Precision Fluency Shaping Programs

Precision Fluency Shaping Programs

• 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

Fluency Shaping Programs

ALL ProgramsFocus on

RETRAININGSPM

DAFStop WatchWork books

Operant Conditioning

Some programs focus onAttitudes and Anxiety

DalyCooper

Shames & Florance

Text information (ch. 5)

• 1.• 2.• 3.• 4.• 5.• 6.• 7.• 8.• 9.• 10

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

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

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

Sound Classes

• Prolong or Hold first sound– equals no articulatory movement

• Practice Organized Systematically• IV Classes

– Class I All 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

Equipment for PFSP• Trainer’s Manual

• Client’s Workbook• Voice Monitor• Stop Watch• Diaphragmatic Breathing Belt

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

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

How to SLOW DOWN

• RATE DAF Stop watch• 30 wpm 250msec 2 sec. Syl

Str• 45 wpm 200msec• 60 wpm 150msec 1 sec Syl

Str• 75 wpm 100msec• 90 wpm 50 msec 1/2 sec Syl Str

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

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

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

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”

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”

Notes

Notes

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

Stutter Free Speech• Transfer

– uses Contracts

Notes

Daly’s Freedom of Fluency

• Addresses BOTH Attitudes and retrains the Speech Production Mechanism

• Separate discussion

A Fluent end to the discussion!