PRAXIS: Fluency Disorders

right hemisphere

Individuals who stutter have greater activity in which part of the brain than individuals who don't stutter?

rare

Adult onset of stuttering is _______.

easy onset

a speech technique used to reduce stuttering by initiating speech with a gentle breath and relaxed vocal cords

Covert Repair Hypothesis

theory suggests that stuttering results from the brain detecting and attempting to correct speech errors before articulation

percent disfluency rate

the percentage of words in a speech sample that are dysfluent, indicating the severity of a fluency disorder which helps to quantify stuttering frequency (5% is usually stuttering criteria)

avoidance behaviors

occur before speaking to prevent stuttering (e.g., word substitutions, circumlocution, avoiding speaking situations)

escape behaviors

earned responses to get out of a stuttered moment

escape behaviors

occur during a moment of stuttering to end the disfluency

light articulatory contacts

using gentle movements to produce speech sounds and reduce tension in speech muscles

cerebral dominance theory

the hypothesis that one hemisphere of the brain is more responsible for language processing than the other, suggesting a neurological basis for fluency disorders

white matter

Children who stutter have decreased _____ ______ connectivity.

right

Which hemisphere of the brain is responsible for prosody?

left

Which hemisphere of the brain is responsible for fine motor control of verbal output?

true

Areas of the auditory cortex are deactivated during stuttering.

Anticipatory Struggle Hypothesis

suggests that stuttering develops when a person expects speaking to be difficult and, as a result, experiences tension and struggle while trying to speak

mazes

disruptions in the forward flow of speech by the production of a string of words, initial parts, or unattached fragments of words that do not in and of themselves contribute to the message

continuous phonation

maintaining a smooth, unbroken flow of voicing across words

phrasing and pausing

breaking speech into manageable phrases with natural pauses to reduce pressure

slowed rate of speech

speaking slower to enhance control and reduce disfluencies

breath control

coordinating breath with speech for efficient airflow and voicing

stuttering modification

techniques like cancellations or pull-outs to reduce the impact of stuttering moments

right hemisphere

associated with the processing of emotional and social aspects of language and speech

right hemisphere

Studies indicate that individuals who stutter exhibit increased activity in the ___________ ___________ compared to those who do not.

constitutional, environmental, genetic

After comparing multiple family studies about fluency, which of the following can be inferred that stuttering is caused by a mix of which factors?

consistency

tendency for individuals who stutter to be disfluent on the same words when reading a passage multiple times

anticipation

an individuals ability to predict the words that they will be disfluent on

adaptation

the tendency for speakers to have less disfluent behaviors after reading a passage multiple times

prevalence

a term used to indicate how widespread a disorder is over a relatively limited period of time

heterogenity

difference among various types of disorders

proprioception

sensory information from the body that conveys position of and movement of structures

sensorimotor control

the manner in which movements are performed based on the interaction between motor movements and sensory feedback which improves accuracy of movements

congenital factor

physical or psychological trauma that occurs at or near birth that may predispose someone to a particular outcome

anomaly

a difference from normal structure or function

sensory processing

act of interpretation of sensory information

classical conditioning

learning caused by the association of neutral stimulus with a stimulus that provokes a strong response

unconditioned response

a response that occurs naturally and automatically without learning when an unconditioned response is present

conditioned response

a response that is triggered by a conditioned stimulus

operant conditioning

learning caused by the reinforcement of a reward, punishment, or relief from punishment

conditioned stimulus

a neutral cue that triggers a response after being associated with an unconditioned response

unconditioned stimulus

a sensory cue that automatically brings on a response

avoidance conditioning

learning that results in a behavior that is used to prevent a negative consequence

decrease

Stuttering is likely to ______ when speaking to an infant, in a rhythm, and when speaking alone.

operant

Using a cough to end a stuttering event is an example of ________ conditioning.

secondary behaviors

What type of stuttering behaviors are often learned through operant conditioning?

exposure therapy

used to unlearn classically conditioned responses

limbic system

Children who stutter may have a more reactive _________ _______.

limbic system

part of the brain involved in emotions and memory, which may contribute to the emotional responses associated with stuttering

fluency

the ability to express oneself readily and effortlessly

readily, effortlessly

Fluency is the ability to express oneself _______ and _______.

stuttering

an involuntary disorder of fluency that interferes with the forward flow of speech

core behaviors

repetitions, prolongations, blocks

secondary behaviors

learned behaviors to escape or avoid stuttering

core behaviors, secondary behaviors, feelings, attitudes

What are the 4 components of stuttering?

Covert Repair Hypothesis

suggests that stuttering is causes by attempts to repair phonological errors before they are spoken

fluency

the aspect of speech production referring to the continuity, smoothness, rate, and effort of the speech

continuity, smoothness, rate, and effort

What are the 4 aspects you are measuring in regards to fluency?

disfluency

refers to breaks in the continuity of speech

Timing Theory of Stuttering

proposes that stuttering arises from a deficit in temporal programming due to inappropriate localization of some of the speech and language functions in the right hemisphere resulting in an inability to create the precise timing patterns needed to perceive and produce speech efficiently

Language Production Theory of Stuttering

proposes that the major problem in stuttering is not in the motor execution of speech, but rather in the planning and assembly of language units that occur before the speech production

Hershel’s Gyrus

a region in the brain involved in auditory processing and perception, playing a role in language comprehension and production

Wernicke's Area, Hershel’s Gyrus

Auditory dysfunction in individuals who stutter can be attributed to which areas of the brain being underactive?

false

A child is not influenced by the auditory feedback from his or her own speech.

true

When talking with a preschool child, the clinician can comment on his or her own disfluencies.

tension

When analyzing a preschool child's speech sample, the clinician looks for signs of __________ during both prolongations and repetitions.

blocks

may occur at any level- respiratory, laryngeal
or articulatory

blocks

may be accompanied by tremors of the lips, tongue, jaw and /or laryngeal muscles

consistency

the tendency for stuttering to occur on the same words

adaptation

a decrease in stuttering frequency during repeated readings of the same text

attitude

a feeling that has become a pervasive part of a person’s beliefs

avoidance behavior

a speaker’s attempt to prevent stuttering when he or she anticipates stuttering on a word or in a situation.

core behaviors

repetition, prolongation, and blocks

developmental stuttering

a term used to denote the most common form of stuttering that develops during childhood

avoidance behavior

occurs before the stuter

language skills, motor skills

Stuttering is more likely to develop in a child with advanced ______ ______ and delayed ______ ________.

escape behavior

occurs during the stutter

brain tumor, learning disability, neurological disease

Onset of stuttering in adults is often the result of ________, _________, or __________.

true

Research supports that the cause of stuttering is 70% genetic and 30% environment.

2-5 years

What ages does onset stuttering occur?

spontaneous recovery

the improvement of nervous system function after an injury

males

Who stutters more: males or females?

females

Who experiences more spontaneous recovery: males or females?

repetitions, prolongations, blocks

What are the 3 core behaviors?

repetition

repetition of a single sound, syllable or part-word

two

Typically repetitions of more than _____ are perceived as abnormal.

prolongations

sound or airflow continues but articulatory movement is stopped

true

Prolongations as short as ½ second may be perceived as abnormal by the listener.

escape behavior

a speaker’s attempts to terminate a stutter and finish the word, occurring when the speaker is already in a moment of stuttering

fluency

effortless flow of speech

gene

a segment of DNA that contributes to an individual’s traits

concordance

If one twin has a condition, such as stuttering, the other twin also has the condition. This is called ________.

escape and avoidance

What are the two classes of secondary behaviors?

secondary behaviors

a speaker’s reactions to their stuttering in an attempt to end them quickly or avoid them altogether

natural recovery

stuttering that disappears within a year or two after onset from natural causes rather than from treatment

persistent stuttering

stuttering that persists for several years after onset, beyond the time at which natural recovery is likely to occur

predisposition

susceptibility to developing a condition

sensory processing

activity of the brain as it interprets information coming from the senses

temperament

the characteristic mood, behavior, and emotional responses of an individual that influence their interactions and reactions

advanced stuttering

this level is characteristic of older teens and adults who have been stuttering since childhood

beginning stuttering

stuttering in older preschool children

borderline stuttering

stuttering in younger preschool children