Fluency and Fluency Disorders

behaviorism

- the physical aspects we can see and hear about stuttering

- stuttering happens because of motor movements

social constructivism

- concerned with the internal fears / their mental health that comes with stuttering

stuttering - behaviorist

- disruption in the fluency of verbal expression which is characterised by involuntary, audible or silent, repetitions, or prolongation in the utterance of short speech elements (sounds, part-words, and words of one syllable.) disruptions usually occur frequently or are marked in character and are not readily controllable)

- what we can OBSERVE

when does stuttering stat

- between 2 and 6 years of age. Many children go through normal periods of disfluency lasting less than 6 months. Stuttering lasting longer than this may need treatment. There is no one cause of stuttering

- Developmentally, there is a normal thing called "normal disfluencies" because of increase of syntax and such, then it kind of just goes away around 4-5 years (for typical child)

disfluencies behaviors

- interjections

- multi-syllable word repetitions

- phrase repetitions

- revisions

- incomplete phrases

- broken words

- word final disfluencies (rare)

- mid-word insertions (rare)

stuttering behaviors

- sound and part-word repetitions

- word repetitions that are single syllables

- sound prolongations

- blocks

primary characteristics

- things you can HEAR

secondary characteristics

- things you can SEE (excessive blinking)

stuttering - social constructivism

- everything in the behaviorist stand point and...

- Stuttering's impact on the person's ability to function in their everyday life

- What social activities or functional activities can the PWS not carry out due to their stuttering

ways of assessing stuttering

- counting the number of stuttering instances in either a minute of talking or every 100 words or syllables spoken

- counting the length of the stuttering moments

- documenting any physical characteristics that accompany stuttering moments (secondary characteristics, not every stutterer will have secondary characteristics if they are more on the mild side)

- Alternative methods assess the patient / client's feelings about their stuttering using various questionnaires (social constructivist)

causes of suttering

- cerebral dominance (neurological)

- genetics

- environmental / learning theories (big family and has to compete to speak)

- Neurological basis

- it's caused by several factors, not just one!!!

fluency shaping in the therapy room

- teaching:

- slower speaking

- light articulatory contacts

- easy onset for words

- reduce tension / relaxation

- deliberately pausing between words or phrases to allow for a smoother flow of speech

- using prolonged speech (stratchy)

- improving breathing patterns

stuttering modification

- Goal is limit the effects of stuttering (stuttering less severely, understanding and coping with one's stuttering

- includes: identification of stuttering and associated behaviors, desensitization to stuttering, variation of the speech signal to reduce tensions or severity, and stabilization of these techniques

- SLP will teach self-advocacy

- SLP will work with the client to have them stutter on purpose so they feel a sense of control of their speaking

- SLP will teach strategies to lessen severity of stuttering (cancellations, pullouts, preparatory sets, and postponements)

other treatments

- Pharmacological treatment

- Fluency enhancing devices

cluttering

- talking so fast it kind of sounds like they are mumbling

- kind of sounds slurred because they are talking so fast