Fluency Ch. 14

Controlled fluency

a highly conscious style of speaking that induces fluency by modifying certain elements of speech

Spontaneous Fluency

speech without stuttering that doesn't require thinking about it

Acceptable Stuttering

a mild morn of stuttering that neither interferes with communication nor bothers the speaker or listener

Counterconditioning

a way of decreasing a response such as fear of stuttering by pairing the previously feared stimulus (stuttering) is paired with positive stimulus (praise)

Exploring Stuttering

activities that help the client get in contact with the experience of stuttering without the negative emotions usually associated with stuttering. It is a type of approach behavior that can achieve reconditioning thereby decreasing fear

Deconditioning

similar to counterconditioning except that instead of positive stimulus the previously feared stimulus (stuttering) is paired with a neutral stimulus (no negative consequence)

Holding Onto Stutters

with the clinician's encouragement and guidance, staying in the moment of stuttering by, for example, prolonging the posture and tension that characterize the stutter without trying to escape from the moment of stuttering

Reducing Physical Tension While Holding Onto Stutters

the client may automatically reduce tension when she is able to stay in the stutter without feeling an urgent need to push out of it. However, it helps to have the client learn to consciously reduce tension in the moment of stuttering (before releasing it) to transfer that skill to conversational speech in daily situations

Proprioception

attending to the movement of one's articulators, with the aim of using that sensory information to replace auditory input from one's own speech (which may be faulty)

Flexible Rate

slowing the beginning of a word, especially when stuttering is expected

Pausing

inserting pauses while speaking at appropriate linguistic locations, with the aim of gaining control of one's speaking and processing speed

Easy Onsets

beginning phonation by gently bringing the vocal folds together instead of bringing them together quickly and with force

Light Contacts

touching the articulators together lightly while speaking so as to avoid "setting off" a stutter by pushing too strongly

Voluntary Stuttering

stuttering on purpose or at least producing speech in a way that mimics stuttering, with the aim of reducing fear of stuttering

Approach Behavior

consciously going toward something that was previously feared (or still is feared). Part of the reason that stuttering persists is that the individual avoids situations, causing the fear to continue. By deliberately approaching feared words and situations again and again, fear diminishes and so does stuttering

Becoming Your Own Clinician

near the termination of therapy, the client becomes more and more able to give themselves assignments to maintain the fluency they achieved working with their clinician

Someone with advanced stuttering is likely to

a. display tension, struggle, and escape and avoidance behaviors

b. show acceptance of her stuttering and has gotten over anxiety about speaking

c. receive little benefit from further therapy

d. all of the above

e. none of the above

a.

"Controlled fluency"

a. refers to speaking slowly and fluently for several syllables

b. is similar to "super fluency"

c. can be used when a speaker anticipates a stutter

d. all of the above

e. none of the above

d.

When working with someone with advanced stuttering, the clinician should

a. decide for herself what amount of fluency to strive for

b. work on emotions only after fluency has improved significantly

c. understand conditioning principles in order to eliminate avoidance behaviors

d. all of the above

e. none of the above

c.

Avoiding uncomfortable speaking situations

a. will likely help an advanced stutterer maintain fluency

b. will likely help an advanced stutterer overcome her fear of speaking

c. is something that therapy cannot help

d. all of the above

e. none of above

e.

Stuttering therapy should proceed through a hierarchy of

a. least-to most difficult speaking situations

b. least-to-most difficult words

c. shorter to longer periods of "freezing" or "holding onto" a stutter

d. all of the above

e. none of the above

d.

The Modified Erickson Scale of Communication Attitudes

a. may be given to someone more than once

b. is a good way to determine how positively a client feels about her speech

c. has been shown to be predictive of treatment outcomes

d. all of the above

e. none of the above

d.

Three goals that are discussed at the beginning of therapy are

a. spontaneous fluency

b. controlled fluency

c. acceptable stuttering

d. all of the above

e. none of the above

d.

Someone with advanced stuttering is encouraged to explore her stuttering

a. to help her become comfortable confronting it

b. to help her learn which of her stuttering behaviors are learned

c. to help her understand what happens physically when she stutters

d. all of the above

e. none of the above

d.

Confronting stuttering by examining it and talking about it

a. should only be done in a group therapy setting

b. will sometimes initially cause an increase in disfluencies

c. often leads to an increase in negative emotions

d. all of the above

e. none of the above

b.

Outside of treatment sessions, an advanced stutterer

a. should try not to think about her stuttering

b. will sometimes record herself stuttering

c. should not discuss her stuttering with anyone

d. all of the above

e. none of the above

b.

It is helpful for an advanced stutterer

a. to learn about her vocal tract and how speech is produced

b. to try to gain better control over her velum

c. to have a complete orthodontic evaluation

d. all of the above

e. none of the above

a.

Commenting about one's own stuttering when speaking to strangers

a. generally elicits negative feedback

b. is not recommended, even though it brings the stuttering "into the open"

c. generally leads to an increase in disfluencies

d. all of the above

e. none of the above

e.

Flexible rate refers to

a. being able to modify one's speech rate to adjust to a listener's comprehension

b. slowing one's speech rate on syllables that are likely to be stuttered

c. slowly one's speech rate on particularly disfluent days

d. all of the above

e. none of the above

b.

Easy onset and light contact

a. refer to talking softly when anticipating a stutter

b. are ways to get over emotional pain caused by stuttering

c. are methods of beginning a sound gently

d. all of the above

e. none of the above

c.

Proprioception

a. refers to sensory feedback from the lips, jaw, and tongue

b. promotes conscious attention to the articulators

c. can help bypass inefficient automatic sensory monitoring

d. all of the above

e. none of the above

d.

Cancellations

a. involve taking a "timeout" after a stutter

b. are not used with "controlled fluency"

c. should not be self-administered

d. all of the above

e. none of the above

a.

Voluntary stuttering

a. is an effective way to reduce fear of stuttering

b. helps a stutterer practice techniques

c. helps a stutterer be vigilant and ready for a real stutter

d. all of the above

e. none of the above

d.

"Spontaneous fluency"

a. contains no disfluencies

b. is the fluency of a "normal" speaker

c. is the outcome of therapy for most adults who stutter

d. all of the above

e. none of the above

b.

Medication to control stuttering

a. has been found to be of no use

b. has been found to be less effective than placebos

c. was originally effective, but no longer works

d. all of the above

e. none of the above

e.

Group therapy for stuttering

a. not only offers emotional support, but aids in treatment

b. was discontinued by Van Riper after he measured treatment outcomes

c. is effective for children, but not for adults

d. all of the above

e. none of the above

a.

Advanced stuttering is characterized by

- repetitions

- prolongations

- blocks

- over learned patterns of tension, struggle, and escape

- avoidance behaviors

The author believes that because these behaviors are so well-learned, treatment must focus on

teaching the stutterer new fluency and coping skills as responses to old cues that will still tend to elicit struggle and avoidance behaviors

Ideally, ____________ is a goal for advanced stutterers

spontaneous fluency

Realistically, spontaneous fluency in all situations is not

achievable for many advanced stutterers

Therefore, there are three realistic goals for advanced stutterers:

- controlled fluency when fluency is important

- easy, mild stuttering when controlled fluency is not available

- acceptable stuttering when neither #1 nor #2 can be achieved