Fluency Disorders - Quiz 1

what is the underlying message, focusing on fluency, of the video with the author

- the problem is not the stutter, it's how their listening partner reacts

- in real life, a person who stutters cannot magically remove blocks, prolongations, or repetitions

- stuttering is a part of who they are

- my job is to fill in their "gaps" of stuttering with PATIENCE

Discuss how you, as a clinician, can incorporate their message into your practice. What are some of the micro-aggressive comments that can be harmful?

- I can make sure that therapy is more about functional communication and less-so about fluent speech

- First I can consider what it feels like to have others tell me how I should be talking

- I can take a step back and really think about what I say to people who stutter

- I can ask reflective questions to myself such as "Do you say/think "good" fluency?"

- "You did really well, you didn't stutter at all!"

- "Don't be nervous, just relax"

- "I hardly even noticed you stuttered, it's okay"

Review the definition of stuttering according to the ASHA stuttering homepage, with the contribution from Craig Coleman

- A disruption in the flow of speaking characterized by repetitions (sounds, syllables, words, or phrases), prolongations, blocks, interjections, and/or revisions. These disfluencies may be accompanied by physical tension, negative reactions, secondary behaviors, and avoidance of sounds, words, or speaking situations

- Craig Coleman: "We need a comprehensive definition to allow for improved understanding and validation of the speaker's experiences of stuttering"

Review the top 6 risk factors for the persistence of stuttering

- Sex: Boys are more likely to continue stuttering

- Family history: genetics

- Age at onset: Later onset = more likely to continue stuttering

- Time since onset: The longer the child stutters, the greater the risk of persistent stuttering

- Consistency: Children who show increased stuttering disfluencies while still developing are less likely to "recover"

- Temperament: Harder to regulate their reactions to stuttering; Increases likelihood that stuttering persists

- Concomitant disorders: Autistic, ADHD, weaker language system, stuttering will persist

- Disfluency types: More stutter-like disfluencies = higher risk of persistent stuttering

Review the current model for the etiology of stuttering. Review the components of the model and how you can apply the model to your practice

- Genetics: I can set realistic expectations

- Environment: Create a safe environment and have that "trust" so that the client can feel open to share, low stress levels

- Demands / capacities: I can reduce demands by simplifying a task or game so that it takes less pressure off of them

- Temperament / Personality: Create a calm environment if they are easily tempered so that it decreases disfluencies; If hyper personality, maybe dim lights and create a "chill" vibe

- Neurophysiology: Use evidence-based techniques

According to the ASHA homepage, when does stuttering normally begin?

- Between the ages of 2 and 6

What is the worldwide prevalence of stuttering?

- 70 million worldwide

- 1% of adults

- Over 3 million in the US

Review the benefits of using indirect questions to establish a "fluency-friendly" environment

- The child can share information when they are comfortable

- They feel less time pressure

- They receive a strong language model

Review the graphic below. What is the overarching goal of therapy for borderline and beginning? (scale image)

- The overarching goal is to help children become effective communicators

- If a child is able to have positive feelings and attitudes towards their communication, their speech will become more effective. Not necessarily decreasing disfluencies, but it's about boosting their confidence levels which in turn may lead them to spontaneously having smoother speech and decreasing those avoidance behaviors.

Review the chart below, focusing on the progression of stuttering, paying particular attention to the progression from normal disfluency and borderline disfluency

- Normal:

- 10 or fewer disfluencies per 100 words

- 1 unit repetitions

- Mostly repetitions, interjections, and revisions

- NO secondary behaviors

- Feelings: not aware

- Have stress of speech/language and psychosocial development

Borderline:

- 11 or more disfluencies per 100 words

- More than 2 unit repetitions, more within words

- More repetitions and prolongations than revisions or interjections

- NO secondary behaviors

- Feelings: generally not aware, may occasionally show momentary surprise or frustration

- Have stresses of speech/language and psychosocial development INTERACTING with constitutional predisposition