SHS unit 2 - Stuttering

stuttering causes

not really understood

fluency

• Speech is effortless in nature

• Easy, rhythmical, and even-flowing

• Average speech rate

  • 3.5 syllables per seconds

  • Young school aged children 2.5 syllables/sec

disfluency

• Marked by word or phrase repetitions. interjections/fillers, pauses, revision

  • Normal speakers produces disfluencies some of the time

• NORMAL

stuttering

• unusual , tense disfluencies that interfere with communications

• Developmental stuttering is the most common form of fluency impairment

  • Others include acquired/neurogenic

cluttering

• Rapid bursts or dysrhythmic, unintelligible speech

• A rate that is perceived to be abnormally rapid, irregular

how stuttering affects quality of life

• Anticipating communications breakdowns

• Avoidances of socials interactions

• Emotional strain can worsen the problem

• Restrictions in social, educational, and vocational participation

repetitions

• Phonemes, b-b-b-ball

• Syllables, ba-ba-ba-baby

• Prolongations, Vvvvvvvvvvan

blocks

SILENT prolongations “getting stuck”

counterproductive behaviors

• Looking away

• Eye blinks

• Open jaw

• Urse lips

• Facial grimaces

• Change words

• Limb movements

• Can be very distracting to listening

prevalence

1% (people who stutter)

incidence

5% (people who have stuttered before)

ratio of males to females

3:1

What increases disfluencies (causes more stuttering)

• Greater communicative demand, words that cannot be replaced ex. Your name

• Longer and more complex utterances

• Speaking to authorities

• Feeling rushed or pressured

What increases FLUENCY

• Singing

• Using pretend voices

• Choral speech

• Talking to babies or animals

Differences between stutters and nonstutterers

• Temperament

  • Children that may be more frightful/anxious

• Language abilities

• Motor systems

  • Slower motor responses

• Neurological differences 

  • More activation in right hemisphere speech and language areas

  • Less dense neural fibers connecting areas

myths about stuttering

• Stuttering is a nervous reaction

  • General anxiety levels

  • Relaxation therapies not effective

  • Increased anxiety may increase suttering, but it is not the underlying cause

• Overly sensitive caregivers

  • Parental anxieties

  • Overprotectiveness

development of stuttering

• The speech of preschool aged kids contains a lots of disfluencies

• Sometimes develops suddenly

• Avoidant of speaking

• Secondary behaviors

genetic predisposition

• Strong genetic influence

• 3 stuttered words per 100

• Multiple genes seem to contribute and interact

resolution

• Stuttering will resolve in about 60-80 of kids who stutter

persistant stuttering

• continues from childhood into adulthood

stuttering modification

• Midvas

• Approximation stage

  • Cancellations- stuttering on a word, going back and repeating it

  • Pull-outs middle of a stutter, stop, continue

  • Preparatory sets

fluency shaping

• Change the way people talk 

• Aiming for stutter-free speech

• Control rate/onset.trasitions/phrasing

• Airflow therapy

• Gradual increase in length and complexity of utterances

CARE model

• Communication

  • Improves communicative effectiveness and confidence

  • Think about language use/variability

• Advocacy

  • Encourages self love

  • Teach other people about stuttering

• Resilience

  • Uses real life speaking contexts for practice, voluntary stuttering

  • Supports authentic speech without fluency pressure

  • Reduces the negative impact of stuttering

• Education

  • Basic facts about stuttering, common myths

therapy for young children (direct, indirect)

• Direct therapy

• Teaches kids slower, easier speech

• Turtle talk (slow)

• Smooth versus bumpy speech

• Indirect therapy

  • Train caregivers to modify their own speech

  • Reduce stressors in home environment

cultural considerations

• we must realize that families have different views on disabilities

• usually bilinguals stutter in both languages

• must assess in both languages

• must know clients cultural background