9/9/13- Fluency Lecture 2 & 3 Flashcards

1
Q

Who said, “Stuttering is characterized by an abnormally high frequency and/or duration of stoppage in normal flow of
speech.”

A

Peters & Guitar

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2
Q

Who said, “Stuttering is the result of a conflict between opposed urges to speak and to hold back from speaking.”

A

Sheehan

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3
Q

Who said, “Stuttering is the disorganization of normally fluent speech that is a consequence of conditioned emotion…it is the fluency failure that results when conditioned stimuli evoke a disruptive emotional response.”

A

Brutten and Shoemaker

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4
Q

Who said, “Stuttering consists of disorders of rhythm of speech, in which the individual knows precisely what he wishes to say, but at the same time is unable to say it because of an involuntary repetition, prolongation or cessation of a sound.”

A

World Health Organization

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5
Q

Who said, “Stuttering is an anticipatory, apprehensive, hypertonic, avoidance reaction.”

A

Johnson

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6
Q

Who said, “Stuttering occurs when the forward flow of speech is interrupted by motorically disrupted sound, syllable, or word….or by the speaker’s reaction thereto.”

A

Van Riper

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7
Q

Who said, “Stuttering is the disruption in the fluency of verbal expression characterized by the involuntary “,…. audible or silent repetitions or prolongations… “in the utterance of short
speech elements such as sounds syllables and words of one syllable. The disruptions usually occur frequently, marked in character, and are not readily controllable”

A

Wingate

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8
Q

Who said, “Stuttering is speech that is produced intermittently with excessive force.”

A

Starkweather

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9
Q

Who said, “Whatever the source of stuttering is, it is not amenable to the treatment I have developed. Therefore, I refuse to deal with it further.”

A

Sigmund Freud

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10
Q

Who said, “The lack of cerebral processing center on one side of the brain which was powerful enough to impose it’s timing patterns on the other hemisphere was viewed as basic, organic factors in stuttering.”

A

Van Riper, 1982

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11
Q

True or false:

Stuttering is not difficult to define or operationalize?

A

False

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12
Q

True or false: stuttering is more than just simply the number and type of disfluency?

A

true

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13
Q

What makes stuttering so complex?

A

Emotion, cognitive & behavioral reactions

*** like an iceburg- you see the tip of the iceburg above the water, but there is much more to be uncovered below the surface.

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14
Q

How did Sigmund Freud view stuttering?

A
  • as a neurotic disorder
  • personality disorder
  • a reflection of simultaneous & competing desires to talk & remain silent.
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15
Q

Who developed the Cerebral Dominance Theory?

A

Dr Samuel Orton & Dr. Lee Edward Travis (1920s)

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16
Q

What does the Cerebral Dominance Theory say?

A
  • Lack of central synchronization so the muscles of speech would be smoothly coordinated. The midline didn’t act in concert with the pacing provided by the dominant hemisphere.
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17
Q

Who said, “The lack of cerebral processing center on one side of the brain which was powerful enough to impose it’s timing patterns on the other hemisphere was viewed as basic, organic factors in stuttering.”

A

Van Riper

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18
Q

Who founded the Diagnostic/Semantogenic Theory?

A

Dr. Wendell Johnson (1930s)

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19
Q

What is the Diagnostic/Semantogenic theory?

A

It says that stuttering is in the ear of the listener and it is caused by undue attention to normal disfluency

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20
Q

Which theory is referred to as the blame game?

A

Diagnostic/Semantogenic theory

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21
Q

Who was one of the major father’s of our field?

A

Dr. Charles Van Riper

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22
Q

What was the therapy approach that Dr. Charles Van Riper developed?

A

The Van Riper/Iowa Therapy (1940s)

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23
Q

What were the goals of the Van Riper/Iowa Therapy approach / Stuttering Modification Therapy?

A
  1. Reduce the feelings of shame and anxiety. Desensitization oneself.
  2. Teach stutters to modify the way they stutter.
    * focused on the stuttering itself and to change the stuttering
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24
Q

What therapy technique resulted from the Van Riper/Iowa Therapy approach?

A

Stuttering Modification Therapy

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25
Q

What are the 5 components of stuttering modification therapy?

A
  • Cancellation
  • Fake or Voluntary stuttering
  • Pullouts
  • Bounce
  • Preparatory sets
26
Q

What is cancellation?

A
  • cancel stutter by saying the word again without accessory characteristics
  • intended to reduce anxiety and negative emotions
  • designed to cancel old learning stuttering patterns by using newly learned, controlled patterns
  • Uses self- confrontation and evaluation (not ashamed)

** give client ways to stop cancellation to make speech more smooth.

** Stop the stutter midstream and break the pattern

27
Q

What is fake or voluntary stuttering?

A
  • Stuttering voluntarily
  • client is controlling speech
  • intended as tension/stress reducer (** because they are not stressed that can help form their articulation)
  • Stuttering is in the “open”
  • Builds confidence
28
Q

What are pullouts?

A
  • Stop the stutter when it occurs (don’t complete it)
  • The stop is done instantaneously
  • Modify mid-stutter
  • Use small exhalation of air, insert /h/, extension of sound, shorten sound if prolonged, reduction of tension in speech mechanism
29
Q

What is bounce?

A
  • Stuttering more easily
  • Easy repetition of stuttered syllable

** I want the bbbbbb-ball, is said with less tension

30
Q

What are preparatory sets?

A
  • Adopt a different tension free appropriate ‘preparatory set’
  • ‘set’ the articulators in the correct, relaxed position ensuring air flow before saying sound
  • Avoid stopping
  • identify upcoming problem and plan
31
Q

Which components of stuttering modification therapy is the easiest to hardest?

A
  • Fake or voluntary stuttering
  • Cancellation
  • Pullouts
  • Bounce
  • Preparatory sets
32
Q

Boberg and Kully Therapy Method is what type of therapy?

A

Fluency Shaping Therapy

33
Q

What is the goal of The Boberg and Kully Method?

A

Reduce or eliminate the amount of stuttering

34
Q

What therapy methods fall under Fluency Shaping Therapy?

A
  • Boberg & Kully Therapy Method
  • Speech Processing Therapy
  • Precision Fluency Shaping
  • Onslow & Packman Program
35
Q

What is the most important phase of the Boberg and Kully method?

A

Establishing a baseline

36
Q

What is the primary factor for The Boberg and Kully method?

A

Therapy intensity

37
Q

What are the phases of the Boberg and Kully method?

A
  1. Establish a baseline
  2. identification of stuttering patterns
  3. Early modification using fluency skills:
    - easy onset
    - soft contact on consonants
    • short phrases
    • continuous airflow
  4. Begin with one word or syllable, progress to two words or syllables etc…getting more complex as techniques are mastered.
    Clinician looks to see if client is fluent 75% of the time before they move onto the next phase.
  5. Prolonged speech mastery. May or may not be part of the program
  6. Normalizing rate and correcting errors using cancellations
  7. Self-monitoring normal sounding speech
  8. Transfer to normal sounding speech in non-clinic settings
38
Q

How do you establish a baseline for fluency shaping therapy?

A
  • interview
  • observe
  • review case history

** getting a baseline of the behavior your client is exhibiting both orally and physically (by looking for secondary behaviors)

39
Q

In the Boberg and Kully Method what are some fluency techniques used? And what is the most important?

A
  • easy onset
  • soft contact
  • short phrases
  • continuous airflow ** this is the most important
40
Q

What is the goal of Speech Processing therapy?

A

Changing what people do when they produce speech so that the result will be fluent

41
Q

Who discovered Speech Processing Therapy?

A

Dahm 1997

42
Q

Does Fluency Shaping therapy focus on fluency or the stutter?

A

Fluency

43
Q

Does Speech Processing therapy focus on fluency or the stutter?

A

Fluency

44
Q

What are the components of Speech Processing therapy?

A
  • Attend to vocal fold vibration during production of multisyllabic words
  • Progress to spontaneous speech
45
Q

Does Stutter modification therapy focus on fluency or the stutter

A

Stutter

46
Q

Who developed Precision Fluency Shaping Therapy?

A

Webster (1966)

47
Q

What are the steps for the Speech Processing Therapy?

A
  1. Simple to complex using set phrases (similar to Boberg)
  2. Short speech utterances moved to longer speech utterances
  3. Slow production to a normal rate (extended phonation eliminates stuttering)
  4. Intentional behaviors to habitual behaviors (* working on slowing rate. Stretching the speech out.)
  5. Low anxiety situations to high anxiety situations (* in therapy work on small units of sounds and move to sentences and conversations then bring someone else into therapy room or use phone)
  6. Clinical evaluation to self evaluation (* client evaluating themselves)
48
Q

What are the sounds classified into for Precision Fluency Shaping method?

A
  • Vowels
  • Voiced continuants / nasal
  • voiceless fricatives
  • Plosives
49
Q

What is practiced with the Precision Fluency Shaping method?

A

Sound behavior targets are practiced sequentially with emphasis on gentle onset of voicing.

  • like a preparatory set
50
Q

What are the 4 sounds of Precision Fluency Shaping therapy compared to?

A

The baseline

51
Q

Of the 4 sound classes for Precision Fluency Shaping method, which has the most airflow? Least airflow?

A

Vowels (most)

Plosives (least)

52
Q

What does the Onslow and Packman Program focus on?

A
  • The behavioral program focusing on prolonged speech through operant conditioning
  • controlled speech
53
Q

What year was the Onslow and Packman Program developed?

A

1997

54
Q

What are the pre-treatment issues for the Onslow and Packman Program (factors for success in the treatment)

A
  • quality of life
  • drive (does client have drive to change behavior?)
  • anxiety or stuttering (will the anxiety get in the way?)
  • sufficiently organized (are they organized in other aspects of life?)
  • self or others motivate (do they have support?)
55
Q

What are the components of the Onslow and Packman Program?

A
  • Easy talking
  • prolonged speech
  • move into natural sounding speech
56
Q

What are the differences between Stuttering Modification Therapy and Fluency Shaping Therapy in regards to Speech behaviors?

A

Speech Modification therapy- Stuttering

Fluency Shaping Therapy- Fluency, deal with stutter

57
Q

What are the commonalities within all the methods in Fluency Shaping Therapy?

A
  • establishing extensive baseline data
  • ongoing data collection
  • teaching easy talking/onset strategies
  • establish improved fluency in therapy gradually in a structured/sequential manner
  • start with short speech units: syllables, words, phrases, and then move into larger ones
  • take learned strategies and shape into normal speech (*goal is to make speech more normal/natural)
  • transitioning learned fluent patterns out into the real world
  • very little or no focus on negative feelings, fear, or avoidance repression (*similar to stuttering modification therapy
  • some have intensive components (*Boberg & Kully)
58
Q

What are the differences between Stuttering Modification Therapy and Fluency Shaping Therapy in regards to data?

A

SMT- no info avail

FST- baseline and ongoing data collection

59
Q

What are the differences between Stuttering Modification Therapy and Fluency Shaping Therapy in regards to feelings and attributes?

A

SMT- boost confidence. A lot of emotion

FST- don’t address the feelings. It is a by product

60
Q

Review from 9/9

What are the two types of stuttering behaviors?

A
  • Core behaviors

- accessory behaviors

61
Q

What are the differences between Stuttering Modification Therapy and Fluency Shaping Therapy in regards to clinical method?

A

SMT- pullouts, stopping and fix

FST- ignore stutter and focus on fluency. Get in front of the stutter.