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Impact of Stuttering. Speaking fears are normal, not exceptional . Studies show that public speaking is the number one fear of FLUENT speakers (death was ranked as number 6). Related to Perceptions . Stutterers, parents, teachers, peers, etc. Stereotype.

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Speaking fears are normal not exceptional l.jpg

Speaking fears are normal, not exceptional

Studies show that public speaking is the number one fear of FLUENT speakers (death was ranked as number 6)


Related to perceptions l.jpg

Related to Perceptions

Stutterers, parents, teachers, peers, etc.


Stereotype l.jpg
Stereotype

  • Personality characteristics and attitudes of person who stutters

    • self-consciousness

    • reticence

    • shyness

    • fearfulness

    • unpleasantness


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Stereotype

  • Personality characteristics and attitudes of person who stutters

    • unfriendliness

    • nervousness

    • introversion

    • tension

    • anxiety


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Adults often judged negatively in areas of:

  • Intelligence

  • Sensitivity

  • Aggression


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Women who stutter considered more negatively than other women relative to their male stuttering counterparts and other men.

Stuttering women considered to be:

Naïve insecure boring

Unsociable lacking influence

masculine


Impact of those attitudes on stutterer l.jpg
Impact of those attitudes on stutterer women relative to their male stuttering counterparts and other men.

  • Feelings of inadequacy

  • guilt

  • powerlessness

  • shame

  • helplessness


Impact of those attitudes on stutterer9 l.jpg
Impact of those attitudes on stutterer women relative to their male stuttering counterparts and other men.

  • hopelessness

  • failure

  • altered body image

  • negative self-concept


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Research Results women relative to their male stuttering counterparts and other men.

  • Non-stutterers prefer to interact with severe stutterers who acknowledge their stuttering


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  • Mild and severe women relative to their male stuttering counterparts and other men.

    stutterers who

    acknowledged their stuttering received more favorable ratings on intelligence, personality, appearance than those who did not acknowledge their stuttering


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  • Pediatricians: women relative to their male stuttering counterparts and other men.

    • strong tendency to

      delay intervention

    • preference for

      parent-oriented

      treatment

    • indicated strong

      interest in learning

      more about the

      subject


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Impact on Children women relative to their male stuttering counterparts and other men.

  • Stuttering is an “expectancy disorder”

  • For child who stutters, fearful expectation regarding speaking can lead to justification of the belief that talking is hard.

  • The correlation between fear & avoidance is strong



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Attitude Scales/Tests associated with stuttering

  • Children’s Attitude Test (Dr. Gene Brutten)

  • A-19 Scale for Children


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Attitude Scales/Tests associated with stuttering

  • Children’s Attitude Test (Dr. Gene Brutten)

  • A-19 Scale for Children

  • Modified Erickson

    Scale of Communication Attitudes


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Attitude Scales/Tests associated with stuttering

  • Stutterers’ Self Rating of Reactions to Speech

    Situations

  • Perceptions of

    Stuttering Interview

    (PSI)


It doesn t mean you re not a human being still 8 year old stutterer l.jpg

“It doesn’t mean you’re not a human being still” associated with stuttering

8 year old stutterer


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Keep parent’s role in perspective associated with stuttering

  • They did not cause this problem…but

  • Conversational behaviors can exacerbate or alleviate symptoms, as many chronic disease states (i.e. asthma)


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Keep parent’s role in perspective: associated with stuttering

  • They did not cause this problem….but

  • Conversational behaviors can exacerbate or alleviate symptoms, as in many chronic disease states (i.e. asthma)


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Current recommendations to parents of young children who stutter

  • Slow down

  • avoid interruptions &

    ”simultalk”


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Current recommendations to parents of young children who stutter

  • Slow down

  • avoid interruptions &

    ”simultalk”

  • use simpler language

  • reduce communicative pressures

    on child


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Multicultural Considerations in Intervention stutter

  • Need to understand

    precipitating

    and perpetuating

    factors


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  • Need to understand stutter

    • linguistic demands of culture

    • patterns of family interaction

    • behavioral expectations

    • gender behaviors

    • education

    • religion… spiritual beliefs

    • fears, attitudes, values



Examples l.jpg
EXAMPLES stutter

  • Event: Family arrived late for their scheduled appointment and was admonished by the clinician


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Clinician’s Interpretation stutter

  • Family is irresponsible and unmotivated

    Cultural Interpretation

  • Families culture is not time oriented


Recommendation l.jpg
Recommendation stutter

  • Clinician might schedule this family earlier to allow for late arrival

1:30

2:00


Event l.jpg
Event stutter

  • Clinician who is feeling time pressure began an interview by asking parents questions about the child’s development.


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Clinician’s Interpretation stutter

  • Clinician used clinical time efficiently

    Cultural Interpretation

  • Clinician rudely discussed

    business before social

    interaction


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Recommendation stutter

  • Value people and build interpersonal rapport first.


Event32 l.jpg
Event stutter

  • Clinician directed questions to the

    mother who did not respond and

    who deferred to the father

    who was present.


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Clinician’s Interpretation stutter

  • Mother was conversationally passive

    and uninvolved versus in this

    patriarchal family, the father

    speaks for he family and the

    wife does not speak when

    the husband is present


Cultural interpretation l.jpg
Cultural Interpretation stutter

  • In this patriarchal family, the father

    speaks for the family and the wife

    does not speak when the

    husband is present


Recommendation35 l.jpg
Recommendation stutter

  • Address both parents and allow them

    to decide who will respond;

  • Address each parent in

    separate settings


Event36 l.jpg
Event stutter

  • Clinician determined that the father

    speaks for the family and directed

    questions to him. The father seemed

    awkward and responded

    tentatively.


Clinician s interpretation37 l.jpg
Clinician’s Interpretation stutter

  • Father became upset at questions

    Cultural Interpretation

  • Father was not accustomed

    to a female (i.e. clinician) being

    in authority and questioning his responses.


Recommendation38 l.jpg
Recommendation stutter

  • Share purposes and accept tentative responses


Event39 l.jpg
Event stutter

  • Clinician interviewed the parents about communication-related family matters


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Clinician’s Interpretation stutter

  • Parent’s became silent and agitated

    Cultural Interpretation

  • Family matters are private

    and not to be shared with

    strangers


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Recommendation stutter

  • Plan treatment based on general information


Event42 l.jpg
Event stutter

  • Clinician repeatedly praised child

    and child’s behavior

    to the parent.


Clinician s interpretation43 l.jpg
Clinician’s Interpretation stutter

  • Mother was uncomfortable hearing clients

    Cultural Interpretation

  • Mother believed clinician

    would abduct the child or

    cast the evil eye (a powerful

    spell) on the child


Recommendation44 l.jpg
Recommendation stutter

  • Be positive, but not to excess


Event45 l.jpg
Event stutter

  • Family refused to allow a male

    clinician to escort a female child

    away from her parents to the clinical

    room


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Clinician’s Interpretation stutter

  • Family has trouble with separation

    Cultural Interpretation

  • Culture does not allow a female

    child to be alone with a male

    stranger (not related to her

    family)


Recommendation47 l.jpg
Recommendation stutter

  • Allow parent to accompany child

  • Assign a female

    clinician


Event48 l.jpg
Event stutter

  • Clinician patted child on the head


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Clinician’s Interpretation stutter

  • Clinician was offering nonverbal form of reward


Clinician s interpretation50 l.jpg
Clinician’s Interpretation stutter

Cultural Interpretation

  • Clinician broke religious rule that hair is sacred and not to be touched by a stranger and thereby insulted the family

  • Clinician was offering nonverbal form of reward


Recommendation51 l.jpg
Recommendation stutter

  • Know the family before using touch

    as a nonverbal form of reward

    or affection


Event52 l.jpg
Event stutter

  • Client did not stutter openly as directed by the treatment program and clinician


Clinician s interpretation53 l.jpg
Clinician’s Interpretation stutter

  • Client was not committed to treatment process

    Cultural Interpretation

  • Culture highly regard speech, thus dysfluency invites ridicule by others within that culture


Recommendation54 l.jpg
Recommendation stutter

  • Us a more fluency oriented program


Event55 l.jpg
Event stutter

  • Client refused to maintain eye contact with the clinician as prompted by clinician


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Clinician’s Interpretation stutter

  • Client did not follow instructions

    Cultural Interpretation

  • Culture views direct eye contact as a sign of hostile or sexually aggressive behavior and lowering the eyes is a sign of respect


Recommendation57 l.jpg
Recommendation stutter

  • Interpret apparent resistance from multiple perspectives


Event58 l.jpg
Event stutter

  • Clinician offered a gesture (forming a

    circle with tip of thumb touching index

    finger) after which the client

    fell silent


Clinician s interpretation59 l.jpg
Clinician’s Interpretation stutter

  • Clinician’s gesture was a form of

    nonverbal praise

    Cultural Interpretation

  • The gesture is interpreted as an obscenity in the client’s culture


Recommendation60 l.jpg
Recommendation stutter

  • Use verbal forms of feedback

Very

good


Event61 l.jpg
Event stutter

  • Clinician did not observe or perform deliberate repetition of a disfluency on a word containing “th”.


Clinician s interpretation62 l.jpg
Clinician’s Interpretation stutter

  • Client was noncompliant

    Cultural Interpretation

  • Client was reluctant to expose the tongue, which is considered impolite


Recommendation63 l.jpg
Recommendation stutter

  • Modify behavior so that tongue is barely visible between the teeth

Th


Event64 l.jpg
Event stutter

  • Client did not perform transfer activities at home


Clinician s interpretation65 l.jpg
Clinician’s Interpretation stutter

  • Client was noncompliant

    Cultural Interpretation

  • Client’s home is not child-oriented, thus speech initiation by child is penalized


Recommendation66 l.jpg
Recommendation stutter

  • Interpret apparent resistance from multiple perspectives


Event67 l.jpg
Event stutter

  • Client refused to dialogue with clinician


Recommendation68 l.jpg
Recommendation stutter

  • Invite and understand client’s and

    family’s causal assumptions about

    stuttering and expectations for

    treatment


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