5240 FInal Exam

T/F: 1% is the prevalence rate of stuttering

true

What is the incidence rate of stuttering?

5%

Between what age does stuttering most commonly begin?

2-5 years

T/F: The approximate number of children who will recover from stuttering without intervention is 80%

true

The male to female ratio of stuttering unschool children is

3:1

The male to female ratio of stuttering in very young children who stutter is

1:1

T/F: Gender, age at stuttering onset, and phonological skills tend to be good predictors of whether a child's stuttering will resolve on its own without therapy.

true

Escape behaviors include

** all of the above

• eye blinking

• head nod

• interjections of extra sounds

Blocks can occur at which level of speech production

** all of the above

• respiratory

• laryngeal

• articulatory

Avoidance behaviors

happen before core stuttering behaviors would take place

T/F: "Prevalence" of stuttering measures how many people currently stutter

true

"Developmental" stuttering

is the most common form of stuttering

"Core" stuttering behaviors include

repetitions, prolongations, blocks

In what situations is stuttering likely to decrease

• when speaking to a baby or young child

• when speaking to one's pet

T/F: The ratio of males to females who stutter decreases as children get older

False

Congenital and early childhood factors

** all of the above

• can be associated with stuttering even if there is not family history of stuttering

• can include physical or psychological trauma

• can cause stuttering even if there is not a genetic predisposition for stuttering

many studies show that people who stutter

have slower reaction times than people who don't stutter

Studies have shown that the brains of people who stutter, when compared with non stutters, may have differences in function or structure

** all of the above

• basal ganglia

• Broca’s area

• planet temporale

T/F: Studies of the brain show that people who stutter have greater left hemisphere activity when speaking as compared to typically fluent speakers

false

Tests of central auditory processing have shown that

**none of the above

• stuttering and normal disfluencies are entirely different phenomena

• there is no difference in auditory professing between people who stutter and those who don't

• people who stutter have difficulty hearing themselves talk

We think that genetics play a role in stuttering because

** all of the above

• the stuttering of boys is more likely to persist when compared to girls

• most people who stutter have a family history of stuttering

• we have identified specific chromosomes that may carry genes for stuttering

Substitutions, circumlocutions, and postponements

are ways to avoid saying a word

Situations that can cause typical disfluencies to increase include

** all of the above

• stressful times, such as a death in the family or birth of a new sibling

• when competing to be heard, such as with a sibling

• exciting times that disrupt routines, such as going on vacation.

situational avoidance can include

** all of the above

• asking a friend to order for you in a restaurant

• emailing when it would be better to call someone

• not asking for directions when lost.

secondary behaviors

** all of the above

• include tension in reaction to disfluency

• are a sign of stuttering, rather than normal disfluency

• include pauses or interjections before disfluencies.

normal disfluency can be distinguished from stuttering by

** all of the above

• the number of units in each repetition or interjection

• the types of disfluency

• the amount of disfluency

Efforts to get out of a block may include

** all of the above

• snapping one’s fingers

• jerking one’s head

• blinking one’s eyes

compared with borderline stuttering, beginning stuttering is characterized by

faster repetitions of stuttered syllables

blocks

can be felt in the larynx, lips, or elsewhere

A person with intermediate stuttering

tends to anticipate and avoid saying difficult sounds

theoretical perspective on stuttering include

** all of the above

• stuttering as a disorder of brain organization

• stuttering as a disorder of timing

• stuttering as a language production deficit

the "demands and capacities" model proposes that stuttering can develop

** all of the above

• when parental expectations are too high

• when children place too many demands upon themselves

• if children with limited speech production capacities grow up in an environment with normal levels of demand.

between the ages of 3 and 4

Children begin to compare their own behaviors with those of their peers

stressful speaking situations for children include

** all of the above

• parents who speak rapidly

• when children place too many demands upon themselves

• parents who use overly complex syntax

according to some theories, stuttering would most likely develop in

a child with advanced language development and delayed motor development

According to Wendell Johnson's Diagnosogenic Theory

stuttering can arise from parents overreacting to normal disfluencies

for young children, treatment for stuttering may involve

lessening demands on the child, rather than treating the disfluencies directly

parents can help improve the linguistic environment of a child who stutters by

** all of the above

• slowing their speech rates

• interrupting less

• having dedicated one-on-one conversations with their child

put the following developmental levels of stuttering in the correct order form least severe to most severe

1. typical disfluencies

2. borderline stuttering

3. beginning stuttering

4. intermediate stuttering

5. advanced stuttering

T/F: The severity of a client's stuttering cannot be determined on the Stuttering Severity Instrument - (SSI-4)

false

T/F: The frequency score on the Stuttering Severity Instrument-4 (SSI-4) is derived from % syllables stuttered

true

According to de Sonneville-Koedoot et al. (2015), which of the following is true about direct treatment (the Lidcombe Program) versus indirect treatment (RESTART)?

• at 18 months, clinical outcomes for direct and indirect treatment were comparable

• direct treatment decreased stuttering more quickly during the first three months of treatment

According to Plexico and Burrus (2012), which of the following are true about parents with a preschooler who stutters?

• parents don't necessarily know which disfluencies in their children's speech should be considered typical

• parents are uncertain about whether stuttering should be acknowledge in the home

• parents seek speech services due to concerns about their child's future, bullying, and negative emotions

Plexico and Burrus (2012) found that, before their child was enrolled in speech therapy for stuttering, parents would often engage in which of the following behaviors?

• telling the child to slow down his/her rate of speech

• instructing the child to breathe

- instructing the child to breathe

- telling the child to think about what they want to say

- actively listening to the child

- reducing time pressure

children with borderline stuttering

likely have an innate predisposition toward disfluency

parents of a child with borderline stuttering

may feel they caused their child to stutter

when starting to work with a child with borderline stuttering, the clinician should

begin working with the family immediately

indirect treatment for a child with borderline stuttering

is largely based on reducing stresses on the speaker

Speech patterns in some homes that might put pressure on a child include

** all of the above

- high speech rates

- lack of pauses between speakers

- advanced levels of syntax

Children with borderline stuttering

may be particularly sensitive to speech patterns that are common in many homes

an important aspect of indirect treatment for borderline stuttering is for a parent

** all of the above

- to spend one-on-one time with the child each day

- to engage in non directive play with the child

- to show understanding of the child's feelings

Having a child produce intentional stutters for his or her own parents

** all of the above

- helps desensitize the child to stuttering with his or her peers

- helps desensitize the parents to their child's stuttering

- can give the child a feeling of accomplishment

when children are able to modify their own stutters in the clinic

they should be praised for slower and easier stutters

treatment for a child with beginning stuttering

includes daily practice of fluency

in the Lidcombe Program

parents conduct daily treatment sessions

during weekly Lidcombe sessions

** all of the above

- the clinician demonstrated to the parent how to conduct daily sessions

- the parent and the clinician discuss the child's speech while the child is present

- the clinician assess the child's fluency

Verbal contingencies in the Lidcombe Program

** all of the above

- include pointing out a stutter

- might include, "That sounded a little bumpy."

- are given in a ratio of about 5 praises for fluency to 1 contingency for stuttering

a child with beginning stuttering

will have part-word repetitions as the predominant core stuttering behavior

T/F: when beginning to model easy stutters, the clinician makes accepting comments about his or her own stutters

true

T/F: "playing" with stutters tends to make a child more self-conscious of his or her own stuttering

false

T/F: The RESTART-DCM therapy approach is based on decreasing pressure in the child's environment and eventually reinforcing the child's capacities.

true

T/F: Mirror work can help clients identify what it is they do when they stutter.

true

T/F: we would not typically encourage our clients to stutter on purpose and/or stutter in a different way in our sessions

false

T/F: Contrasting normal speech production with soft starts can be a helpful way for clients to understand the technique.

true

which of the following are representative of soft starts

- "easing" or "flowing into" the sound with smooth airflow and voicing

- saying a word in a slower, easier way at the beginning

Stuttering can be compared to an ____ because the bulk of stuttering (especially emotional and cognitive effects) is not easily observed by listeners and is "below the surface"

iceberg

T/F: Helping clients to have a slower rate will necessarily mean that their speech will sound a bit disconnected or choppy due to lack of flow.

false

How can we achieve rate change

??

- pausing and phrasing

- stretching sounds and syllables

- combining stretchy speech with pausing and phrasing

what is the hierarchy of prompting that we typically use with clients when teaching them a new skill?

1. the clinician models for the client

2. the client and clinician practice together

3. the client is asked to demonstrate the skill independently

Which of the following are benefits of voluntary stuttering

- desensitizes client to listener reactions

- decreases fear and avoidance

- helps clients to confront word and situations that they might otherwise avoid

explaining how the speech mechanisms work

exploring talking

developing a personal "iceberg" to identify stuttering behaviors

exploring stuttering

using soft starts

changing the way the client talks