SPHY304 - Fluency Disorders Across the Lifespan

Year

Credit points

Campus offering

Prerequisites

SPHY200 Neuroscience Speech Pathology AND SPHY207 Speech Pathology Practice 2B

Unit rationale, description and aim

Stuttering and other fluency disorders impact on an individual's ability to function and participate in society, with people who stutter at a significantly increased risk for developing anxiety disorders and social phobia. As such, fluency is a designated Range of Practice (RoPA) in which speech pathology students are expected to demonstrate competency in order to meet professional entry level requirements.

In this unit, students will analyse research about stuttering typology, epidemiology, causal, and prognostic factors associated with stuttering to support a foundation for clinical practice. Additionally, they will apply the International Classification of Functioning (ICF) framework to people who stutter to identify client needs and provide holistic and comprehensive client care. Finally, through collaboration within a national community of practice, students will develop their professional competencies in using new technologies to provide intervention and support for people who stutter.

This unit provides a theoretical base, and opportunities for applying knowledge in practical activities, to ensure successful preparation for future professional practice in the Range of Practice Area of fluency disorders. The overall aim of this unit is for students to develop skills in assessment, analysis, planning and management of stuttering and its impact, guided by evidence-based principles and client-centred practice. 

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

On successful completion of this unit, students should be able to:

LO1 Demonstrate knowledge of fluency disorders through describing salient features, epidemiology and prognosis; and describe and demonstrate appropriate methods to evaluate fluency and its impact. (GA5)

LO2 -Analyse and interpret assessment information to accurately diagnose fluency disorders (GA5)

LO3 -Formulate and justify person-centred, culturally responsive and evidence-based management plans for individuals with fluency disorders, guided by relevant frameworks of practice (including the ICF and EBP) (GA5, GA8)

LO4 - Demonstrate skills in utilising evidence-based speech pathology interventions and contemporary methods and technologies in service delivery for individuals with fluency disorders (GA5, GA7, GA10)

Graduate attributes

GA5 - demonstrate values, knowledge, skills and attitudes appropriate to the discipline and/or profession 

GA7 - work both autonomously and collaboratively 

GA8 - locate, organise, analyse, synthesise and evaluate information 

GA10 - utilise information and communication and other relevant technologies effectively

Content

Topics will include:

• An Introduction to Stuttering
• Assessment of Stuttering
• Stuttering Management – Early Intervention
• Stuttering Management – School Age and Adolescent Stuttering
• Stuttering Management – Adults who Stutter
• Service Delivery Options and Technologies 
• Complex Cases: Stuttering, Anxiety and Social Phobia
• Other Disorders of Fluency

Learning and teaching strategy and rationale

This unit involves 150 hours of focused learning. A blended learning approach has been chosen and students will be expected to take responsibility for their learning by completing reading tasks, watching video material, and engaging thoughtfully in online learning forums and quizzes. In tutorials, students will actively participate in group work to develop their professional competency through clinical skills and case-based activities.

1) Online Lectures and associated activities. Lectures will be delivered online in this unit with accompanying activities and associated readings which prompt for active learning and flexible student engagement with content. Online learning in this unit will be asynchronous (i.e., materials are made available online for students to engage, read and watch individually prior to class). This will enable students to prepare adequately for face to face clinical skills activities. In this way, students will be familiar with important concepts and can explore, consolidate and apply these concepts within class time. Independent study also reflects the Speech Pathology Australia competencies related to ‘Lifelong Learning and reflective practice’ (CBOS unit 7, SPA, 2011).

2) Face to face tutorials. Content will be delivered by experienced clinicians and academics in tutorials. Emphasis will be placed on consolidating key, fundamental concepts and exploring application to practice through discussion, discipline specific case studies and peer simulation. Learning activities will involve mostly small group work and whole class activities with a focus on enquiry based learning. Tutorials will focus on the practice of clinical skills and reasoning required to treat fluency disorders at an entry level competency. Successful participation in skills class activities are dependent on student preparation; therefore it is expected that the lecture materials, pre-reading and any prescribed tasks will be completed prior to tutorials.

3) Consumer forum. One mandatory lecture will be held face to face on campus and/or via video conference. This will take the format of a structured forum, facilitated by academic staff, where consumer representatives (people who stutter) will attend, and engage in discussion about their lived experience. This will enable authentic learning to occur in a community-centred teaching environment, as well as providing an opportunity for you to participate as a learning community in a question and answer-style panel. 

Assessment strategy and rationale

The assessment tasks for this unit are designed to demonstrate achievement of each learning outcome, which reflect development of knowledge and skills in assessment, analysis, intervention planning and management for fluency disorders.

The measurement and identification of stuttering behaviours is an essential clinical skill to enable ethical assessment, planning and management of stuttering. The Ungraded Hurdle Task allows students to practice these skills and receive feedback, and to re-attempt the task if required to develop the skill to entry level competency. 

Assessments 1 and 2 are case-based, requiring students to respond in professional written, oral, and telehealth communication contexts. The final examination (Assessment 3) combines analysis, synthesis and application of knowledge in a case-based clinical context. This assessment requires students to apply their clinical reasoning skills independently and immediately in response to a clinical problem as a trigger. The complexity of assessment tasks will provide an opportunity for students to develop and demonstrate skills in the range of practice area of fluency. 

Overview of assessments

OVERVIEW OF ASSESSMENTS 

In order to successfully complete this unit, students must submit and make a credible attempt at all assessment tasks and are required to:

- obtain a cumulative mark that is equal to or greater than 50% of the possible marks available 

Representative texts and references

Baxter, S., Johnson, M., Blank, L., Cantrell, A., Brumfitt, S., Enderby, P. et al. (2016). Non-pharmacological treatments for stuttering in children and adults: a systematic review and evaluation of clinical effectiveness, and exploration of barriers to successful outcomes. Health Technology Assessment, 20, 2. DOI link: https://doi.org/10.3310/HTA20020

Donaghy, M., & Smith, K. (2016). Management options for pediatric patients who stutter: current challenges and future directions. Pediatric Health, Medicine and Therapeutics, 7, 71–77. DOI https://doi.org/10.2147/PHMT.S77568

Guitar, B. (2014) Chapter 13: Treatment of school-age children: Intermediate stuttering. Guitar, B., Stuttering: An integrated approach to its nature and treatment (4th ed.).Lippincott, Williams, & Wilkins.

O’Brian, S., Carey, B., Lowe, R., Onslow, M., Packman, A., & Cream, A. (May, 20186) The Camperdown Program Stuttering Treatment Guide. Available free from:  https://www.uts.edu.au/research-and-teaching/our-research/australian-stuttering-research-centre/asrc-resources/resources

Onslow, M. (November, 2018). Stuttering and its Treatment: Eleven Lectures. Available free from: https://www.uts.edu.au/research-and-teaching/our-research/australian-stuttering-research-centre/asrc-resources/resources

Onslow, M., Webber, M., Harrison, E., Arnott, S., Bridgman, K., Carey, B.,…Lloyd, W. (2017). The Lidcombe Program treatment guide.Available from: http://www.lidcombeprogram.org/?page_id=280

Daniels, D. E., Gabel, R. M., & Hughes, S. (2012). Recounting the K-12 school experiences of adults who stutter: A qualitative analysis. Journal of Fluency Disorders, 37, 71–82.

Iverach, L., O’Brian, S., Jones, M., Block, S., Lincoln, M., Harrison, E., Onslow, M. (2009). Prevalence of anxiety disorders among adults seeking speech therapy for stuttering. Journal of Anxiety Disorders, 2, 928–934.

Lowe, R., O'Brian, S., Onslow, M. (2013). Review of Telehealth Stuttering Management. Folia Phoniatrica Logopedia, 65, 223-238. doi: 10.1159/000357708

Menzies, R. G., Onslow, M., Packman, A., & O’Brian, S. (2009). Cognitive behavior therapy for adults who stutter: A tutorial for speech-language pathologists. Journal of Fluency Disorders, 34, 187-200.