Fluency Disorders Final

Blocks can occur at which level of speech production?

respiratory, laryngeal and articulatory

Avoidance behaviors

happen before core stuttering behaviors would take place

Escape behaviors include

eye blinks, heads nods, and interjections of extra sounds.

The ratio of males to females who stutter decreases as children get older. (T/F)

false

Congenital and early childhood factors

-can be associated with stuttering even if there is no family history of stuttering.
-can include physical or psychological trauma.
-can cause stuttering even if there is no genetic predisposition.

Gender, age at stuttering onset, and phonological skills are good predictors of whether a child's stuttering will resolve independently without therapy. (T/F)

true

Prevalence of stuttering measures how many people currently stutter. (T/F)

true

Developmental stuttering

is the most common form of stuttering.

core stuttering behaviors include

repetitions, prolongations, and blocks

In what situations is stuttering likely to decrease?

when speaking to a baby or young child and when speaking to one's pet.

Many studies show that people who stutter

have slower reaction times than people who don't stutter.

Studies have shown that the brains of people who stutter, when compared with non-stutterers, may have differences in function or structure of:

basal ganglia, in the planum temporale and in Broca's area.

Studies of the brain show that people who stutter have greater left hemisphere activity when speaking than typically fluent speakers. (T/F).

false

Test of central auditory processing have shown that ..

none of the above.

Theoretical perspectives on stuttering include:

-stuttering as a disorder of brain organization
-stuttering as a disorder of timing
-stuttering as a language production deficit

There is evidence that treatment for stuttering..

repairs deficits in auditory processing.

The onset of stuttering generally occurs..

between the ages of 2 and 5.

It is likely that stuttering is generally caused by..

a mix of environmental and developmental factors.

Having to carry out complex speech and language tasks...

is a possible factor in the development of stuttering.

We think that genetic play a role in stuttering because..

we have identified specific chromosomes that may carry genes for stuttering.

Substitutions, circumlocutions, and postponements...

are ways to avoid saying a word.

Situations that can cause typical disfluencies to increase include..

-stressful times, such as a death in the family
-when competing to be heard, such as with siblings.
-exciting times that disrupt routines.

Situational avoidances can include..

asking for a friend to order for you, emailing when it would be better to call, and not asking for directions when needed.

Secondary behaviors..

- include tension in reaction to disfluency
- include pauses or interjections before disfluencies
- are a sign of stuttering rather than normal disfluency

Normal disfluency can be distinguished from stuttering by ..

-the number of units in each repetition or interjection
-the type of disfluency
-the amount of disfluency

Efforts to get out of a block may include..

-snapping one's fingers, jerking one's head, and blinking one's eyes.

Compared with borderline stuttering, beginning stuttering is characterized by:

faster repetition of stuttered syllables.

Blocks..

can be felt in the larynx, lips or elsewhere.

A person with intermediate stuttering..

tends to anticipate and avoid saying difficult sounds.

Theoretical perspectives on stuttering include..

-stuttering as a disorder of brain organization
-stuttering as a disorder of timing
-stuttering as a language production deficit

The "demands and capacities" model proposes that stuttering can develop ..

-when parental expectations are too high
-when children place too many demands upon themselves
-if children with limited speech production capacities grow up in an environment with normal levels of demand.

Between the ages of 3 and 4..

children begin to compare their behaviors with those of peers.

Stressful speaking situations for children include...

-parents who speak too rapidly
-parents who interrupt often
-parents who use overly complex syntax

According to Wendell Johnson's Diagnosogenic Theory..

stuttering can arise from parents overreacting to normal disfluencies.

For young children, treatment for stuttering may involve..

Lessening demands on the child, rather than treating disfluencies directly.

Parents can help improve the linguistic environment of a child who stutters by..

-slowing their speech rates
-interrupting less
-having dedicated one-on-one conversations with their child

List the following developmental levels of stuttering from least severe and ending with most severe.

1. typical disfluencies
2. borderline stuttering
3. beginning stuttering
4. intermediate stuttering
5. advanced stuttering

The severity of a client's stuttering cannot be determined on the stuttering severity instrument-4 (SSI-4) . (true/false)

false

The frequency score on the SSI-4 is derived from % syllables stuttered (T/F)

true

According to de Sonneville-Koedoot et al. (2015), which of the following is true about direct treatment (the Lidcombe Program) versus indirect treatment (RESTART)? (Select all that apply.)

-at 18 months clinical outcomes for direct and indirect treatment were comparable.
-direct treatment decreased stuttering more quickly during the first three months of treatment.

According to Plexico and Burrus (2012), which of the following are true about parents with a preschooler who stutters? (Select all that apply.)

-Parents don't necessarily know which disfluencies in their child's speech should be considered typical.
-Parents are uncertain about whether stuttering should be acknowledged in the home.
-Parents seek speech services due to concerns about their child's future, bullying, and negative emotions.

Plexico and Burrus (2012) found that, before their child was enrolled in speech therapy for stuttering, parents would often engage in which of the following behaviors? (Select all that apply.)

-telling the child to slow down his/her rate of speech
-instructing the child to breathe
-telling the child to think about what they wanted to say
-actively listening to the child
-reducing time pressure

Children with borderline stuttering..

likely have an innate predisposition toward disfluency

Parents of a child with borderline stuttering

may feel they caused their child to stutter

When starting to work with a child with borderline stuttering, the clinician should..

begin working with the family immediately

Indirect treatment for a child with borderline stuttering..

is largely based on reducing stresses on the speaker.

Speech patterns in some homes that might put pressure on a child include..

-high-speed rates
-lack of pauses between speaker
-advanced levels of syntax

Children with borderline stuttering..

may be particularly sensitive to speech patterns that are common in many homes

An important aspect of indirect treatment for borderline stuttering is for a parent..

-to spend one-on-one time with the child each day
-to engage in non-directive play with the child
-to show understanding of the child's feelings

Having a child produce intentional stutters for his or her own parents..

-helps desensitize the child to stuttering with his or her parents
-helps desensitize the parents to their child's stuttering
-can give the child a feeling of accomplishment

When children are able to modify their own stutters in the clinic,

they should be praised for slower and easier stutters.

Treatment for a child with beginning stuttering

includes daily practice of fluency

In the Lidcombe Program

parents conduct daily treatment sessions

During weekly Lidcombe sessions,

-the clinician demonstrates to the parent how to conduct daily sessions
-the parent and the clinician discuss the child's speech while the child is present
-the clinician assesses the child's fluency

The RESTART-DCM therapy approach is based on decreasing pressure in the child's environment and eventually reinforcing the child's capacities. (T/F)

true

"Playing" with stutters tends to make a child more self-conscious of his or her stuttering.

false

When beginning to model easy stutters, the clinician makes accepting comments about his or her own stutters. (T/F)

true

A child with beginning stuttering..

will have part-word repetitions as the predominant core stuttering behavior

Verbal contingencies in the Lidcombe Program..

-include pointing out a stutter
-might include, "That sounded a little bumpy."
-are given in a ratio of about 5 praises for fluency to 1 contingency for stuttering

Mirror work can help clients identify what it is they do when they stutter. (T/F)

true

We would not typically encourage our clients to stutter or purpose and/or stutter in a different way in our sessions. (T/F)

false

Contrasting normal speech production with soft starts can be a helpful way for clients to understand the technique. (T/F)

true

Which of the following are representative of soft starts? Select all that apply.

-"easing" or "flowing into" the sound with smooth airflow and voicing
-saying a word in a slower, easier way at the beginning

Stuttering can be compared to an ______ because the bulk of stuttering (especially emotional and cognitive effects) is not easily observed by listeners and is "below the surface."

iceberg

Helping clients to have a slower rate will necessarily mean that their speech will sound a bit disconnected or choppy due to lack of flow. (T/F)

false

How can we achieve rate change? Select all that apply.

-pausing and phrasing
-stretching sounds and syllables
-combining stretchy speech with pausing and phrasing

What is the hierarchy of prompting that we typically use with clients when teaching them a new skill?

1. the clinician models for the client
2. the client and clinician practice together
3. the client is asked to demonstrate the skill independently.

Which of the following are benefits of voluntary stuttering? Select all that apply.

-desensitizes clients to listener reactions
-decreases fear and avoidance
-helps clients to confront words and situations that they might otherwise avoid

According to Bernstein-Ratner's (2005) article, "Evidence-based practice in stuttering: some questions to consider," the level of evidence in our field is relatively low when compared to medicine or psychology.

true

A clinician's belief about the etiology of stuttering can have an effect on..

-how the clinician approaches treatment
-what the clinician might say to parents of a child who stutters
-what the clinician might look for in assessing someone who stutters

Avoidance behaviors..

-include saying "um" before attempting a feared word
-include not talking on the telephone
-help keep someone who stutters from learning how to stutter more easily

Treatment for advanced stuttering..

should attempt to reduce negative feelings about stuttering

When deciding on a treatment plan, a clinician should..

look for data that support a treatment's effectiveness

Which technique requires that the client: 1) stays in the moment of stuttering, 2) locates the source of tension within the articulators, and then 3) changes the stutter by reducing tension and then slowly moving forward?

pullout/in-block correction

We typically start with holding and tolerating a moment of stuttering before moving onto identification activities. (T/F)

false

When exploring talking with our clients who stutter, one of the first things we do is to explain how the speech mechanism works. Why do we do this? (Select all that apply.)

-to help explain how breathing, phonation, and articulation work together
-to provide a common vocabulary
-to help clients identify what happens physiologically when they stutter

Which of the following are true when it comes to cancellations? Select all that apply.

-clients must pause for a moment to plan how to say the word again with less tension
-the client must finish the stuttered word before trying again

Freezing technique

holding or tolerating a moment of stuttering

soft starts technique

light contacts, easy onsets

pullouts

in-block corrections

cancellations

post-block corrections

Classroom teachers can help students with intermediate stuttering by..

changing the classroom environment if necessary

Conditioning in someone with intermediate stuttering has been reinforced by..

-his or her "success" when avoiding certain words and situations
-negative reactions from listeners
-frustration and embarrassment during stuttering

It is reasonable to expect that most people with intermediate stuttering will..

none of the above

One of the first things to do when treating someone with intermediate stuttering is to..

help them feel accepted even when stuttering

Someone with intermediate stuttering has not yet begun to use escape devices to get out of a stutter. (T/F)

false

When beginning therapy with a child with intermediate stuttering, the clinician might ..

-find out what the child's goals are
-explain how stuttering develops
-explain how speech is produced

Which of the following is a characteristic of someone with intermediate stuttering?

-shame
-avoidance
-fear

"Automatic fluency" uses prolonged speech to generate fluency and can be used when a speaker anticipates a stutter. (T/F)

false

A goal that might be discussed with someone with advanced stuttering is..

-spontaneous fluency
-controlled fluency
-acceptable stuttering

Commenting about one's own stuttering when speaking to strangers...

none of the above

Confronting one's stuttering by examining it and talking about it should only be done in a group therapy setting in order to avoid an increase in negative emotions. (T/F)

false

The participants in the Daniels et al. (2012) study reported a range of coping strategies for their stuttering that included which of the following?

- physical coping strategies including concomitant behaviors
- linguistic coping strategies including ways of manipulating discourse and language to enhance fluency
- social-interactional coping strategies including ways of manipulating social routines and participation with others

According to Daniels et al. (2012), many school-age children are so anxious about their stuttering that they do not find any educational benefits from orally presenting information, answering questions in class, or participating in group work. (T/F)

true

Avoiding uncomfortable speaking situations will likely help someone with advanced stuttering maintain fluency. (T/F)

false

Treatment for neurogenic stuttering usually includes surgery as well as behavioral interventions. (T/F)

false

Whereas apraxic stuttering stems from problems with motor planning, dysarthric stuttering is seen in conjunction with aphasia. (T/F)

false

Psychogenic acquired stuttering often begins in adulthood and can begin after psychological stress. (T/F)

true

We suspect psychogenic stuttering whenever a client has an increase in disfluency when expressing emotion. (T/F)

false

A neurologist and psychiatrist are often consulted when stuttering begins in adulthood. (T/F)

true