Fluency CD 450 case study PDF

Preview

Summary

Fluency CD 450 ...

Description

Case study #1: Gail Based on the age and genetic history of Gail as well as the current contributing environmental factors I would most likely begin with a consultation and full evaluation. I would recommend the first option of parent education and follow up. The reason I would choose this option is because Gail has only been stuttering for 6 months. Although she may have genetic contributing factors, she is still less than 3 years of age and is female meaning in this case that she still falls within the age range of spontaneous recovery. Parent education would be an important aspect of my evaluation with Gail because the environmental factors that she is currently experiencing with divorced parents, her father living with a new woman, and that woman having two children of her own may be one of the many contributing factors to her recent onset. Parent education is also important in this instance because they may not understand that the reason these changes may be affecting her so much is because her temperament may be highly sensitive. Thus, educating them on this may allow them to feel more empathy and understanding of their daughters’ feelings. Gail’s parents also should be educated on the current research showing that 75% of children between the ages of 2 to 5 years old will grow out of their stuttering without any intervention. Understanding this allows them to also understand my reasoning for choosing a follow up approach versus therapy. In the follow up, I would ask a series of questions such as; how is Gail adjusting to her environment? Are her disfluencies declining or persisting? Is she still mainly using whole word and syllable repetitions? Or are other behaviors arising? Is she aware of her disfluencies (if there are any)? What is her current environment like? What is her overall development like? Are you

concerned with her speech at this time? If further therapy is needed, I would bring her in to further assess her. Because prevention would be my main focus for a three and a half year old I would work on intensity reducers and assertiveness builders. Intensity reducers would be vital for Gail if her stuttering is increasing because this method would allow her to acquire new techniques to utilize in moments of disfluency. On the other hand, assertiveness builders would be vital in reinforcing her communication, which will help her to have a positive outlook on her disfluencies. Case study #2: Sky Skys background information shows that he is five years old, has been stuttering for two years, is more fluent in Spanish, struggles with schoolwork, has four siblings (one of which has ADHD), and two parents that work full time. Due to his sex, age, time of onset, length of time exhibiting disfluencies, and environmental factors I would recommend a consultation and full evaluation consisting of parent education and short term therapy at which point I could see if further therapy is needed. Many issues may arise during the parent education and discussion portion of the full evaluation because he is a dual language learner, which is why a consultation is necessary. Examples of this include possible need for an interpreter, a better understanding on how his family views his stuttering, and a closer look at his family communication dynamic (since he comes from such a large family). There is also quite a bit of information that is missing from his bio such as what type of disfluencies he has, if secondary behaviors exist, what his medical history is, where he is developmentally, what his gross and motor skills like, how they typically communicate as a family, how his temperament is at home, how is his temperament around his

brother who has ADHD, what (if any) events occurred during his onset, if he’s ever received therapy for it, what language he’s more comfortable speaking in, what language is spoken most at home, and what his biggest difficulty is with his schoolwork. All this information is vital in choosing a therapy approach. In the parent education portion, I would emphasize how this highly stressful at home environment may be one of the factors contributing to his stuttering and then see if we could work together to reduce some of these demands. At this point, I would move forward by educating them on the facts about stuttering at his age and the chances that still may exist for spontaneous recovery. Furthermore, because he is a dual language learner I would let them know that based on current research stuttering within this population is more typical since they are rapidly processing two languages at one time. After adequate parent education is established, I would begin short- term therapy using a combination of three methods. The first would be language blooming if necessary, as he may be struggling with word finding in the English language. The second would be assertiveness builders because due to his at home environment Sky may have been feeling time pressures, lack of acknowledgement when communicating, and shame of his stuttering (based on how his family views stuttering). Assertiveness builders would help to reverse these feelings with more positive beliefs about his communication. Last is the use of intensity reducers. If I saw little to no improvement following the use of these other approaches I would begin applying this technique into our therapy sessions since he has been stuttering for 2 years already and is five years old which may be evidence that his stuttering will continue to persist. If all three of

these methods were applied and no progress was made then I would definitely require intensive therapy for Sky moving forward....