[SLP10415] Developmental, Environmental, and Learning Factors in Stuttering

around 6 years old (Preschool years)

What age should stuttering be dissolved?

beyond 6 years old

What age do we consider a child to have persistent stuttering?

Developmental, environmental, and learning factors

What interacts with predisposing constitutional factor that can worsen stuttering?

Constitutional factors

What factor leads to the onset of stuttering?

gradual/cumulative effect, appears out of nowhere or diminishes and may or may not reappear

Developmental, environmental, and learning factors in stuttering may appear .. (3)

More competitive, with high standards, and less tolerance of differences

Higher incidences of stuttering in cultures with (3)

Developmental factors

Has something to do with the development of everything

Physical and Motor skills development, speech and language development, cognitive development, social and emotional development

Developmental factors (4)

Neural resources

Areas of development in the child compete for _____ ______ to be allotted to different demands

Problem of shared resources

More acute in children because their immature nervous systems have less processing capacity to share

Increasing

Demands _____ as the child _____ in age

Neurological maturation

May provide more functional cerebral space that supports fluency, but it also spurs development of other motor behaviors that may compete with fluency for available neural resources

Motor development

Somewhat delayed skills in ___ development may cause stuttering

Onset of stuttering

• Between the ages 2 and 4 — a time when children acquire new sounds and learn new words

• Areas of the brain used for integration of articulator planning, sensory feedback, and motor execution are compromised

Greater demands

A child produces longer, faster, and more complex sentences not within their level / capacity = ?

Speech traffic jam

Development of maladaptive learning or development of compensatory strategies paving way to normal speech

Delayed and deviant

_____ and ______ speech and language development are momst common among children who stutter than those who do not

Cognitive development

It refers to the growth of perception, attention, working memory, and executive functions that play roles in spoken language but are separate from it.

Spurts in cognitive development and self-awareness of the stutter

2 ways cognitive development can affect stuttering

Spurts in cognitive development

Advanced cognitive abilities accompany the onset of stuttering as well as the sudden increases in stuttering, and may cause the development of self-awareness

Self-consciousness / self-awareness

More likely to become aware of the stutter at the age of cognitive development

Cognitive development and the onset and fluctuation of stuttering

Learning to think may make great demands on cognitive-linguistic abilities, leaving fewer resources available for rapid production of fluently spoken language

Internalizing standards and behaviors

Between the ages 3 and 4, children’s cognition mature enough that they ____ ______ and ______ of those around them, including peers

Age 4

Most children at ___ _ showed a preference for fluent speech, suggesting a negative evaluation of disfluent speech

Interference with speech by emotion

There are effects of strong emotions on one’s speech, which are more prevalent in early childhood when a child’s speech and language neural networks and structures are immature, not fully myelinated and may not be buffered from “cross talk” or the interference of the limbic system structures and pathways involved in the regulation and expression of emotion

Cross talk

someone talking at the same time as another

Excitement

Commonly mentioned emotion that makes children more disfluent

social , emotional

Some stages of development may provide ____ and ____ stress than others

Emotional Security

• Many threats to feelings of _______ can create ______ stress that may disrupt speech of children who are predisposed to stutter.

• A child’s resentment at having to share his mother’s attention may elicit feelings of anger, aggression, and guilt.

Self-consciousness and sensitivity

Reflects the child’s growing awareness of how he is performing relative to adult expectations.

Self-corrections

________ a child makes in speech are evidence of their self-awareness

Sensitive temperaments

People who stutter as a group may have unusually ____ ______

Fearfulness and withdrawal

Social-emotional traits of _____ and _____ that accompany more sensitive temperaments can change over the course of a child’s preschool years

More anxious

Some parents of stutters are ___ ____

Hypersensitivity

____ to parent’s concern and their increased tension as a response to their disfluencies is a component of an overall vulnerable temperament found in some children who stutter

Speech and language environment

The child’s communication at home is part of their ____ and ______ _______

rapid speech rate, polysyllabic vocabulary, complex syntax, use of two languages in home

Stressful adult speech models (4)

competition for speaking, frequent interruptions, demand for display speech, hurried when speaking, frequent questions, excited when speaking

Stressful speaking situations for children (6)

Life Events

• Happenings in a child’s life that may stress them

• Ex: parent’s divorce, being hospitalized, death of someone close

Psychogenic stuttering

A condition where the cause of stuttering is a traumatic event

Periods of tension

All children speak more disfluently during ____ _ _____

Life events that may precipitate stuttering

• Child’s physical environment changed (e.g., moving to new house) 

• Child became ill

• Child realized his mother was pregnant

• A new baby arrived

• The child’s family moves to a new house, a new neighborhood, or a new city.

• The child’s parents separate or divorce.

• A family member dies.

• A family member is hospitalized.

• The child is hospitalized.

• A parent loses his or her job.

• A baby is born, or a child is adopted.

• An additional person comes to live in the house.

• One or both parents go away frequently or for a long period of time.

• Holidays or visits occur, which cause a change in routine, excitement, or anxiety.

• A discipline problem involving the child.

Classical conditioning, operant conditioning, avoidance conditioning

Learning Factors (3)

Classical Conditioning (Pavlov)

It is the repeated pairing of a neutral stimulus (such as a person) with a stimulus (a humiliating long stutter) that elicits a response (such as fear), so that the neutral stimulus eventually elicits the response.

Unconditioned stimulus

A stimulus that reliably elicits a response

Unconditioned response

The response an unconditioned stimulus elicits, often reflexive or hardwired response

Conditioned stimulus

A neutral stimulus that doesn’t elicit a particular response, paired with the unconditioned stimulus that will be conditioned to elicit a response

Desensitization

A stuttering treatment that can break the link of classical conditioning which pairs the old behavior that elicited a response with a different response

Operant Conditioning

It is following a behavior with a reward or punishment so that the behavior becomes more frequent (if rewarded) or less frequent (if punished).

Avoidance Conditioning

This type of learning occurs when a person uses a behavior to try to prevent an unpleasant occurrence by doing something, often perpetuated by the successful prevention of the unpleasant experience.