. & Throneburg, R.N, (1996) Predictive factors of persistence and recovery: Pathways of childhood stuttering. Journal of Communicative Disorders, 77, pp. 53-77 COLLECTED

Yairi, E., Ambrose, N., & Cox, N. (1996) Genetics of stuttering. Journal of Speech and Hearing Research, 39, 771-784

Schwartz, H. & Conture E. (1988) Subgrouping young stutterers: Preliminary Behavioral Observations. Journal of Speech and Hearing Research. 62-71. COLLECTED

Schwartz, H.D., Zebrowski, P.M. & Conture, E.G. (1990). Behaviors at the onset of stuttering, Journal of Fluency Disorders.

Conture 1-34

Peters and Guitar 21-107

Starkweather C. W., Gottwald, S. R., & Halfond, M. M. (1990). Stuttering Prevention, pp. 7-29. COLLECTED

(3) STUTTERING MODIFICATION VERSUS FLUENCY SHAPING

Gregory, H. (1979). Controversial issues: Statement and review of the literature, in H. Gregory (Ed.) Controversies about Stuttering Therapy, Baltimore:University Park Press, pp.1-31 COLLECTED

Peters & Guitar 111-128

Bloodstein, O. (1993). Iowa Therapy, Stuttering: The Search for a Cause and Cure. Boston: Allyn and Bacon, pp. 42-55 COLLECTED

(4) ADULT THERAPY PROGRAMS

Costello Ingham, J. (1993). Behavioral Treatment of Stuttering Children, in R. F. Curlee (ed.) Stuttering and Related Disorders of Fluency. New York:Thieme Medical Publishers, pp. 68-100, ON RESERVE

Ham, R. (1990). Therapy of stuttering, Englewood Cliffs, NJ: Prentice-Hall

Symptom Modification Procedures 326-358 COLLECTED Attitude, Motivation, and Emotions 212-258 COLLECTED

Bloodstein, O. (1993). Stuttering: The Search for a Cause and Cure. Boston: Allyn and Bacon, pp. 42-70 COLLECTED

(5) PRESCHOOL THERAPY PROGRAMS

Conture 85-148

Kelly, E.M. (1992). Speaking rates, response time, latencies, and interrupting behaviors of young stutterers, nonstutterers, and their mothers. Journal of Speech and Hearing Research, 35, pp 1256-1267. COLLECTED

Kelly, E.M. (1993). Speech rates and turn-taking behaviors of children who stutter and their parents. Seminars in Speech and Language, 14, 3, pp. 203-213. COLLECTED

Kelly, E.M., (1994). Speech rates and turn-taking behaviors of children who stutter and their fathers. Journal of Speech and Hearing Research, 37, 1284-1294. COLLECTED

Kelly, E.M., (1995). Parents as partners: Including mothers and fathers in the treatment of children who stutter. Communicative Disorders, 28, 93-105. COLLECTED

Peters & Guitar 247 - 308

(6) TEACHING FLUENCY SKILLS

Schwartz, A Primer for Stuttering Therapy,

FIRST DRAFT: Fundamental therapy procedures for all clients: speech modification and attitude change

(7) OLDER CHILDREN AND ADOLESCENTS

Conture, CHAPTER ON OLDER CHILDREN AND ADOLESCENTS

Phelan T., 1-2-3 Magic, Glen Ellyn:Child Management. ON RESERVE

Schwartz, H. (1993) Adolescents who stutter, Journal of Fluency Disorders, 18, 289-302 COLLECTED

(8) INTENSIVE FLUENCY THERAPY PROGRAMS

Neilson, M. & Andrews, G., (1993). Intensive fluency training of chronic stutterers. In R. F. Curlee (ed.) Stuttering and Related Disorders of Fluency. New York:Thieme Medical Publishers, pp. 139-165, ON RESERVE

(9) ADULTS FLUENCY, COUNSELING TRANSFER AND MAINTENANCE

Schwartz, A Primer for Stuttering Therapy,

FIRST DRAFT: CHAPTERS ON ADULTS AND COUNSELING

Bloodstein Chapter on Self-Help Groups COLLECTED

Schwartz, H. (1994) Transferring fluency: Paper presented at First International Fluency Congress, Munich, Germany, August, 1994 COLLECTED

COMD 544 STUTTERING MANAGEMENT AND TREATMENT

In the pages that follow, you will find your assignments for the semester. Remember that each of these papers will be a maximum of five doubled spaced typed pages excluding the reference page. Your writing style should reflect the conventions contained within the Publication Manual of the American Psychological Association (4th edition). The assignments will be due in class on the date assigned. Late papers will lose one letter grade for each 12 hours (from beginning of class at 9 am) late.

Assignment One - September 19, 1995

Assignment Two - October 10, 1995

Assignment Three - November 14, 1995

Assignment Four- December 5, 1995

Extra Credit- Anytime after November 14, 1995

COMD 544 STUTTERING MANAGEMENT AND TREATMENT ASSIGNMENT 1

You have two case histories of children who stutter. The first child is a preschooler and the second child is in third grade with a confirmed stuttering problem. Select one of the case histories and address the following issues:

1. What specific information will you attempt to obtain from the parents?

2. Describe an evaluation that is specific to this child. What information will you attempt to obtain from the child and how will you obtain this information. Focus your attention on both the characteristics of the child's problem as well as the characteristics of the child. Provide a rationale for your selections.

CASE 1

Bruce's mother phones and reports to you that her son has been stuttering for three months. Mrs. Wayne indicated to you that she just knows that her son is stuttering because both her brother and father are stutterers. "Bruce repeats words and phrases and occasionally gets stuck on a word." Mrs. Wayne reported that her husband is in sales and is one of the top producers in his company. In addition, Mrs. Wayne indicated that she was a theater major in school and often participates in community theater productions. Upon questioning, Bruce's mom indicated that her son doesn't appear to be aware of his stuttering, "he just continues talking even when he's repeating a lot." The mother stated that Bruce has an older brother (John, age 8) who "is always talking." The mother stated "At dinner, it's hard to get a word in when the boys get going." Mrs. Wayne noted that Bruce will sometimes blink his eyes when he get stuck on a word but "I don't think he knows that he's doing this." Bruce presently attends the Tokyo Toddlers play group, five mornings per week where he is learning Japanese. The parents believe that learning Japanese is crucial for Bruce's future success in business.

CASE 2

Jack and Jill are fraternal twins who are in third grade at the M. Goose elementary school. You are presently working as the speech-language pathologist at M. Goose although this is your first year (you transferred this year from H. Dumpty Junior High). Mrs. Hill, the twin's mother indicated to you that Jill has been stuttering since she's three years old. "I just don't understand why Jill has a problem and Jack doesn't" said Mrs. Hill. The mother stated that when she was younger she used to stutter although she grew out of the problem before receiving any kind of help. "I just don't understand why my kid needs therapy, I outgrew the problem." Reportedly, Mr. Hill is an accountant and is very quiet. "My husband is very successful but he doesn't talk an awful lot." Sometimes, we can sit for hours and not say a word" reported Mrs. Hill. Our kids play together and don't need to include us in their games. Finally, Mrs. Hill stated "I think it will be a good idea for Jill to wait and see if she grows out of her problem.

COMD 544 STUTTERING MANAGEMENT AND TREATMENT ASSIGNMENT 2

Develop your own model for the onset and development of stuttering. You want to include an explanation for:

I expect you to develop your own model, rather than reword a model that you've read about or discussed in class. If you use concepts from an existing model, please give credit to that author.

Your model should be in the form of some type of diagram. The diagram should be able to stand alone without an accompanying text.. You will also write a four page paper that describes in more detail the components of your model.

COMD 544 STUTTERING MANAGEMENT AND TREATMENT

ASSIGNMENT 3

Given our discussions regarding adult therapy programs, please describe your own approach to stuttering therapy. Feel free to borrow techniques from any of the programs that we discussed and discuss your reasons for selecting those procedures. While we recognize that not all stutterers are the same and our approaches to therapy may vary according to the client, you can still develop a basic philosophy and strategy that will be used for most adult stutterers. It is important that your paper is organized and proceeds from early stages of therapy to later stages of therapy. Address the follow issues where appropriate:

1. How do you address stuttering
2. How do you address fluency
3. Are associated behaviors addressed in your program?
4. What is the role of emotion (if any) and how do you address this issue.
5. Techniques for transfer
6. How is maintenance addressed.

COMD 544 STUTTERING MANAGEMENT AND TREATMENT ASSIGNMENT 4

1. During the last week on an intensive fluency training program you are being asked to develop three activities that can be used to effectively help your adult client to learn to transfer his/her newly learned fluency from the clinical setting to the real world. These three activities should reflect three increasing levels of communicative demand ranging from least demanding to most demanding (you are being asked to be creative in this process (Copying another writer's suggested tasks will not be sufficient). You will need to explain your rationale for each task selected as well as describe in detail the nature of each of the tasks.

COMD 544 STUTTERING MANAGEMENT AND TREATMENT

EXTRA CREDIT

You are about to enter the third week of your intensive fluency therapy program and you recognize that your clients have not internalized their locus of control of fluency. Each of the clients continues to believe that stuttering is something external and beyond their control, despite the fact that they are all consistently fluent. Being a skilled clinician, you recognize that without a change in attitude and an internalized locus of control, your clients will not be able to remain fluent when your program is completed. As a result, you decide to deliver a *wake-up call* to your clients in the form of a *hell-fire and brimstone* speech. Write out the speech as you will deliver it to your clients.


added with permission - February 14, 1997