V&F Ch 6: Theories About Stuttering

systematic assembly of research findings that enable scientists to explain a phenomenon and predict future occurrence

theory

Theories about stuttering focus on:

• perspectives focus on anomalies in the ____ nervous system that result in a vulnerable speech ____ system

• ______ and ________ influences that may explain it

• perspectives focus on anomalies in the CNS that result in a vulnerable speech production system

• developmental and environmental influences that may explain it

• 
  

Lack of _____ dominance leads to _____ of muscle activation = stuttering

Lack of hemispheric dominance leads to mistiming of muscle activation = stuttering

___-hemisphere delay, ___hemisphere dominance _____ for speech = stuttering

left-hemisphere delay, right hemisphere dominance inefficient for speech = stuttering

•  related to cross talk, wherein left and right hemisphere are supplying redundant or conflicting information, and the crossed signals caused disruptions 

  
  

___ - hemisphere supplementary ____ area, responsible for initiation, planning, and sequencing of movement, is vulnerable to ___ = stuttering

left-hemisphere supplementary motor area, responsible for initiation, planning, and sequencing of movement, is vulnerable to disruption = stuttering

• related to C B G T loop→basal ganglia overactive→ extra dopamine muddles/disrupts timing information 

• too much pressure on RH for language than intended (stuttering)

Theories with stuttering as a disorder of timing:

1. disruption of timing of _____ sequencing = stuttering

2. deficit in ___ timing that regulates speech production and integrates left brain ____ and right brain _____ aspects of speech production; this deficit produces stuttering

1. disruption of timing of muscle sequencing = stuttering

2. deficit in central timing that regulates speech production and integrates left brain segmental and right brain suprasegmental aspects of speech production; this deficit produces stuttering

• left brain in charge of segmental info vs suprasegmental

indiv speech sounds (vowel and consonants) fundamental parts of making a word

• ___ brain primarily handles that, like the core of making speech

• cat vs cut

segmentals

• left brain

PROSODY = stress patterns, intonation, rhythm, “add ons” or enhancements of contextual information 

• stressing noun REcord versus the verb reCORD, or using a rising pitch at the end of a sentence to indicate a question 

• ____ brain

suprasegmentals

• right

Temporal Sequencing Theory

• speech motor control may have shifted to ___ hemisphere, which is not designed for rapid ____ of ____

  • speech motor control ___ and RH ___ disrupt timing

• speech motor control may have shifted to right hemisphere, which is not designed for rapid sequencing of movement

  • speech motor control bad and RH emotion disrupt timing

In typical speech production, it is the _____ hemisphere c____ g____-t_______ loop (BG loop) that is active and where the deficits for stuttering are thought to be located

• BG and its interconnections with the _____ cortex may be critical in providing internal ____ cues to control speech production and how this may go wrong

In typical speech production, it is the _____ hemisphere corticobasal ganglia-thalamcortical loop (BG loop) that is active and where the deficits for stuttering are thought to be located

• BG and its interconnections with the cerebral cortex may be critical in providing internal timing cues to control speech production and how this may go wrong

• when the BG loop malfunctions, there are no appropriate internal timing cues for initiation of ____ and appropriate ____ of movement, coming thru the BG loop

• fluency can only be sustained by _____ timing cues (metronome, etc) coming thru lateral ____ cortex

  • ex: singing in tune, speaking in unison, etc)

• when the BG loop malfunctions, there are no appropriate internal timing cues for initiation of movement and appropriate stoppage of movement, coming thru the BG loop

• fluency can only be sustained by external timing cues (metronome, etc) coming thru lateral premotor cortex

Stuttering as Reduced Capacity for Internal Modeling

• stuttering is thought to result from a weakness in using the ____ model to transform the child’s ____ for the sounds of a word into motor ____ leading to _____ producing speech

• stuttering is thought to result from a weakness in using the internal model to transform the child’s plans for the sounds of a word into motor commands leading to movements producing speech

Stuttering as a Language Production Deficit

• stuttering results from deficits in ____ and ___ the ____ for language production

• language production is monitored ____

• if problem in _____ plan is in error, production ___

• repetitions, prolongations, and blocks can all be explained by different responses to an ___

• stuttering results from deficits in planning and assembling the units for language production

• language production is monitored internally

• if problem in phoneme plan is in error, production halts

• repetitions, prolongations, and blocks can all be explained by different responses to an error

• analogy can be made of a bicycle production plant

Stuttering as a Multifactorial Dynamic Disorder

• no cause of stuttering but an array of factors contributing to it

  • problem is to find relevant factors and discover how they interact

  • see stuttering as “____ ” bc behaviors are only ____ features of ever-changing process

    • underlying factors= linguistic load, speech motor instability, emotional stress, etc

• multiple _____ interact result in stuttering

• no cause of stuttering but an array of factors contributing to it

  • problem is to find relevant factors and discover how they interact

  • see stuttering as “dynamic” bc behaviors are only surface features of ever-changing process

    • underlying factors= linguistic load, speech motor instability, emotional stress, etc

• multiple stressors interact result in stuttering

what is a physiologial tremor

factor that may make the initial disorder more severe

physiological tremors are the most important elements in more ____ stuttering

• found tremors in ____ children who stuttered but not ____ children

• tremors may be evoked or amplified by ____

physiological tremors are the most important elements in more ____ stuttering

• found tremors in older children who stuttered but not younger children

• tremors may be evoked or amplified by emotion

Tremors may develop when speech or stuttering is associated with ___

• this may occur when stuttering has been associated with fear, embarrassment, or other ____ emotions

Tremors may develop when speech or stuttering is associated with emotion

• this may occur when stuttering has been associated with fear, embarrassment, or other negative emotions

Diagnostic Theory

Stuttering may result when parents _____ their child’s normal _____ as stuttering

• thought children who were _____ by their parents or other listeners developed ____ and ____ in their speech in an effort to avoid disfluencies

• thought children who were misdiagnosed by their parents or other listeners developed tension and hesitation in their speech in an effort to avoid disfluencies

did the diagnostic theory data collection make sense?

no the interpretations were conflicting with each other

• one said typical children first disfluencies were similar to stutters and other study found they were very different

Communicative Failure and Anticipatory Struggle

• in many cases, stuttering begins when a child finds talking ___

• ____ difficulty in talking produces ____ and _____ of speech

• leads to more _____ and _____ in communication, which ______ anticipation of ____

• in many cases, stuttering begins when a child finds talking difficult

• anticipated difficulty in talking produces tension and fragmentation of speech

• leads to more frustration and failure in communication, which increases anticipation of difficulty

Capacities and Demands

• stuttering may emerge when child’s _____ for _____ are overwhelmed by ____

• stuttering may emerge when child’s capacities for fluency are overwhelmed by demands

  • Capacities: Child’s ability to plan and program for language while making fast, coordinated movements for speech.

  • Demands: Some children’s advanced conceptual and linguistic abilities; models of rapid and complex speech and language in environment; emotional stress on child from environment.

Capacities and demands theory leads to treatment based on reducing ____ and, when possible, increasing ____ .

Capacities and demands theory leads to treatment based on reducing demands and, when possible, increasing capacities.

early stuttering, near the onset of the disorder, that is usually characterized by loose, easy repetitions

• children assumed to be unaware of this and not react to it

primary stuttering

stuttering with tension and struggle and sometimes escape behaviors and avoidances

• in some views seen to be reaction to primary stuttering as children become self conscious

secondary stuttering

process of building maps that code the motor commands to hit the auditory targets that the speaker intends; a bidirectional process in which maps that code the motor commands are adjusted if errors detected

sensorimotor modeling

the targets that contain auditory info and info about movements of articulators

sensory targets