1. Precision Fluency Shaping Programs

2. Common Features –Teach skills, all teach easy onset prolongations other skills –Skill progression –May or may not deal with attitudes/anxiety –May or may not include a transfer program

3. Fluency Shaping Programs ALL Programs Focus on RETRAINING SPM DAF Stop Watch Work books Operant Conditioning Some programs focus on Attitudes and Anxiety Daly Cooper Shames & Florance

4. Text information (ch. 5) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10

5. Selected Fluency Shaping Programs Webster, Precision Fluency Shaping program Cooper, Personalized Fluency Shaping Program Daly, Freedom of Fluency Shames and Florance, Stutter Free Speech Easy Does It

6. Training Paradigm –Format: –1. Read about the skill, comprehend it, learn vocabulary – 2. Clinician demonstrates (Example-NON- Example-Example) –3. Client demonstrates on same paradigm –4. Client practices under observation –5. Client practices with periodic monitoring

7. Skill Progression Principles according to Webster –build from -bottom up-respiration first –start at syllable level and continue progression Steps –2 second syllable stretch –Diaphragmatic Breathing –Easy Onsets –Articulatory Focus prolongations light contact for plosives –Combine in words –Loudness Contour continuous phonation ‘ –Increase Rate to Slow Normal

8. Sound Classes Prolong or Hold first sound –equals no articulatory movement Practice Organized Systematically IV Classes –Class IAll Vowels –Class II All Voiced Continuants prolong voiced continuant –Class III All Voiceless Continuants brief prolongation on voiceless consonant, moving to voiced sound –Class IV All Plosives light contact on plosive

9. Equipment for PFSP Trainer’s Manual Client’s Workbook Voice Monitor Stop Watch Diaphragmatic Breathing Belt

10. Practice Sequence for Classes Base 5, % correct 80-100 (4/5, 5/5) Sequence –Class I ALL Vowels –Class II Voiced Continuants –Class III Unvoiced Continuants –Class IV Plosives Items: –one syllable words –two-syllable words RULE: HOLD THE FIRST SOUND, –except Class IV, then the second sound

11. Rate Progression 2 second Syllable Stretch= 30 wpm 1 second Syllable stretch=60 wpm 1/2 sec Syllable delay=90 wpm Slow Normal –within normalcy range –rate at which you can monitor targets of breathing easy onset continuous phonation articulatory control concern for Speech Naturalness Rating

12. How to SLOW DOWN RATEDAFStop watch 30 wpm250msec2 sec. Syl Str 45 wpm200msec 60 wpm150msec1 sec Syl Str 75 wpm100msec 90 wpm50 msec1/2 sec Syl Str

13. Therapy Paradigm 1 hour session –20 minutes instruction, independent practice –10 minutes transfer –20 minutes instruction, independent practice Home Assignment –practice on same schedule 20/10 transfer skill with someone

14. Precision Fluency Shaping Transfer and Maintenance Transfer –1. Within Establishment program within sessions home assignments –2 Transfer PHASE specific assignments –variables: 3 of interchanges –need to record event and report –# of itransfers increases as progress dictates

15. Telephone Transfer Progression –dial –after listener responds, take a comfortably full breath of air –begin your message using appropriate monitoring rate –use for 1 exchange “What time do you close?” –record feelings –continue increasing frequency and # of exchanges

16. Maintenance Instructions 1. Fluency depends on MONITORING –Therefore, NEED to practice for at always 1 year 2. PRACTICE EVERY DAY 3. There may be some decline in fluency 4 Keep in contact through post cards 5. If regression, come back for a “miniprogram”

17. Cooper’s Freedom From Fluency Based on Webster’s program 3 Parts to Program –1. Comprehensive Evaluation which can be used alone –2.Fluency Shaping multiple worksheets –3.Added Attitudinal Component “Monkey’s On My Back”

18. Notes

20. Stutter Free Speech Shames and Florance Program Goal: Stuterer is responsible for his fluency through self-regulation and reinforcement Uses DAF –starts at 250 msec. Delay and progresses –uses 3 modes –monitored and unmonitored Addresses feelings and attitudes

21. Stutter Free Speech Transfer –uses Contracts

22. Notes

23. Daly’s Freedom of Fluency Addresses BOTH Attitudes and retrains the Speech Production Mechanism Separate discussion

24. A Fluent end to the discussion!