Fluency Disorders Exam #1

as apposed to “stutterers”, use

“people who stutter”

Differences in white matter

PWS have extra gyri in the superior bank of Sylvian fossa (has extra bumps)

adolescents who stutter have more white matter connections in the …

right hemisphere

early definition of stuttering

1920: “neurotic disorder, personality disturbance.”

1930: “epileptic and neuromotor disorder.”

fluency

the effortless flow of speech; factors include rhythm, rate, intonation, and stress

fluency disorder

abnormal fluency, rate, and rhythm of speech

2 main types of fluency disorder

1. stuttering

2. cluttering

Wendell Johnson’s stuttering definition

anticipatory apprehensive hypertonic avoidance reaction

Wingate definition of stuttering

a disruption in fluency of verbal expression characterized by involuntary, audible or silent, repetitions or prolongations, which may be accompanied by accessory activities and emotional states

Van Riper definition of stuttering

stuttering occurs when the forward flow of speech is interrupted by a motorically disrupted sound, syllable, or word, or by the speaker’s reaction thereto.

stuttering is a _______ problem

communication

3 ways chronic stuttering may affect PWS

1. socially

2. vocationally

3. psychologically

etiology

cause

impairment

the stuttering itself

disability

limitation in ability to communication

handicap

limitations in an individual’s abilities to fulfill rolls in life events

core behaviors (basic behaviors)

• repetitions

• prolongations

• blocks

2 types of blocks

1. tonic

2. clonic

tonic block

continuous, inappropriate contraction of articulatory musculature. Too much pressure/tone

clonic block

alternating cycles of tension and release

escape behaviors

eye blinking, head noddingav

avoidance behaviors

changing the word altogether

ABC of stuttering

A: affective

B: behavioral

C: cognitive

example of affective reaction

anxiety or fear

example of cognitive reaction

lack of self confidence and low self esteem

attitudes in stuttering

feelings that are pervasive or a part of a person’s belief system

2 main types of disfluncies

stuttering like disfluency (SLD) and other disfluency (OD)

SLD

part word repetitions, whole word, dysrhythmic phonations, prolongations and blocks

OD

disfluencies present in the speech of everyone

what is epidemiology

a. how many persons affected?

b. what segments of the population?

c. when does it happen and how long does it last?

d. is it familial?

e. what are its signs and symptoms

incidence

how many people have EVER stuttered

prevalence

how many people continue to stutter

% of incidence

% of prevalence

5%

1%

gender ratio

near onset- 2:1 males to females

later on- 5:1 males to females

% of natural or spontaneous recovery

75%

when does onset happen?

16-60 months

mostly 25-36 months

of all those who ever begin stuttering, about _____ continue to stutter beyond ______ past onset.

a. 25%

b. 4-5 years

strongest indicator of stuttering

family history of persistance

greatest risk for stuttering is prior to age

3

critical period for onset

2-4 years old

theory

an explanation of a phenomenon that has been supported by consistent, repeated experimental results

model

a verbal, mathematical, or visual representation that allows scientists to explain and test theories

theory of incomplete cerebral dominance

stuttering due to lack of any clear cerebral dominance over speech function by one of the 2 hemispheres

• Orton and Travis

Freud’s psychoanalysis theory

stuttering was an overt symptom of conscious conflict between child and parent

a. based on the belief that stuttering satisfies repressed needs

• Freud

diagnosogenic theory

stuttering began from the parents’ reactions to disfluencies and making child afraid to speak wrong.

• Wendell Johnson

tudor study (monster study)

attempt to infect with stuttering

• Wendell Johnson

anticipatory-avoidance theory

due to negative past experiences, PWS will anticipate difficulty with a sound or word, which leads to struggle

• Oliver Bloodstein

capacity and demand

when the communicative demands on a child are larger than their capabilities, disfluencies are the result.

Approach avoidance theory

desire to communicate versus drive to avoid speech anxiety

• Joseph Sheehan

covert

feelings, things unseen

overt

visible symptoms

example of demand

family speech language behaviors

stuttering is a ______ that changes over time

behavior, phenotype

multifactoral model of stuttering

views stuttering as an imbalance between various factors

• physiological

• speech and language

• environment

• personality

stuttering is marked by definite changes

• loss of existing normal function

• appearance of unusual speech characteristics

traditional view of stuttering onset

a. mild

b. easy repetitions

c. no tension

d. gradual

e. no awarenesss

normally fluent children show consistent awareness of fluency by age

5

early symptoms variable in

type and frequency

onset may be

gradual OR sudden

T or F: normal disfluencies are not shaped into stuttering

True

early on, stuttering onset and development were characterized by 4 features

1. uniformity in gradual appearance

2. uniformity in repetition

3. uniformity in lacking tension

4. uniformity in awareness

Froeschel’s stuttering development

only in rare cases did the beginning of stuttering deviate from the traditional pattern

Bluemel’s stuttering development

• primary stuttering: pure speech disorder, no tension or awareness

  • secondary stuttering: begins when child becomes more aware

most important feature of Bluemel’s model

the assumption that early symptoms are essentially normal disfluencies or develop from them.

Bloodstein Continuity Hypothesis

stuttering comes out of normal disfluencies instead of defining stuttering as its own entity