Fluency Disorders (ASLP 5800)

Fluency disorder

speech disruptions that can be accompanied by a change in frequency and severity

Fluent speech

ease and ongoing flow of speech muscular movements and the resulting produced speech sounds

Persistent stuttering

people who continue to present characteristics of stuttering throughout their lifetime

_____ Percent of people who have a family member with a history of stuttering have a higher chance of the stuttering persisting in the child

50%

Physical tension in stuttering

tense chest, hands, feet, jaw, head jerking, eye blinking, leg tapping

Typical disfluencies

10 or fewer disfluencies per 100 words (usually less than 6)

• everyone exhibits these on the regular

Atypical disfluencies

• when there are secondary behaviors

• 11 or more disfluencies per 100 words

What affects the likelihood of persistent stutter?

• family history

• gender

• age at onset

• trend of stuttering frequency and severity

• duration since onset

• duration of stuttering moments

Most likely characteristics of persistent stutter

Prevalence of stuttering

• About 1% of the population of the US has persistent stuttering

• 5% of all children go through a period of stuttering lasting 6 or more months

• 3-4 times as many boys who stutter as girls

___% of children who stutter also have a family member who stutters

50%

___% of school-aged children stutter

1%

___% of preschoolers stutter

3.5%

___% of children aged 3-17 who stutter

2%

Incidence of stuttering

1% overall but in preschool and school populations it is around 4%

Conclusive incidence of stuttering correlation

• gender

• family history

• age

Inconclusive incidence of stuttering corrrelation

• Autism

• culture

• geography

• bilingualism

Etiology/cause of stuttering

unknown

• theorized to be a combo of constitutional and environmental factors

Types of disfluencies

blocks, repetitions, prolongations, interjections/hesistations, filler words

Types of repetitions

• part-word

• whole word

• single syllable word

• multisyllabic word

• phrase

Secondary behaviors

a speaker’s reactions to his or her moments of disfluency in an attempt to end stuttering

• may start as a random struggle but turns into a learned pattern

Types of secondary behaviors

avoidance and escape

Avoidance behaviors

speakers’ attempt to chanfe a word or topic to prevent a stuttering moment

Escape behaviors

Speaker’s attempt to terminate a stutter and finish the word. Occurs when the speaker is already in a moment of stuttering

Sensorimotor factors b/w ppl who stutter and ppl who don’t

Factors that impact the development of stuttering

Diagnosogenic theory

(Johnson) stuttering is a learned response. Proposed that stuttering didn’t begin until after the diagnosis. Stuttering began when parents assigned the stuttering label to typical disfluency

(the monster study)

Examples of Psycholinguistic theories

covert-repair hypothesis, fault line hypothesis, neuropsycholinguistic theory

Psycholinguistic theories

propose that the processes responsible for the retrieval and integration of phonology are failing to operate smoothly

Covert-repair hypothesis

• identifies the breakdown and the covert behaviors

• weaknesses: PWS don’t make more phonological errors than others

Fault line hypothesis

• execution of stress is a phonatory response

• weaknesses: not all stressed syllables are stuttered

Neuropsycholinguistic theory

• stuttering is the speakers time and place holding activity until speech components are arranged and ready for execution

• weaknesses: no insight to why children are prone to this and not

Biological theories

• stuttering as a disorder of brain organization

• disorder of timing

• reduced capacity for internal modeling

• language production deficit

• multifactorial dynamic disorder

Audition theory

Two-stage etiologcial model

primary stuttering: repetitions due to dyssynchrony and biology

secondary stuttering: secondary behaviors appear as a result of the speaker’s consitutional factors

Factors in stuttering onset

Most common types of typical disfluencies

interjections, revisions, and whole-word repetitions

4 stages of stuttering

• Borderline

• Beginning

• Intermediate

• Advanced

Borderline stuttering stage

• resembles typical disfluency but is more frequent

• 6-10 disfluencies per 100 words

• little evidence of secondary behaviors or avoidance or reaction, momentary surprise or mild frustration

Beginning stuttering stage

• beginning signs of muscular tightenings

• fixed articulatory posture due to tension (jaw/lip tension)

• possible escape behaviors

• beginning awareness of difficulty of speaking and feelings of frustration, may verbalize frustration

Intermediate stuttering stage

• escape behaviors are used to minimize/terminate blocks

• anticipation of blocks will increase avoidance behaviors in words and situations

• fear before stuttering, embarassment during stuttering, shame after stuttering

Advanced stuttering stage

• stuttering may be suppressed in some people through extensive avoidance behaviors

• complex patterns of avoidance/escape behaviors. sometimes speaker may not be aware of his/her behaviors

• emotions of fear, embarrassment, and shame are very strong. Negative feelings about self, feelings of helplessness and ineptness

Define/describe Iceberg analogy

speaker’s thoughts and emotions about their own stutter