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Instructor: Jan Lougeay 214-905-3114 lougeay@utdallas.

edu

Consultant: Art Cuestas Spring 2006

COMD 6222-Stuttering Course Syllabus The purpose of this class is to develop an understanding of fluency disorders and treatment. We will begin with a brief review of the theories that form the foundation for fluency assessment and intervention. Next, we will discuss specific assessment and treatment procedures and programs and relate them to individual dysfluency patterns and symptoms. Strategies to evaluate treatment outcome and efficacy will be addressed. Finally, ethical issues as they relate to the treatment of stuttering will be discussed. Throughout the class Art Cuestas, a member of the National Stuttering Association, will provide comments, anecdotes and other insights into stuttering from the perspective of someone who stutters. Acquired knowledge will be assessed via quizzes, which will cover information presented in lectures, readings and videotapes. Knowledge will be applied and skills demonstrated via class discussion, patient interview and treatment plan project. Art Cuestas has agreed to consult with our class as a person who stutters. He will be attending many of the classes and will augment the lectures by providing information about his experiences growing up as a child who stuttered and the support that was provided to him by his parents. He will share his therapy experiences and provide you with insight about how it feels to be at the receiving end of the assessment and therapy strategies you are learning about. In addition, he will discuss how living with stuttering has affected his life and career. OBJECTIVES Students will develop knowledge about: 1. Theories that underlie assessment and treatment of stuttering. 2. Assessment and diagnosis of stuttering. (Std. III-C,III-D, IV-B) 3. Use of assessment data to develop treatment plans for individuals who stutter. III-C. III-D, and III-E, IV-B, IV-G) 4. Rationale and application of a variety of treatment approaches. (Std. III-C, III-D, III-E,IV-G) 5. Evaluation of patient progress and treatment efficacy. (Std. III-F,) 6. Ethical considerations and professional issues that relate to the assessment and treatment of stuttering. (Std. III-G,III-H, IV-G.) Text: Guitar, Barry. (2006) Stuttering: An Integrated Approach to It's Nature and Treatment. Third Ed. Baltimore: Lippencott Williams and Wilkins. January 12 Introduction to stuttering, description, etiology Guitar, Chap. 1 January 19 Biological and Physiological Factors Guitar, Chap. 2 January 26 Developmental, Environmental and Learning Factors Guitar, Chap. 3 February 2

Thoughts and theories that underlie treatment and prevention of stuttering Treatment Considerations and ethical concerns Guitar, Chap. 4 February 9 Normal Non-fluency and the Development of Stuttering Guitar, Chap. 5 February 16 and 23 Assessment and diagnosis Assessment/Eligibility decisions in public school settings Intervention planning Guitar, Chap. 6 and 7 TSHA Fluency Eligibility Template Manual for Stuttering Severity Instrument (Riley, 1980) March 2 QUIZ over class notes January 9-February 23 and chapters 1-7 March 9 SPRING BREAK March 16 Issues in Treatment Planning-Introduction to Methods Guitar, Chap. 8 March 23 NO CLASS-TSHA CONVENTION March 30, April 6, Managing stuttering and managing fluency-treatment options Fun With Fluency, (Walton and Wallace, (1998) Chap. 4, (This source is on reserve in the library) It has wonderful suggestions for therapy activities. You are encouraged to go to the library and look at this book as a reference.) Guitar, Chap. 9-12 April 13 Assessing progress and assuring positive outcomes Designing therapy to meet individual needs Managing dismissal Professional issues and specialization April 20 QUIZ over lectures March 16-April 13 and chapters 8-13 April 27 Treatment Plans Due

CLASS PROJECTS 1. VIDEOTAPE VIEWING There are several copies each of 3 Stuttering Foundation of America videotapes on reserve in the library. They are: Therapy in Action: The School-aged Child Who Stutters The Child Who Stutters: Practical Advice for the School Setting The School Clinician, Ways to be More Effective You are required to view each of the tapes and complete the corresponding quiz. The quizzes are available on the Callier Library web site under electronic reserves. The web address is http://library.utdallas.edu. You will get 2 points of extra credit added on to your final grade for each quiz if you correctly answer 8 out of 10 questions.

2. NSA/TOASTMASTERS MEETINGS At Callier we have a chapter of Toastmasters International specifically designed for individuals who stutter. This is a group designed to improve public speaking skills through self study. They meet in Auditorium at Callier on the 1 st and 3 rd Wednesday of the month from 7:00 to 9:00. Our chapter of the National Stuttering Association (NSA) meets the last Tuesday of the month at Callier in Room J108 from 7:00 to 9:00. Their website is http://www.geocities.com/dallasnsa. The Plano chapter of National Stuttering Association meets the second Wednesday of each month from 7:00 to 9:00 at Plano Medical Center. Their website is http://members.aol.com/cjroach/PlanoNorthDallasNSA.html. The Fort Worth chapter meets the 3rd Tuesday of each month from 7:00 to 9:00 at the Miller Speech and Hearing Clinic on the TCU campus. You must attend at least one of the above meetings this semester. After you attend, list 3 things you learned about stuttering and individuals who stutter from attending the meeting. Turn it in to me. Be sure to include the date of the meeting you attended. This is a good opportunity to get to know individuals who stutter that are working to improve their speaking skills. Please do not leave this requirement until the end of the semester. This requirement is not graded. However, if you fail to attend a meeting, 10 points will be deducted from your final grade. 3. ASSESSMENT INTERVIEW You will conduct an assessment interview with an adult who stutters. NSA members have agreed to be “patients/evaluators” for this project. You will be assigned a patient whom you will contact via e-mail to set up an assessment date, time and place. During the assessment you will collect speech samples, discuss stuttering and discuss treatment options as they relate to the issues you identify. After you have completed the assessment, the individual will provide you with feedback, both written and orally, evaluating your performance from their perspective. You will then turn in to me, a one page journal report reviewing the experience and what you learned. More specific information about this project will be provided later. This project is required, but will not be graded. If you fail to complete the project, 15 points will be deducted from your final grade. 4.TREATMENT PLAN PROJECT This paper will be your final exam for this class. It will provide you the opportunity to synthesize the information you have acquired via lectures, reading, and class discussion and apply it to treatment planning and implementation. You will develop a treatment plan for an individual who stutters. You can choose the person whom you evaluated for your class project, someone you have met during the class, at NSA or Toastmasters, worked with in practicum or know personally. Your plan will include: 1. A description of your assessment/diagnostic session including the rationale for the strategies you have decided to use in your assessment. This is an assessment PLAN. Tell what you would do, if you did a complete assessment. You do not have to actually assess the person using the strategies you plan. 2. The goals and objectives you would target with the person if you

were to work with him/her in therapy and the rationale for the goals and objectives you have chosen. 3. A description of the strategies you intend to use to accomplish the goals and the rationale for use of those strategies with the person you have chosen. 4. A list and description of practice activities or exercises you will use. This should include a few activities for each goal that will provide me with insight into how you plan to help the individual learn and practice the strategies during therapy. These are actual activities, excises you use during your therapy sessions. 5. Strategies to assess progress and efficacy of your program. 6. Strategies to manage dismissal. In this section you should discuss dismissal criteria and how you will handle the dismissal process. There is no specific number of pages required. You should be able to develop this plan using the information covered in class and in your text but use of additional sources will strengthen your paper. Be sure to attribute information used from specific sources and programs to the appropriate author. GRADING There will be a total of 2 quizzes over lectures and readings. The average of the quizzes will count for 50% of your grade. The final paper will count for 50% of your grade You will earn 2 bonus points for each videotape quiz in which you get 8 or more questions correct. **Class lecture notes will be posted on Blackboard. Please print out the Power Point handouts prior to class to you can use them to take notes efficiently. This course has been designed to ensure that students demonstrate required knowledge and skill as outlined in the Standards and Implementation Guidelines for the Certificate of Clinical Competence in Speech-Language Pathology. The specific standards addressed in this class are: Standard III-B The applicant must demonstrate knowledge of basic human communication and voicing processes including their biological, neurological, acoustic, psychological, developmental, linguistic and cultural bases. Specific knowledge will be demonstrated in this class in the area of fluency. Provided via class lectures and readings. Demonstrated via class discussions, exams and required projects. 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, characteristic, anatomic/physiological, acoustic, psychological, developmental, and linguistic and cultural correlates. Specific knowledge will be demonstrated in this class in the area of fluency. Provided via class lectures, readings, required videotape viewing, and visit to NSA or Toastmasters. Demonstrated via class discussions, required quizzes over videotapes, and class projects. Standard III-D The applicant must possess knowledge of the principles and methods of prevention and assessment, and intervention for people with communication and

swallowing disorders, including consideration of anatomical/physiological, psychological, developmental, and linguistic and cultural correlates of the disorders. Provided via class lectures, readings and videotape viewing and demonstrated via quizzes, class projects and class discussion. Standard III-E The applicant must demonstrate knowledge of standards of ethical conduct. Provided via class lecture and readings and demonstrated via class discussion. Standard III-F The applicant must demonstrate knowledge of processes used in research and the integration of research principles into evidence-based clinical practice. Provided via lectures and readings demonstrated via treatment plan project. Standard III-G The applicant must demonstrate knowledge of contemporary professional issues. Provided via lectures, readings and videotape and demonstrated via class discussion. Standard III-H The applicant must demonstrate knowledge about certification, specialty recognition, licensure, and other relevant professional credentials. Provided via lectures and readings and demonstrated via quizzes. Standard IV-B The applicant must possess skill in oral and written communication sufficient for entry into professional practice. Demonstrated via class projects and discussion. Standard IV-G 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 (in addition to clinical experiences, skills may be demonstrated through successful performance on academic coursework and examinations, independent projects or other appropriate alternative methods). Specific knowledge will be demonstrated in this class in the area of fluency. Provided via lectures and readings and demonstrated via class discussion and projects. Students will demonstrate the following skills: 1.Discussion and explanation of theories that explain causes of stuttering As measured by successful completion of quizzes Interview project Treatment plan project Class discussion 2. Identification and description of dysfluencies As measured by: Ability to count dysfluencies of videotaped sample Successful completion of quizzes Scoring and interpreting Stuttering Severity Instrument (SSI) Successful completion of interview project Successful completion of Treatment plan project 3. Identification and discussion environmental influences on stuttering and issues in prevention

As measured by: Successful completion of quizzes Ability to explain environmental influences during interview project 4. Description of developmental process of stuttering and normal nonfluencies As measured by: Successful completion of quizzes Class discussion 5. Discussion of demographics of stuttering As measured by: Successful completion of quizzes 6. Discussion of variability and predictability of stuttering As measured by: Successful completion of quizzes Ability to explain during interview project 7. Discussion of emotional aspects of stuttering and treatment concerns As measured by: Successful completion of quizzes Ability to explain to family members Successful completion interview project Successful completion of treatment plan 8. Conduction of an assessment of a client who stutters including: Case history interview Collection of speech sample Description of dysfluencies and associated behaviors Taking and interpreting fluency counts Describing atypical qualities of fluent speech Administration and scoring of SSI As measured by: Successful completion of quizzes Completion of interview project SSI in class exercise Successful completion of treatment plan project 9. Planning intervention based on assessment data including: Choosing approaches appropriate for patient Providing rational for choices based on current theory As measured by: Successful completion of treatment plan project Successful completion of quizzes 10. Writing appropriate behavioral goals As measured by: Successful completion of treatment plan project Successful completion of quizzes 11. Determining appropriate use of direct or indirect approaches. As measured by: Successful completion of treatment plan project Successful completion of quizzes 12. Discussion and implementation of Stuttering Modification, Fluency Shaping and Combined approaches As measured by: Successful completion of quizzes Successful completion of treatment plan project Explanation of approaches during interview project 13. Planning of strategies to achieve generalization of skills As measured by: Successful completion of quizzes

Successful completion of treatment plan project 14. Planning strategies to monitor therapy outcome As measured by: Successful completion of quizzes Successful completion of treatment plan project 15. Discussion of standards of ethical conduct as they relate to practice in stuttering As measured by: Successful completion of quizzes Participation in class discussion 16. Discussion of cultural issues that affect stuttering Successful completion of quizzes 17. Demonstrate understanding of procedures for specialty recognition in stuttering As measured by: Successful completion of quizzes 18. Discussion of strategies to prevent stuttering As measured by: Successful completion of quizzes Important web addresses: http://www.WeStutter.org National NSA website http://www.geocities.com/dallasnasa Dallas Chapter website http://www.geocities.com/callier3216 Toastmasters website Stuttering Foundation of America http://www.stuttersfa.org http://www.stutteringhomepage.com Stuttering home page http://www.mankato.msus.edu/dept/comdis/kuster/voices.html Voices Past and Present