development /experience of stuttering

Typical disfluency (2-6)

• most children have typical repetitions, prolongations, pauses

• Perpetuations are more common in younger children, revisions are more common in older children

Typical disfluency ( 2-6) factors

• typically disfluency children don’t react to their disfluencies; they seem unaware of them

• Huge piece of information to gather in a case history/ interview

Factors

• demands on language acquisition

• Delayed speech motor skills

• Stress

• Competition and excitement when speaking

Younger preschool children (2-3.5) borderline stuttering

1. More than 6-10 disfluencies per 100 words

2. Often more than two units in repetition

3. More repetitions and prolongations than revisions or incomplete phrases

4. Disfluencies loose and relaxed

5. Rare for child to react to his or her disfluencies

Underlying process environmental

Communication stress

• models of fast talking/few pauses

• Interruptions, questions

• Models of advanced vocabulary and syntax

• Competition to be heard

Psychosocial stress

• Conflicts in family

• Birth of a new sibling

• Changes in home, moving transitions

Older preschool children “ beginning stuttering ( age 3.5-6)

1. Signs of muscle tension and hurry appear in stuttering. Repetitions are rapid and irregular with abrupt terminations Of each element

2. Pitch rise may be present toward the end of a repetition or prolongation

3. Fixed articulators postures are sometimes evident when the child is momentary unable to begin a word, apparently as a result of tension in speech musculature

4. Escape behaviors are sometimes present in the beginning stuttering. These include among other things eye blinks, head nods and UMB

5. Awareness of difficulty and feelings of frustration are present but there are no strong negative feelings about self as a speaker

Underlying processes of older school age

• increases in muscle tension and tempo

  • These increases are seen as a sign that stutting is advancing

  • These changes may be attempts to control or escape from stutters

• Effects of learning on stuttering

  • Classical conditioning - spreads the emotion associated with with stuttering to more situations, this means more tension and faster tempo

  • Operant conditioning - increases frequency of escape behaviors: this means more eye blinks, head nodes

School- age children ( ages 6-13)

1. Frequent core behaviors are blocks in which the child shuts off sound or voice. He or she will also probably have many repetitions and prolongations than

2. Child uses escape behaviors to terminate blocks

3. Child appears to anticipate blocks, often using avoidance behaviors prior to feared words. He or she also anticipates difficult situations and sometimes avoids them

4. Fear before stuttering, embarrassment during stuttering, and shame after stuttering characterize their level especially fear

Teens and adults ( advanced stuttering) ages 14+

1. Most frequent core behaviors are longer, tense blocks, often with tremors of the lips, tongue, or jaw. Individual will also probably have receptions and prolongations.

2. Stuttering may be suppressed in some individuals through extensive avoidance behaviors ( covert)

3. Complex patterns of avoidance and escape behaviors characterize the stutterer. May not be aware of what they do

4. Emotions and fear, embarrassment, shame are very strong. Individual has negative feelings about himself as a person who is helpless and inept when he stutters.

Covert stuttering

• coping styles of PWS

• Avoidance behaviors are common covert features of stuttering that are highly amenable to change in therapy - but you have to be able to identify them

• Level of avoidance

Stuttering gain

• lack of fluency

• Negative thoughts and fluency

• Avoidance of eye contact