Stuttering Class
Terms
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- Fluency
- The effortless flow of speech
- Stuttering
- characterized by an abnormally high frequency or duration of stoppages in the forward flow of speech
- Core behaviors
- Repetitions, prolongations, blocks
- Accessory Behaviors
- Escape behaviors, avoidance behaviors
- Wendell Johnson "stuttering is an
- anticipatory, apprehensive, hypertonic, avoidance
- Feeling and attitudes- Sheehan
- Stuttering is a disorder of the social presentation of the self. Stuttering is not a speech disorder but a conflict around self and role, an identity problem
- Van Riper
- Stuttering occurs when the forward flow of speech is interrupted by a motorically disrupted sound, syllable or word or by the speaker's reactions thereto
- Other disfluencies which are probably not stuttering
- Hesitations and interjections, voluntary, meditative, circumstantial. Revisions and incomplete phrases are not considered by listeners to be stuttering
- Accessory Features
- Speech-related movements, ancillary body movements, verbal features
- Cluttering
- A disorder of rate and intelligibility
- Dysphatic stuttering
- Disfluencies associated with word finding problems
- Other terms for stuttering
- Stammering, dysphemia, tachyphemia, spasmophemia
- Onset
- May occur 18mo-12 years but most likely 2-5 years, this age coincides with a period of rapid expansion of speech and language skills
- Prevalence (current stutterers)
- around 1% of school children
- Incidence (ever stuttered)
- around 5%
- Gender
- 3:1 male to female in 1st grade, 5:1 5th grade
- Anticipation
- When asked to read aloud can predict which words they will stutter on
- Consistency
- Tend to stutter on the same words
- Adaptation
- When reading same passage repeatedly, there is a reduction in stuttering
- Brown discovered that stutterers stutter more on
- Consonants, sounds in initial position, contextual speech, nouns, verbs, adjectives, longer words, stressed syllables
- Reaction time
- The time between stimulus and response is slower in PWS
- Cerebral Dominance
- We all use both left and right but left specialized for processing brief, rapidly changing signals, right better at processing slowly changing stimuli, PWS have more right dominance than non-PWS
- Speculations about constitutional factors in stuttering
- disorder of cerebral localization, disorder of timing, reduced capacity for internal modeling, language production deficit
- A disorder of timing
- Van Riper and Kent say the temporal programming of perception and production of speech in inefficient
- A language production deficit
- stuttering onset is during a period of intense language development. Stuttering is most frequent when language load is heaviest
- Physical Development
- Toddlers are learning to walk this ties up much neuronal space
- PWS have increase stuttering when adults use
- rapid speech rate, polysyllabic vocab, complex syntax, two languages
- SWS have more stuttering when:
- competing for speaking, frequent interruptions, demand for display speech, loss of attention, hurried, frequent questions, excited, many things to say
- Accessory behaviors by
- 4 years
- As a group PWS⬦
- have lower IQ, poorer in school, more language and artic disorders, slower reaction time, CAP worse, use right more often in processing speech
- Learning factors in stuttering
- classical conditioning, instrumental conditioning, avoidance conditioning
- Instrumental conditioning
- Occurs when a behavior is followed immediately by a reward or punishment or a negative stimulus is followed by something that alleviates the stimulus. If the reinforcement tapers down to intermittent reinforcement, the behavior is even more likely to occur
- Normal dysfluency - core behaviors, accessory behaviors, feelings, underlying processes
- part word repetition, single syllable, multi-syllabic word, phrase repetition, interjection, revision, prolongation, tense pause. 7/100 words dysfluent, no accessory behaviors, no feeling or attitudes. Emerging language, motor control emerging, stresses
- Borderline stuttering - core behaviors, accessory behaviors, feeling, underlying processes
- more than 7/100 words, more part word and whole 1 syllable and phrase repetitions and prolongations, few accessory behaviors, feelings not an issue. Explosive language
- Beginning Stuttering - core behaviors, accessory behaviors, feeling, underlying processes
- Child now stuttering more, more than 1/10, more tension, more struggle, onset often related to delayed language development or emotional events, repetitions more rapid, tension throughout speech mechanism, blocks begin. Accessory behaviors appear to be responses to muscle tension, at first voluntary. Feel frustrated, fear/helplessness/loss of control. Increased muscle tension and rate, effects of learning on stuttering (conditioning)
- Intermediate Stuttering - core behaviors, accessory behaviors, feeling, underlying processes
- Blocks are most noticeable core behavior, not surprised, tension not just laryngeal. Escape behavior more frequent, word and situation avoidances are common. Feel fear, helpless, shame and avoidance.
- Advanced Stuttering- core behaviors, accessory behaviors, feeling, underlying processes
- Older adolescents, stuttering pattern well-learned, life shaped by stuttering. Blocks, avoidances become expert, repetitions are more tense, rapid, irregular,
- Spontaneous Fluency
- that of normal speakers, no dysfluency
- Controlled fluency
- high effort, listener may hear differences in rate/rhythm
- Acceptable Stuttering
- Speaker has noticeable, not severe, dysfluency and feels comfortable, not embarrassed or fearful of stuttering
- Assessment
- Interview, speech sample, feelings and attitudes, other speech and language behaviors, other factors
- Normal speaking rate
- 115-165 wpm, 162-230 spm for reading
- Indirect treatment
- Studying family interaction patterns, involve family
- Direct treatment
- modeling easy stutters, active participation by child
- modification
- seek to modify
- fluency shaping
- eliminate stuttering