Fluency Disorders and Stuttering

Comprehensive vocabulary flashcards covering fluency disorders, core and secondary stuttering behaviors, theories of onset, evaluation measures, and direct/indirect therapeutic techniques.

Fluent Speech

The consistent ability to move the speech production apparatus in an effortless, smooth, and rapid manner, resulting in a continuous, uninterrupted, forward flow of speech.

Stuttering

A fluency disorder characterized by involuntary repetitions of sounds and syllables, prolongations, and blocks, manifesting as problems with speech rate and effort (Starkweather, 1980; 1987).

Core Behaviors

The primary involuntary speech characteristics of stuttering, specifically identified by Dr. Reed as repetitions, prolongations, and blocks.

Repetitions

A core stuttering behavior consisting of single-syllable word or part-word repetitions repeated more than two times (e.g., 'li-li-li-like') that occur $3\times$ faster in children who stutter compared to fluent speakers.

Prolongations

A core stuttering behavior where sound or airflow continues while the movement of the articulators has stopped, which can be perceived as abnormal even when as brief as $\frac{1}{2}\text{ second}$.

Blocks

An inappropriate stoppage of airflow or voicing where articulatory movement stops at the respiratory, laryngeal, or articulatory levels, lasting about $1\text{ second}$ on average and sometimes accompanied by tremors.

Secondary Behaviors

Also known as accessory characteristics, these are learned behaviors triggered by the experience or anticipation of stuttering, including eye blinking, facial grimacing, head/shoulder movements, and interjected speech fragments.

Escape Behaviors

Secondary behaviors (such as eye blinks and head nods) that occur while the speaker is stuttering in an attempt to terminate the stuttering moment and finish the word.

Avoidance Behaviors

Secondary behaviors that occur when a speaker anticipates a stutter and attempts to prevent it before it happens, such as changing words or saying 'uh'.

Clustered Disfluencies

Multiple disfluencies occurring together or in close succession, which are commonly observed in young children who stutter.

Developmental Stuttering

The most common form of stuttering, which typically begins gradually during preschool years (average age of onset $\text{around } 33.38\text{ months}$, with $75\text{\%}$ of risk occurring before $3.5\text{ years}$).

Organic Theory

A category of theories positing a physical cause for stuttering, supported by findings of structural/functional brain differences and limb motor control studies showing right hemisphere interference on left hemisphere motor planning.

Behavioral Theory (Diagnostic Theory)

A theory suggesting that stuttering is learned and begins in the parent's ears when overly concerned parents react negatively to normal speech hesitations, famously linked to the 'Monster study' by Tudor.

Demands and Capacities Model

A conceptual model asserting that stuttering develops when environmental demands placed on a child to produce fluent speech exceed their physical and learned capacities.

Covert Repair Hypothesis

A model proposing that stuttering is an internal repair reaction to a detected flaw or atypical phonetic plan during the internal checking of language components prior to speech production.

Packman and Attanasio (P&A) 3-Factor Model

A model stating that moments of stuttering are caused by an underlying deficit in neural language processing, spoken language triggers with high motor demands, and modulating physiological arousal factors.

Multifactorial Dynamic Pathways Theory

A theoretical model describing how critical factors, including genetics, motor-language experience, and environmental influences, interact dynamically over time with developing systems to yield recovery or persistence.

Watchful Waiting

An evaluation strategy proposed by Guitar where children exhibiting borderline stuttering with no significant family history are monitored over time rather than immediately enrolled in direct treatment.

Indirect Treatment

An intervention designed for early or mild stuttering that facilitates fluency through environmental manipulation (such as training parents to provide slow, relaxed speech models) without explicitly discussing or modifying speech.

Direct Therapeutic Techniques

Treatment approaches that directly modify speech production, typically indicated for children who have stuttered for at least a year and demonstrate moderate to severe disfluencies.

Fluency-Shaping (FS)

Direct therapy techniques (also known as fluency enhancing) that alter overall speech timing patterns, utilizing prolonged speech, light articulatory contacts, and gentle voicing onsets to reduce or eliminate stuttering.

Stuttering Modification (SM)

Therapeutic techniques designed to change only the stuttering behaviors and manage negative attitudes through strategies such as cancellations, pull-outs, and preparatory sets.

Cancellation

A stuttering modification technique where the speaker completes the stuttered word, pauses for at least $3\text{ seconds}$, and then reproduces the word in slow motion.

Pull-Out

A stuttering modification technique where the speaker identifies and alters the stuttered word during its occurrence, easing out of the stutter to finish the word fluently.

Preparatory Set

A stuttering modification strategy where the speaker anticipates an impending stutter and deliberately uses slow-motion speech strategies to initiate the word in a fluent manner.

Lidcombe Program

A direct behavioral intervention involving parent-administered verbal contingencies for both stutter-free speech and moments of stuttering, alongside requests for self-correction.

SpeechEasy

A wearable delayed auditory feedback (DAF) device costing between \\$2{,}500 and \\$4{,}500 whose fluency-enhancing effects typically fade over time.

Cognitive-Behavioral Therapy (CBT)

An adjunct approach used to eliminate negative thought patterns and replace them with positive patterns through attitude modification, self-talk, and social skills training.