neurogenic stuttering and cluttering

neurogenic stuttering

resembles stuttering of early childhood onset, but it is associated with diagnosed neurological disorder or disorders

up to 5% fo patients with stroke may experience neurogenic stuttering

may be transient or persistent, and may be associated with aphasia or AOS

etiologic factors of NS

cerebral vascular disorders that cause strokes are the most frequent causes

right hemisphere disorder

parkinson’s, brain tumors, seizures, brain surger, dementia

drug toxicity

bilateral brain damage

characteristics of neurogenic stuttering

• evidence of neuropathology

• adult onset of stuttering

• generally increased rate of dysfluencies including syllable and word repetitions and frozen articulatory postures

• repetitions of medial and final syllables in words, dysfluent production of function words, dysfluenices in imitated speech, rapid speech rate, and general symptoms of brain injury

  • no or minimal adaptation effect, minimal variability in stuttering frequency, few associated motor behaviors, minimal effects with DAF, no obvious anxiety, no word fears etc

treatment of NS

done in the context of other speech or language disorders that coexist (aphasia, AOS, dysarthria)

handle treatment symptomatically by reducing rate of speech, DAF, pacing board

cluttering

often coexists with stuttering

characterized by a reduced speech intelligibility, rapid and irregular speech rate, imprecise articulation, dysfluencies - especially word and phrase repetitions, interjections, and revisions - disorganized language, poor prosody, reduced awareness, inefficient management of discourse, lack of anxiety, spoonerisms (many thinkle peep for many people think), monotonous tone, omissions and compression of sounds and syllables, clearer rate of speech when slowed down

assessment of cluttering

similar to early childhood onset with emphasis on special features (excessive rate and rate variations, articulatory breakdowns and speech intelligibility, prosodic variations, dysfluenices, lack of concern)

may administer the cluttering severity instrument to assess and rate the special features

treatment of cluttering

reducing the rate of speech usually improves clarity as well as fluency, teaching the client to plan sentences and other forms of expression before actually producing them

increasing a client’s awareness through the use or audio or video tapes