V &F Chapter 1 - Nature of Stuttering

• the term “___ _____ _____” is preferable in comparison to:

  • Stutterer

  • PWS

• is “Disfluency” or “dysfluency” preferable?

• the term “people who stutter” is preferable in comparison to:

  • Stutterer

  • PWS

• “Disfluency” is preferable to “dysfluency”

T/F disfluency is always abnormal

• FALSE - “Disfluency” is either normal or abnormal

  • every speaker has some degree of typical disfluency - this is considered normal disfluency

  • abnormal disfluency occurs when there is a higher rate of interruptions, stops, etc

• T/F Stuttering is found in all parts of the world and in all cultures and races.

• T/F Stuttering depends on occupation, intelligence, and income.

• T/F Affects both sexes and people of all ages, from toddlers to the elderly.

• TRUE - Stuttering is found in all parts of the world and in all cultures and races.

• FALSE - Indiscriminate of occupation, intelligence, and income.

• TRUE - Affects both sexes and people of all ages, from toddlers to the elderly.

• The causes of stuttering are not completely understood, but scientists believe these are important factors:

  • G_____ and c______ influences

  • D_______ influences

  • E_______ influences

• Genetic and congenital influences

• Developmental influences

• Environmental influences

• T/F Repeated negative emotional experiences with stuttering have no impact on subsequent feelings and attitudes.

• FALSE - Repeated negative emotional experiences with stuttering lead to negative feelings and attitudes.

can stuttering be cured - does it need to be?

• T/F Stuttering often cures itself.

• T/F Good treatment of mild and moderate stuttering leaves no trace of stuttering

• T/F All stuttering clients have the goal of eliminating their stutter

• TRUE - Stuttering often cures itself.

• FALSE - Good treatment of mild and moderate stuttering may leave little trace of stuttering.

• FALSE - Some adolescent and adult clients may want to learn to communicate effectively but continue to stutter.

• Fluency: The ____ ____ of speech.

fluency: the effortless flow of speech

• Disfluency: An ______ of speech that can occur in both _____ speakers and those who _____

• Disfluency: An interruption of speech that can occur in both typical speakers and those who stutter.

• Starkweather (1980, 1987) suggests that _____ and _____ are critical to fluency.

• Thus, a fluent speaker _____ produces speech at a rate ______ to listeners.

• Starkweather (1980, 1987) suggests that rate and effort are critical to fluency.

• Thus, a fluent speaker effortlessly produces speech at a rate comfortable to listeners.

• insert purple chart

stuttering general descrip

• Abnormally high frequency and/or duration of stoppages in the flow of speech

• Includes speakers’ reactions to stoppages

• Reactions are behavioral, emotional, and cognitive responses to repeated experiences of getting stuck while talking

• Must distinguish between stuttering and typical disfluencies, as well as from neurogenic and psychogenic stuttering

• Repetitions: may be single-syllable word or part-word repetitions

  • Word or syllable repeated more than two times, li-li-li-like this.

• Prolongations: sound or airflow continues but movement of articulators is stopped

  • Prolongations as short as 0.5 second may be perceived as abnormal.

• Blocks: inappropriate stoppage of airflow or voicing; movement of articulators may be stopped

  • Blocks may occur at any level—respiratory, laryngeal, and/or articulatory.

  • Blocks may be accompanied by tremors of lips, tongue, jaw, and/or laryngeal muscles.

  • On average, stutterers stutter on about 10% of words while reading.

  • On average, stutters last about 1 second.

core behavior

secondary behavior

• Learned behaviors triggered by the experience of stuttering or anticipation of it

• Escape behaviors: attempts to terminate the stutter and finish the word (eg, eye blinks and head nods)

• Avoidance behaviors: anticipation of a stutter and attempts to avoid it by, for example, changing the word or saying “uh” just before the word

potential feelings & attitudes

• The experience of stuttering often creates feelings of embarrassment and frustration in a speaker.

• Feelings become more severe as the speaker has more stuttering experiences.

• Fear and shame may develop and may contribute to the frequency and severity of stuttering.

• Attitudes are feelings affect the person’s beliefs.

• Beliefs may be about oneself or listeners.

onset

• May start as gradual increase in normal childhood disfluencies or may start as sudden appearance of prolongations or blocks.

• Often sporadic at outset, coming and going for periods of days or weeks before becoming persistent.

• Onset may occur between 18 months and 12 years but most often between 2 and 3.5 years (average 2.8 years).

prevalence

• A measure of how many people stutter at any given time.

• Prevalence is 2.4% in kindergarten, about 1% in school-age children, and slightly less than 1% in adults.

incidence

• A measure of how many people have stuttered at some point in their lives

• About 5%

recovery from stuttering

• Somewhere between 70% and 80% of children who begin to stutter recover without treatment

Basic Facts About Stuttering and Their Implications for the Nature of Stuttering #3

• Children with these attributes have less likelihood of spontaneous recovery (Yairi & Ambrose, 2005):

  • Having relatives who were persistent stutterers

  • Being male

  • Onset after 3.5 years

  • Stuttering not decreasing during first year after onset

  • Stuttering persisting beyond 1 year after onset

  • Multiple unit repetitions (li-li-li-li-like this)

  • Continued presence of prolongations and blocks

  • Below normal phonological skills

  • trouble with reading

• There is also evidence that recovery is associated with:

  • Being right-handed

  • Growing up in a home with a mother who is nondirective

  • Having a slower speech rate and more mature speech motor system

t/f stuttering is associated with left-handedness

TRUE GURL

• ome evidence of other factors influencing persistence versus recovery:

  • Mothers of children who recovered used simpler language when talking to their children.

  • White matter tracts in brains of children who recovered may be more developed/mature than those who persisted.

  • Duration of breastfeeding was longer for children who recovered than for persistent children.