راهکارهای درمانی خاص در درمان لکنت زبان کلینیک تخصصی لکنت کرج مهرشهر-کیانمهر-میدان امام

راهکارهای درمانی خاص در درمان لکنت زبان کلینیک تخصصی لکنت کرج مهرشهر-کیانمهر-میدان امام

 

answer all questions. Thus the maximum score (indicating maximum negativity toward speech) is 24, whilst the minimum score is 0. A key problem with the S-24 is

that many respondents find it difficult to be constrained by the binary answers they are required to give. For example, statement 16 – “I am embar¬rassed by the way I talk” – may be considered “true” in some circumstances but “false” in others. The respondent must decide which response is the most appropriate, allowing for the noted variability.

Table 9.3 shows the mean and standard deviation scores for a group of 36 adults who stutter at various stages in the therapeutic process and 25 control speakers, as reported by Andrews and Cutler (1974). The pattern of improved confidence immediately following treatment together with some regression as the speakers encounter difficulties during the transfer phase of therapy is a common one.

As with other cognitive self-assessments described in this section, the S-24, in addition to providing a useful baseline and post-therapy assessment tool, can also be used to help direct therapy. Note, however, that early claims that the S-24 could be used to predict therapeutic outcome have been strongly refuted (Ingham, 1984). Figure 9.4 shows a completed S-24 of an Apple House client. Despite having a very mild stutter perceptually and pre¬senting as a very competent and articulate speaker, Andrew maintained a very poor perception of his speaking abilities, as shown in his baseline score of 24.

Therapy comprised a counselling approach directly addressing his responses to some of the S-24 questions, particularly those relating to avoidance. These responses were explored further to determine the underlying issues respon¬sible for the skewing of his self-perception. A post-clinic score of 8 indicated his attitude toward his speech now approximated that of nonstuttering speakers (see Table 9.3), and a score of 10 at a final 12-month follow-up suggested that this new perception had stabilized.

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