What is stuttering?
disruption in the fluency of verbal expression
What causes stuttering?
unknown
How many people stutter in the US?
1%
What is the prevalence of stuttering in children in preschool?
4%
Do males or females stutter more?
males
Do people who stutter always stutter?
no`
What are the characteristics of stuttering?
core behaviors, secondary behaviors, feelings and attitudes
What are the core behaviors of stuttering?
repetitions, prolongations, and blocks
What should a clinician consider when evaluating a client’s fluency?
Name 4 risk facts associated with stuttering.
Family History (68% of PWS have a family member that stutters) Age (greater before the age of 5) Child's reaction to stuttering Child's pattern of stuttering
What are 3 environmental risk factors associated with stuttering?
Communication style Parental expectations Important events Family reactions
When is the onset of stuttering for the majority of children?
age 4
Is the onset of stuttering usually acute or gradual?
gradual
What type of disfluencies are the most common when stuttering is emerging?
Repetitions and voiced or voiceless prolongations
______ of children who are diagnosed as beginning to stutter show sign of tension.
1/3
Name and describe the following types of disfluencies. Stuttering or nonstuttering-like? Fi-fi-fi-fine
part-word repetition (stuttering-like) sound and syllable repetitions usually occurs at the beginning of words
Name and describe the following types of disfluencies. Stuttering or nonstuttering-like? I-I-I-I-I can’t
whole-word repetition (stuttering-like) usually single-syllable words usually repeated once or twice
Name and describe the following types of disfluencies. Stuttering or nonstuttering-like? I will I will try again
phrase repetition (nonstuttering-like) repetitions of units consisting of 2 or more words usually repeated once or twice
Name and describe the following types of disfluencies. Stuttering or nonstuttering-like? Um I err I am okay
interjections (nonstuttering-like) some people who stutter use interjections to hold listen's attention while deciding what to say next most people who stutter use them to avoid stuttering
Name and describe the following types of disfluencies. Stuttering or nonstuttering-like? I want the purple, no I mean the pink one
revisions (nonstuttering-like) incomplete phrases or utterances that the speaker does not complete
Name and describe the following types of disfluencies. Stuttering or nonstuttering-like? I want to ssssssstop working
prolongations (stuttering-like) the lengthening of a sound for 1/2 second +
Name and describe the following types of disfluencies. Stuttering or nonstuttering-like? I—--if you —can
broken words (stuttering-like) abnormal pauses within words less than 5 seconds
List the stuttering-like disfluencies
repetitions (part word, whole word), prolongations, blocks, tense pauses
What are four possible associated motor behaviors that a person who stutters may experience?
tension in facial muscles tension in the chest muscles grinding of teeth laryngeal tension hand and feet movement closing the eyes quivering of the nostrils moving the head back
What are secondary behaviors?
Between ______ and _______ children commonly have normal non disfluencies due to rapid expressive and receptive acquisition of language.
2.5 and 4
Explain how we know the difference between stuttering and normal disfluencies.
frequenncy type duration
Explain 3 conditions that reduce the severity of stuttering.
speaking in a nonhabitual manner shadowing speaking in chorus singing using a metronome experiencing delayed auditory feedback speaking to animals and young children speaking in monotone adaptation
What are 2 conditions that make increase an individual’s stuttering severity?
speaking on the telephone saying one's own name Speaking to authority figures speaking to large audiences
Explain abnormalities in breathing that may be observed during stuttering (3)
thoracic breathing clavicular breathing irregular breathing cycles prolonged expirations and inspirations complete cessation of breathing
What phonatory abnormalities may occur (2)?
breath holding glottal fry
What are 2 abnormalities in articulation that may occur?
tremors prolonged articulatory postures on stop consonants After a block there is a rapid increase in articulatory rate
True or false: Research shows that individuals who stutter have a lower IQ that people who do not.
false
What are three personality traits that may exist in a person who stutters?
unwilling to express anger openly avoid situations that require a lot of talking restrict social relationships depression related to coping with stuttering
What are 3 questions to ask the client during the interview? 3 for the parent?
expectations? prior treatment? family history of stuttering onset of stuttering? educational or occupational impacts? What does the client think the problem is?
_____% of SLPs express needing direction during the development and implementation of stuttering assessment and treatment programs.
60%
Explain the importance of a speech sample.
focus on variables that affect dysfluency rate (e.g., variability, audience, situations, avoidance)
How long should a speech sample be?
10-20 minutes
Explain the adaptation task
read 5 times in succession without pausing for too long between reading the passage
True or false: A client will be more fluent when they read the passage the 5th time than they were the 1st time that they readit.
true
What should be included during diagnostics (look at pg 24 of class notes)?
type and frequency of disfluencies
% disfluency rate (over 5% recommend therapy) words per minute
Equation for percent of syllables stuttered
(# of stuttered syllables/# of total syllables)*100
Equation for percent of words stuttered
(# of stuttered words/# of total words)*100
What are 2 standardized tests that you can use for a child that is suspected of stuttering?
SSI TOCS
What is the criteria for a diagnosis of stuttering?
5% disfluency rate on same 3% disfluency for certain disfluencies (word, sound, broken words, part-word) duration of disfluency
Speech sample with _______% disfluent.
5%
_________% disfluency rate of specific types of disfluencies.
3%
The average person who stutters is ______% disfluent.
10%
The S-Scale (Erickson, 1969)
provides info about the attitudes towards interpersonal communication of people who have fluency disorders
Three Wish Task (Silverman, 1970 & what can it tell the clinician
If a genie came and said that they would grant 3 wishes, what would you wish for? determines if young children are aware of and concerned about their speech, without inadvertantly suggesting to them that they should be concerned about it **importance to them
Miracle Task
If you woke up tomorrow morning and no longer stuttered, when would you notice?
Speech Locus of Control
task intended to determine whether a person tends to believe in an internal or external locus of control for speech
Communication Attitude Test
a 35 item questionnaire designed to assess the speech-associated disorders
SSI
standardized test to evaluate # of disfluencies in three contexts (out of clinic, in clinic, reading(optional))
Blood’s Analysis
% of words stuttered monologue,reading, conversation in the clinic, conversation out of clinic, telephone Not widely used anymore Takes into consideration nonstuttering and stuttering-like disfluences
How can a fluency specialist be contacted?
look online
What are dysrhythmic phonations?
prolongations of sounds, silent prolongations (1/2 a second) syllable breaks
What are non stuttering-like disfluencies?
these are disfluencies that occur in everyone's speech & are considered normal
Duration for stuttering diagnosis: Prolongation? Repetition?
prolongations: more than one second repetition: more than 2 repeated units
Onset characteristics
age of 4 some people experience a stuttering on their first word attempt some experience fluency prior to onset of stuttering gradual