Client Initial: C. Client’s Age: 3
Client’s Diagnosis: Fluency
Number of years client has been in tx: this is her first semester
Summary of past tx: no past tx
Description of the Technique used:
My client is a 3 year old female, C. Her diagnosis is fluency; however, she exhibits many articulation errors as well, but it is not recommended she work on the two problems simultaneously, so we are focusing on fluency first. She exhibits mostly repetitions in conversation. She has just been admitted into therapy this semester. So, these are her first few weeks of treatment. Upon the recommendation of my supervisor and an expert in the area of fluency that resides in our department here at WVU, I am using the Shine Systematic Fluency Training System. This program has four activities that are arranged on a hierarchy of least to most difficult. They are picture identification, story book activities, picture matching activity, and surprise box activity. The client is only three years old, so her preferences are considered in that the program was modified for her in the beginning to use the slow, easy speech (“new voice”) only during the card activities at first so she could get used to it. When the new voice was used throughout the whole session, she became overwhelmed and was uncooperative. So, we are slowly integrating it into the other activities as she gets used to it so she doesn’t automatically dismiss the treatment. My supervisor and I felt the therapy would be more beneficial to her that way. She is learning unexpected bits and pieces in addition to targeted slow and easy speech for fluency. For example, in the picture card identification sessions, she did not know some of the pictures, but when she was told she began to learn the word/picture associations and use them the following sessions. As far as research literature goes, the Shine System an article on the ASHA website suggests use of this system for children between the ages of 3 and 9 years old. This article also lists the four activities within the Shine System that C. is using. C. is progressing well at this time.
Reference:
Lang Speech Hearing Services in Schools. Ramig and Bennett 26 (2): 138.
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1 comment:
Hey Ashley! It is great to hear everything is going well with your client. I know it is not in this blog, but I remember you mentioning that your client has a family history of stuttering. I know you are planning to release her from therapy because she is doing so well, but I think it is great that you are planning to bring her back every six months or so to be retested.
I feel bringing her back to be retested is a great thing since she is at more of a risk genetically for stuttering. Females are less likely to stutter with a sex ratio of 2.1:1 male to female ratio in children 20 to 69 months of age. But the chance of a female stuttering goes up when she has close relatives who stutter, and she does.
I think the Shine Systematic Fluency Program was the most appropriate choice to make, but as you have said in your blog, it is difficult for her because she is so young. I think it is great that you have modified the program to fit her needs. It sounds like you are doing a great job, and making good decisions about her therapy.
References:
Guitar, B. Ph.D. (2006) Stuttering an Integrated Approach to its Nature and Treatment P.22
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