SPED 5240 Stuttering Seminar
Dr. Sheree Reese Office Hours: Mondays (4-6PM)
Spring, 2001 Tuesdays (10-12AM)
Office Telephone: 629-7190
Email: sh-reese@home.com
FAX: (732) 636-1076
Purpose of Course:
The purpose of this professional course is to prepare you to effectively diagnose and treat fluency disorders in a variety of patients. The course will include significant theories, recent research, counseling techniques and current issues relating to providing therapy services for children and adults. In addition, we'll learn about preventative principles to apply to young children. The ultimate goal of the course is to help you develop into effective and efficient clinicians who will be comfortable and competent working with people with fluency disorders.
Course Objectives:
At the conclusion of this course, students will:
Required:
Shapiro, David Allen (1999). Stuttering Intervention. Pro-Ed, Austin:Tx
There will be supplemental assigned readings posted on the website. They
will be in the form of links taking you directly to the text.
There will be additional supplemental assigned readings which will be
accessible through a virtual library site. You will be able to access the
articles from your home computers.
Highly Recommended:
Complete set of Stuttering Foundation of America publications
The order form will be distributed in class.
Recommended:
Myers, F.L. and St. Louis, K. O. (1986). Cluttering: A Clinical Perspective.
Singular Publishing Group, 4284 41st Street, San Diego, California 92105-
1197, ISBN#1-56593-543-8
Course Requirements:
All students will be required to complete the following course requirements:
Two pre-course (ungraded) assignments are designed to familiarize you with the website support for this class. They include:
The graded components of the course include the following:
1. Listserv assignment 5%
2. Transcription Project 15%
3. Midterm 20%
4. Simulated Stuttering Project 20%
5. Treatment Program Analysis/Web page 20%
6. Final Examination 20%
7. In addition, students can earn up to 5 points of extra credit during the semester by
viewing videotapes on reserve at IRC. Details to be discussed in class.
Grades may be adjusted at the discretion of the professor based on a combination of class attendance, participation (that enhances the class experience in a positive manner), and preparedness (specifically having completed assigned readings prior to class and turned in assignments in a timely manner)
Grading:
80-82 = B- 60-64 = D
Below 60 = F
A Note on Attendance
Regular attendance is expected. Class absences can affect your competency level and your grade. If there is a serious reason that you cannot be in class, please discuss it with me personally. Please be attentive in class; it is unfair to the professor and the other students to talk out of turn.
No make-up examinations or late work will be permitted, except in the case of documented illness, emergency, or by prior arrangement with the professor.
The following is a general outline of the classes and assignments changes may occur as guest speakers, videotapes and 'experiences' are added.
Class # Date Topics Assignment
1&2 1/22 Guest Speaker
& Overview of course
1/29 Definitions
Prevalence and Incidence
Theories of onset & development
Read
Shapiro: Chapters 1,3
Desensitizing SLP's : http://www.mnsu.edu/comdis/isad2/papers/shields.html
Language & Fluency: Nan Ratner
http://www.mnsu.edu/comdis/isad2/papers/ratner.html
Neurophysiological theory: http://www.mnsu.edu/comdis/isad/papers/denil.html
3 2/05 Impact of Stuttering
On stutterer
On family
On clinician
Read
Shapiro: Ch. 2, 5, 6, 7
Case histories:
http://www.mnsu.edu/comdis/isad/papers/casey.html
http://www.mnsu.edu/comdis/isad/papers/jezer.html
Article from a wife: http://www.mnsu.edu/comdis/isad/papers/weiner.html
4 02/12 The Person Who Stutters: Characteristics
Measurement issues
Multicultural considerations
Read
Shapiro, pages 163-175
5 02/19 Preschool Children: Assessment
& Treatment
Read:
Shapiro: Ch 9
*Guidelines for Practice in Stuttering Treatment, SID4
*Treatment Efficacy: Stuttering, Edward Conture
*Treating the Child Who Stutters With Concomitant Language or
Phonological Impairment, Nan Bernstein Ratner
*Fluency Intervention for Preschoolers & Their Families in the
Public Schools, Gottwald & Starkweather
School-Age Children: Assessment
& Treatment
Read: Shapiro: Ch. 10
*Strategies for Treating Elementary
School-Age Children Who Stutter: An
Integrative Approach, Healey & Scott
*Working with 7-12 Year Old Children Who Stutter: Ideas for
Intervention in the Public Schools, Peter Ramig, Ellen Bennett
Pseudostuttering: http://www.mnsu.edu/comdis/isad2/papers/starke.html
Summer camps: http://www.mnsu.edu/comdis/isad/papers/bennett.html
Internet Assignment due
03/5 Class Canceled: Spring Break
7 03/12 Midterm Exam
8 03/19 Adolescents: Assessment & Treatment
Read:
*Helping Adolescents Who Stutter Focus on Fluency
David A. Daly
*Adolescents Who Stutter, Howard D. Schwartz
Waggott: http://www.mnsu.edu/comdis/isad2/papers/waggott.html
Caggiano: http://www.mnsu.edu/comdis/isad/papers/caggiano.html
Transcription Project Due
9 03/26 Counseling:Class held on-line only
Read: *Counseling Parents of Children Who Stutter,
Patricia Zebrowski
*Parental Involvement in the Treatment of Stuttering
Lena Rustin, Frances Cook
Neiders: http://www.mnsu.edu/comdis/isad2/papers/neiders.html
10 04/2 Adults: Assessment & Treatment
Read:
ADA: http://www.mnsu.edu/comdis/isad2/papers/parry.html
11 4/9 Simulated Stuttering Project Due
Class Discussion
12 4/16 Guest Speakers: Support Group
13 4/23 Cluttering and Other Fluency Disorders
Read: Shapiro, Chapter 4
*The Clutterer, David Daly
Read: *Clinical Management of Cluttering,
Ken St. Louis, Florence Myers
Treatment Program Analysis Due
Atypical Stutterer- http://www.mnsu.edu/comdis/isad2/papers/molt2.html
Cluttering: http://www.mnsu.edu/comdis/isad/papers/stlouis.html
14 4/30 Final Exam
In order to ensure full class participation, any student with a disabling condition requiring special accommodations (e.g. tape recorders, special adaptive equipment, special notetaking or test-taking procedures) is strongly encouraged to contact the professor at the beginning of the course.
SPED 5240
SUMMER SESSION I: 1999
INTERNET ASSIGNMENT
1. Each of you should get an e-mail address so you will have computer access to researchers all over the world who are involved in stuttering research. Attached are applications; if youd like, I will accompany you to the computer center to help facilitate the process.
Also attached is a list of resources related to stuttering. On page 2, you will see addresses for three listservs. Listservs are online discussion groups. Each of the listservs on your resource form is different, yet similar in some ways. Controversial issues are frequently discussed... you will be reading on the "cutting edge" of the newest and keenest thoughts of important authorities in the field of stuttering.
b. Read all the postings for one week during the semester and briefly summarize the discussion for that week.
c. "Lurk" the discussion that is going on and "post" at least once to a
discussion that you find interesting. Print out and attach a copy of your posting to your summary.
TRANSCRIPTION PROJECT
Two sensitive measures for describing the behaviors of stutterers are speech rate and stuttering frequency. The goal of this project is to help you develop expertise in assessing both of these areas. A videotape (containing 48 speech samples) and accompanying instruction manual will be on reserve in the IRC. In addition, I will "sign-out" videotapes with an accompanying disk (scheduled to be arranged individually). You will be able to print out forms and transcripts using these disks.
Necessary Equipment:
A VCR with a counter
A stop watch
Copies of forms
The manual talks about performing these measurements using a computer program. While I hope to have the actual program to show you during the semester, you do not have to use it for this project.
Part I: Counting Syllables
Speed of speech, also referred to as 'speech rate', is an important dimension of a speaker's speech pattern and one that changes as a function of treatment. A measure of speech rate is one important descriptor of a person's speech pattern. Pretreatment measures of speech rate will contribute to decisions regarding the kind of treatment that may be appropriate for a client. In order to accurately measure speech rate, you must first learn to count syllables. The first sample in your assignment is from the speech of a nonstuttering person. Before you begin counting syllables, listen to the first 30 seconds or so of the sample to 'calibrate' your ear. When you begin counting syllables, count every syllable that the speaker produces, including 'um's' and 'well's' and other insertions, as long as they are spellable. Be sure to count what the talker actually says, without being influenced by how you might say the word or by how it is spelled.
Sample One: _________________Number of syllables
Part II: Counting Stutters
The frequency of a person's stuttering is obviously an important measure for assessment, treatment and posttreatment phases of the clinical process. Many clinicians and most stutterers view as a major clinical goal the substantial reduction or complete elimination of moments of stuttering. Therefore a valid and convenient measure of stuttering frequency is required. Defining a moment of stuttering is difficult because they take so many different forms within and across speakers and because the same behavior (e.g., a phrase repetition) might be a moment of stuttering on one occasion and not on another, or for one person but not for another.
Use the criteria that we discussed in class and listen to the next three samples. (It is a good idea to just listen to the sample to be judged for 30 seconds or so, until you are familiar with the speaker's stuttering "style" and the kinds of stuttering behaviors you are likely to see and hear.) Then determine the frequency of stuttering for that sample.
Sample two:___________
Sample three:___________
Sample four:__________
Part III: Counting Syllables and Stutters
For Sample #5, compute the following:
# of Syllables:_____________
# Stutters:________________
Percentage of stutters per minute (SPM)
Hierarchy of types of stutters (including percentages):
Part IV: Real-Time Analysis
Read the article by J. Scott Yaruss, "Real-Time Analysis of Speech Fluency Procedures and Reliability Training".
Using Sample #6 attempt to perform this type of analysis. You may use the formats recommended in the article, or develop your own.
SEMESTER PROJECT
'Modeling Stuttering Behaviors' exercise: What would it be like to be a person who stutters?
In order to successfully and effectively deal with the disorder of stuttering in the clinical process, it is necessary to fully understand the disorder. The following are a series of assignments that are designed to help clinicians develop a better understanding of the covert and overt aspects of stuttering.
Part I
Practice 'fake' stuttering (also called pseudostuttering) in class (time will be provided) and with a friend from the class to make sure your fake stuttering behaviors are representative of stuttering. Next, stutter openly in public on 5 different occasions. Examples of situations in which you can stutter include the following:
a. ordering coffee at a coffee bar
b. calling information for a phone number
C. buying a book at the bookstore
d. asking for directions to a building on campus
e. ordering lunch in a restaurant
f buying clothing at a department store
g. ordering pizza over the phone
h. calling a radio talk show
Only one "experience" can be on the telephone . the other 4 must be in person. On at least one of the stuttering "experiences", accompany or be accompanied by another class member. Each of you will then have the opportunity to observe the reactions of bystanders that may not be apparent to the "stutterer".
Please try to make this assignment as real as possible. In other words, don't just stutter once during the conversation and then stop - become the person who stutters during each of the 5 occasions. Try to understand what it would be like to be a person who stutters.
AT NO TIME MAY YOU REVEAL THAT YOU ARE A NORMAL SPEAKER. Please do this exercise respectfully - make sure there is nobody who stutters already present who may think you were mocking him. We will devote class time to an open discussion of your
experiences.
Part II Fluency Shaping Exercise
On two additional instances (one may be with friends or family, one must be in public) speak using "fluency shaping techniques". (Dont attempt this exercise until we have discussed and practiced them in class.) Examples of fluency techniques include using prolonged speech, light articulatory contacts, easy onset, etc. The purpose is also to see through the eyes of your future clients.
Part III
Write a reaction paper (no more than 3 pages):
feelings both before and after you completed this assignment.
4. How did the stuttering affect your ability to communicate?
5. Were some situations easier or harder than others?
6. Did stuttering in public get easier or harder as you progressed
through the assignment?
7. What bystander responses did you "observe" when you went
out in pairs?
Criteria for grading:
Grades will be based on completion of all parts of the assignment, a sincere attempt to make this assignment a learning experience, insights gained from the experience, creativity in selecting sites and developing educational materials.
Select a treatment program from the list provided below. A sign- up list will be distributed in class so that there are no duplicates. If you have familiarity with or access to a program you would like to analyze that is not on the list, be sure and clear it with me.
Include the information suggested on the Treatment Program Analysis format provided below to design your analysis. You will submit your assignment in the form of a web-page. See samples of web pages done by students of Dr. Celia Hooper, of the University of North Carolina, Chapel Hill at
http://www.unc.edu/~chooper/classes/voice/webtherapy/index.html Each of you will prepare a ONE PAGE treatment analysis document suitable for placement on the stuttering class web pages. You may prepare the document using a web editor (such as Microsoft Composer), the WebCT tool called Student Homepages, OR , if this terrifies you you may use the Microsoft Word word processing program. If you DO use Word, you will save your document as an html file and turn it in that way (on disk). A GREAT place to go to teach yourself is http://www.unc.edu/cit/resources/simple/ You must be very careful to reference material and you must understand web copyright infringement. We can talk more about this in class. If you have difficulty, I will be available to help you. In addition, you should print out your page as a handout for the class. (Your handout may be in outline form if desired.)You will be judged/graded on: 1. Accuracy and completeness of the content of information. 2. Quality of web handout. 3. Creativity....try to make this a little more interesting than
watching grass grow. Image files and great web links would be nice. Regular WORD file is fine, SO RELAX.TREATMENT PROGRAM ANALYSIS FORMAT
Name of program:
Author:
Packaged for purchase? By whom? Cost?
Suggested age range
Theoretical basis for the program
Is there an assessment component?
Are the fluency techniques clearly described? What are they?
Are rate and vocal inflection addressed?
What is the client's role in the program? Parent's role?
Does the program deal with attitudes? Self-esteem?
Are social skills training/role playing included in the program?
Are suggestions/techniques for stress reduction included in the program?
Is maintenance and/or relapse talked about? Provided for?
Can the program be easily adapted for different settings/populations?
Can the program be used with a special population?
If not, can you modify it for such use? How?
What is the best feature of this program?
Is there anything you would add, or delete, to make it more effective?
What does the literature say about this program?
(Include appropriate journal references, web links etc. in this section.)
TREATMENT PROGRAMS/APPROACHES
Meyers & Woodford (1992)
Barbara van Kirk Ryan
The Adolescent/Adult Program
The Family Program
Computer Programs:
Extra Credit Assignment
Classic Videotapes from the '70s
Here's your opportunity to see a master clinician at work. Nine videotapes of Charles Van Riper are on reserve at the Instructional Resource Center on the second floor in Hutchinson (J). All of the therapy was done in seven sessions - one week apart - a total of seven hours of therapy. The eighth tape covers a follow-up session one year later. The ninth tape is a 20-year follow-up and discussion of the long-term effectiveness of this therapy.
Be sure and log in and out in the accompanying sign-in book so that there is a record of your loan. If there is no record in the log book, you will not receive the extra credit. There are video rooms at the IRC where you can sit down and view the tapes. They may not be taken home.
STUTTERING MIDTERM
This will be a group experience.
Dr. Sheree Reese
Answer both of the following questions in addition to the case history question. I suggest that you allow no more than 30 minutes for each of the first two questions (15-20 minutes for discussion and the remaining time to actually compose your answer to everyones satisfaction). You will turn in only one set of answers per group thus the grade will be a group grade. The grade will be based on the quality, creativity and thoughtfulness of your answers.
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:
CASE #1
Bruces 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, Bruces mom indicated that her son doesnt appear to be aware of his stuttering, "he just continues talking even when hes repeating a lot." The mother stated that Bruce has an older brother (John, age 8) who is "always talking". The mother stated "At dinner, its hard to get a word in when the boys get going". Mrs. Wayne noted that Bruce will sometimes blink his eyes when he gets stuck on a word but "I dont think he knows that hes 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 Bruces 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 twins mother indicated to you that Jill has been stuttering since shes three years old. "I just dont understand why Jill has a problem and Jack doesnt" 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 dont 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 doesnt talk an awful lot". Sometimes, we can sit for hours and not say a word" reported Mrs. Hill. Our kids play together and dont 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.
FINAL EXAM
After watching the videotape of E.J., you may ask me any questions you like. You will have the opportunity to view the videotape once more and then will answer the following:
I suggest that you develop an outline before writing. (actually, outline form is acceptable). Please write neatly so that I can read it.