Fluency Assessment Procedures, Scope, Sequence

Fluency Assessment Procedures, Scope, Sequence

LOBBY Greeting
Thank you for coming
No rush to get them back, okay if some chatting starts
Ped: play alongside for few minutes; offer them the choice to start walking with the toy or without the toy
Clinic tour
‘magic’ card—offer child choice of making door beep
Bathrooms
Toy closet
Walk the halls & peer into rooms as examples
ped: “lots of play rooms”
make sure to show observation so know where parent might sit
allow them to see clinician on camera w parent from observation room, then switch to see parent in room from observation room
Remain professional as well as courteous, kind, open, and easy-going
Keep you rate of speech slower unless you are offering high-pressure situations
Be watchful of how they end their turn after disfluencies…don’t take a turn right away. Show them you are in no hurry & can let them have as long as they want.

TWO ROOMS prepped for kids; ONE room when adult client
Room prep: parent; have overhead going as backup; have webcam far but don’t block parent with your body
On table: Water glass, Kleenex, hand sanitizer, pen, paper
Room prep: child; have overhead camera going for backup, have webcam close-up
7-10 activities ready to go & above eye level (at least out of reach)
3 stations set out on floor to attract child to go & sit with one right away
Avoid playdoh, drawing, puzzles…anything that takes concentration because you won’t get talking child
Have chairs in case parent can’t be on floor; have puzzle pieces for seat cushions;
Show parent how we want child to face camera…so place child’s puzzle piece accordingly. Let parent know you might be in & out of room to manage camera & supplies.

BILINGUAL STUTTERING ASSESSMENT
All the same as outlined below but get samples of other languages. You can analyze stuttering in another language even if you don’t understand the language. If old enough, get reading as well as speaking in other language.

PEDIATRIC ASSESSMENT routine
Step 1: parent-child play dyad
Play like normal; we want child to be comfortable with talking, so follow the child’s lead (ok if child changes interest)
Show parent how the camera is capturing child’s face during dyad
Show parent how there are books available too…encourage them to read a book & then let the child tell it back (narrative retell sample)
Help them get going if necessary; otherwise, step out & let them have fun!

Step 2: clinician-child time; parent interview
Clinician 1 goes with child
Play dyad expansion; fill-in gaps for play or conversation;
TOCS?
PPVT?
Clinician 2 goes with parent
Review intake form & weave interview questions into conversation
If you can’t take notes well yet (while listening/interacting) then take minimal notes and re-watch interview on videothen move to being able to take notes while maintaining good eye contact
Show them the OASES questionnaire & explain
Teach them how to guide child through OASES (if child old enough)
Ask them to complete the TOCS Observation form
Discuss how it’s helpful to gather that information from other caretaking adults as well as teachers; find out how they feel about that.
Representative sample? Always ask parents if today’s stuttering (that we have observed) is pretty much like it is every day…or if it’s more…or less than usual. If not much stuttering or if stuttering much different/less, then ask then to collect &/or send video samples from home setting (and don’t analyze the speech samples collected in evaluation)

ADOLESCENT-TEEN ASSESSMENT routine
Step 1: Parent-child conversation 5-m
Chat like normal about high interest topic; we want kiddo comfortable with talking, so okay if they take over the conversation;
We’ll be back in 5-minutes and then we’ll split up

Step 2: Clinician 1 with child (while Clinician 2 with parent)
Have conversation; probe with high-pressure
Reading samples from SSI-4
Narrative retell with TOCS narrative (alien) story
Phone: If client is stressed with phone, do a phone conversation call to Best Buy regarding some tech gadget (have a few gadgets prepared in advance with tech specs so you can prep with client about what questions to ask)
Review OASES, describe how we use it; practice 2-3 items per section together; ask them to complete & bring back with them next time
PPVT? If language testing, we’ll do that in longer session or during 2nd session
Ask for video samples from home setting if there is NO stuttering in clinic (and don’t analyze the speech samples)—this can happen with all ages, for a variety of reasons
Representative sample? Always ask client and parents if today’s stuttering (that we have observed) is pretty much like it is every day…or if it’s more…or less than usual. If not much stuttering or if stuttering much different/less, then ask then to collect &/or send video samples from home setting (and don’t analyze the speech samples collected in evaluation)

Step 2: Clinician 2 with parent (while clinician 1 is with kiddo)
Parent interview
Review intake form while weaving in interview questions
Review OASES so they know what the kiddo is being asked for & how they can support (average day vs worst/best day)
Review TOCS observation form & ask them to fill it out; other caregivers? Teachers?
Representative sample? Always ask client and parents if today’s stuttering (that we have observed) is pretty much like it is every day…or if it’s more…or less than usual. If not much stuttering or if stuttering much different/less, then ask then to collect &/or send video samples from home setting (and don’t analyze the speech samples collected in evaluation)

ADULT ASSESSMENT routine
Step 1: Clinicians with adult
Have conversation, low to high interest; probe with high-pressure
Reading samples from SSI-4
Narrative retell with TOCS narrative (alien) story OR movie summary (okay to tell them it’s a different type of speech sample so they expand with the narrative)
Phone: If client is stressed with phone, do a phone conversation call to Best Buy regarding some tech gadget (have a few gadgets prepared in advance with tech specs so you can prep with client about what questions to ask)
Review OASES, describe how we use it; practice 2-3 items per section together; ask them to complete & bring back with them next time
Additional language testing necessary? Need a longer session or do during 2nd session
Representative sample? Always ask client and parents if today’s stuttering (that we have observed) is pretty much like it is every day…or if it’s more…or less than usual. If not much stuttering or if stuttering much different/less, then ask then to collect &/or send video samples from home setting (and don’t analyze the speech samples collected in evaluation)

Page 1 of 4