Exam 2 Stuttering as a Response

distribution of stuttering includes

• = where does stuttering take place

• = what words are likely to evoke stuttering

• Anticipation

• Consistency

• Cue learning

– adjacency

• Attributes of stuttered words

Word‐Specific Anticipation of the occurrence of stuttering

• 83‐96% of stuttering is anticipated (Johnson et al.,

  Milsen, Van Riper)

  • 4‐17% of stuttering is not anticipated

  • Accuracy between expectancy and actual

  occurrence of stuttering decreases the longer the

  time delay

Anticipation in school-age CWS

• Anticipation often operates at a low level of consciousness.

• Use of physiological measurements and eye-tracking studies.

consistency effect

= does the locus of difficulty with respect to words

stay constant

• how can we determine this?

• 65% of stutters during oral reading are consistent

with words stuttered on in previous reading

• importance of no time delay

consistency among preschool children

71% consistency

important to note that preschoolers do not have robust literacy skills; use verbal repetition and visual support

cue learning

• Cues representative of past difficulty lead to

anticipation of stuttering and result in avoidance =

stuttering (Johnson)

• Cues representative of past difficulty lead to

negative emotion, anticipation of stuttering, and

result in breakdown = stuttering (Brutten)

• Neutral stimuli take on negative connotation =

learning (see studies)

• Adjacency effect

• in summary: anticipation of a past difficulty cues the PWS to stutter

Attributes of stuttered words

• Stuttering is a response to cues

• Word characteristics/features of speech responsible

for the consistent occurrence of stuttering in

repeated readings (adults)

• Four attributes of words that determine the loci of

stuttered words in oral reading

– initial sound of word (phonetic factor)

– grammatical function of word

– word in sentence position

– word length

4 factors/attributes of words that determine the loci of stuttered words in oral reading

1. phonetic factor

2. grammatical factor / function

3. word position in the sentence

4. word length

phonetic factor consists of

1.Group Factor

• more than 90% of stuttering on initial sound or syllable of the

word

• consonant‐vowel effect: initial consonants are more difficult

than vowels

2.Individual Factor

• particular sounds that are difficult

More recent research on phonetic factor

Phonetic or phonological, syllabic complexity of

words does not appear to influence stuttering

• Children who exhibit phonological disorders do not

stutter more on words containing systematic speech

errors

• Consonant‐vowel effect might be influenced by

predominance of research in English language

grammatical factor

adults have more problems with content (lexical) words

word position in the sentence

– more stuttering occurs on first word and words early on

in the sentence

– words that initiate phrases and clauses

word length

– longer words occasion more stuttering

– word length in English is negatively correlated with word

frequency and is influenced by word retrieval (longer, less

frequently used words might be harder to retrieve = “sparse”

phonological neighborhoods)

– evaluation (perception) by the PWS of longer words as being

more complex increased likelihood of stuttering

– different for children who stutter: multisyllabic and/or

phonetically more complex words are not necessarily more

frequently stuttered on

the more word weights…

= more likelihood of stuttering on that word

• importance in terms of differential diagnosis

• !!!!!!most important word weight is phonetic factor

followed by word position

frequency of stuttering

Stuttering typically does not happen haphazardly

– cued by words

– cued by situations

• Useful in differential diagnosis

• Little known about consistency relative to situations

• Few lab studies about conditions under which

stuttering decreases relative to situational variables

speech situation checklist ssc

• Brutten & Vanryckeghem, 2007; Vanryckeghem & Brutten,

2018, 2023

– investigate negative emotion (ER) and speech disruption (SD) in

different speech situations

– attributed to word‐ or situation‐specific cues

Conditions under which stuttering

varies in frequency

• Communicative pressure

– communicative responsibility

– time pressure

– difficulty of motor planning

– listener reactions to stuttering

– concern about social approval

– audience size

• Attention factor (distraction)

– novel mode of speaking

– associated activity

– emotional arousal

– intense or unusual stimuli

• Hypnotic suggestion

• Tension, Stress

• Anticipation

• Anxiety

Adaptation effect

• What happens when a person reads the same

passage successively in the same situation

reduction in frequency of stuttering

• On average 50% between reading 1 ‐ 5

• Major reduction occurs between reading 1 and 2

some PWS do not show adaptation

• they may be driven by the situation

• situation might have changed for them

• little adaptation might be indicative of

– word‐specific stutterer

– organic dysfluent

• useful in terms of differential diagnosis

Increase in time interval between successive

readings decrease in adaptation

• Adaptation is temporary

• Reason for adaptation

– Brutten: fatigue effect

• when you do something over and over, it creates fatigue and

decrease in behavior

– Bloodstein, Caruso, Max: practice effect

• by saying words repeatedly, one becomes more capable of

executing them neuro‐motorically

effect of varying the text on adaptation

Adaptation is non‐significant

• Between 10‐20%

• Shows that adaptation is a function of words

predominantly

Effect of varying the situation on adaptation

A decrease in stuttering from reading to reading

• Amount of adaptation is lower compared to

keeping passage and environment constant

• Adaptation depends on the difficulty of the

situation

Importance in assessment

Additional ‘puzzle piece’ in light of differential

diagnosis

– PWS versus person with other fluency disorder

• Differentiation

– word‐specific PWS

– situational PWS

Assessment components

Consistency

• Adaptation

• Locus of stuttering

• Information relative to

– word‐specific stutterer

– situational stutterer

– other type of dysfluent