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![Page 1: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/1.jpg)
Impact of Stuttering
![Page 2: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/2.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)
![Page 3: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/3.jpg)
Related to Perceptions
Stutterers, parents, teachers, peers, etc.
![Page 4: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/4.jpg)
StereotypePersonality characteristics and
attitudes of person who stuttersself-consciousnessreticenceshyness fearfulnessunpleasantness
![Page 5: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/5.jpg)
StereotypePersonality characteristics and
attitudes of person who stuttersunfriendlinessnervousness introversiontensionanxiety
![Page 6: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/6.jpg)
Adults often judged negatively in areas of:
Intelligence
Sensitivity
Aggression
![Page 7: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/7.jpg)
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 boringUnsociable lacking influencemasculine
![Page 8: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/8.jpg)
Impact of those attitudes on stutterer
Feelings of inadequacy
guilt
powerlessness
shame
helplessness
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Impact of those attitudes on stutterer
hopelessnessfailurealtered body imagenegative self-concept
![Page 10: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/10.jpg)
Research Results
Non-stutterers prefer to interact with severe stutterers who acknowledge their stuttering
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Mild and severe 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: strong tendency to delay interventionpreference for parent-oriented treatmentindicated strong interest in learning more about the subject
![Page 13: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/13.jpg)
Impact on Children
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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We need to be aware of our clients’ beliefs and emotions associated with stuttering
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Attitude Scales/Tests
Children’s Attitude Test (Dr. Gene Brutten)
A-19 Scale for Children
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Attitude Scales/Tests
Children’s Attitude Test (Dr. Gene Brutten)
A-19 Scale for Children Modified Erickson Scale of Communication Attitudes
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Stutterers’ Self Rating of Reactions to Speech
Situations
Perceptions of
Stuttering Interview
(PSI)
Attitude Scales/Tests
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“It doesn’t mean you’re not a human being still”
8 year old stutterer
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Keep parent’s role in perspective
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:
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”
![Page 22: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/22.jpg)
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
Need to understand
precipitating
and perpetuating
factors
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Need to understand
linguistic demands of culture
patterns of family interaction
behavioral expectations
gender behaviors
education
religion… spiritual beliefs
fears, attitudes, values
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MULTICULTURAL I.Q. TEST
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EXAMPLES
Event: Family arrived late for their scheduled appointment and was admonished by the clinician
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Clinician’s Interpretation
Family is irresponsible and unmotivated
Cultural Interpretation
Families culture is not time oriented
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RecommendationClinician might schedule this family earlier
to allow for late arrival
2:001:30
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Event
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
Clinician used clinical time efficiently
Cultural Interpretation
Clinician rudely discussed
business before social
interaction
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Recommendation
Value people and build interpersonal rapport first.
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Event
Clinician directed questions to the
mother who did not respond and
who deferred to the father
who was present.
![Page 33: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/33.jpg)
Clinician’s Interpretation
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
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Cultural Interpretation
In this patriarchal family, the father
speaks for the family and the wife
does not speak when the
husband is present
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Recommendation
Address both parents and allow them
to decide who will respond;
Address each parent in
separate settings
![Page 36: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/36.jpg)
Event
Clinician determined that the father
speaks for the family and directed
questions to him. The father seemed
awkward and responded
tentatively.
![Page 37: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/37.jpg)
Clinician’s Interpretation
Father became upset at questions
Cultural Interpretation
Father was not accustomed
to a female (i.e. clinician) being
in authority and questioning his responses.
![Page 38: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/38.jpg)
Recommendation
Share purposes and accept tentative responses
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Event
Clinician interviewed the parents about communication-related family matters
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Clinician’s Interpretation
Parent’s became silent and agitated
Cultural Interpretation
Family matters are private
and not to be shared with
strangers
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Recommendation
Plan treatment based on general information
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Event
Clinician repeatedly praised child
and child’s behavior
to the parent.
![Page 43: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/43.jpg)
Clinician’s Interpretation
Mother was uncomfortable hearing clients
Cultural InterpretationMother believed clinician
would abduct the child or
cast the evil eye (a powerful
spell) on the child
![Page 44: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/44.jpg)
Recommendation
Be positive, but not to excess
![Page 45: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/45.jpg)
Event
Family refused to allow a male
clinician to escort a female child
away from her parents to the clinical
room
![Page 46: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/46.jpg)
Clinician’s Interpretation
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)
![Page 47: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/47.jpg)
Recommendation
Allow parent to accompany child
Assign a female clinician
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Event
Clinician patted child on the head
![Page 49: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/49.jpg)
Clinician’s Interpretation
Clinician was offering nonverbal form of reward
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Cultural InterpretationClinician broke religious rule that hair is
sacred and not to be touched by a stranger and thereby insulted the family
Clinician’s Interpretation
Clinician was offering nonverbal form of reward
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Recommendation
Know the family before using touch
as a nonverbal form of reward
or affection
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Event
Client did not stutter openly as directed by the treatment program and clinician
![Page 53: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/53.jpg)
Clinician’s Interpretation
Client was not committed to treatment process
Cultural Interpretation
Culture highly regard speech, thus
dysfluency invites ridicule by others within
that culture
![Page 54: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/54.jpg)
Recommendation
Us a more fluency oriented program
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Event
Client refused to maintain eye contact with the clinician as prompted by clinician
![Page 56: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/56.jpg)
Clinician’s Interpretation
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
![Page 57: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/57.jpg)
Recommendation
Interpret apparent resistance from multiple perspectives
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Event
Clinician offered a gesture (forming a
circle with tip of thumb touching index
finger) after which the client
fell silent
![Page 59: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/59.jpg)
Clinician’s Interpretation
Clinician’s gesture was a form of nonverbal praise
Cultural InterpretationThe gesture is interpreted as an obscenity
in the client’s culture
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Recommendation
Use verbal forms of feedback
Verygood
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Event
Clinician did not observe or perform deliberate repetition of a disfluency on a word containing “th”.
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Clinician’s Interpretation
Client was noncompliant
Cultural Interpretation
Client was reluctant to expose the tongue, which is considered impolite
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Recommendation
Modify behavior so that tongue is barely visible between the teeth
Th
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EventClient did not perform transfer activities at
home
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Clinician’s Interpretation
Client was noncompliant
Cultural Interpretation
Client’s home is not child-oriented, thus speech initiation by child is penalized
![Page 66: Impact of Stuttering Speaking fears are normal, not exceptional Studies show that public speaking is the number one fear of FLUENT speakers (death was.](https://reader030.fdocuments.in/reader030/viewer/2022032802/56649e0e5503460f94af90a9/html5/thumbnails/66.jpg)
Recommendation
Interpret apparent resistance from multiple perspectives
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Event
Client refused to dialogue with clinician
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Recommendation
Invite and understand client’s and
family’s causal assumptions about
stuttering and expectations for
treatment