Assessment of Fluency D/o

Question 1

What is fluency?

Answer 1

Speech that is flowing, effortless, smooth, rapid, continuous…No muscular/ideational effort

Question 2

When is fluency enhanced?

Answer 2

Good knowledge of matter
Intact speech and lang related neuromuscular mech
An environment free from distractions

Question 3

What causes fluency d/os?

Answer 3

Genetic 45-50%

Environmental factors: abuse, neglect, demanding family structure

Question 4

What is capacity/demands model?

Answer 4

Demands for fluency from social env exceed cog linguistic motor or emo capacities for fluent speech

Question 5

What are types of fluency d/os

Answer 5

Stuttering, cluttering, neurogenic stuttering, malingered stuttering

Question 6

What is most common d/o of fluency

Answer 6

Stuttering

Question 7

What is stuttering? When is onset?

Answer 7

Characterized by increased rate of dysfluencies. Onset early between 18 months and 4 years. Prevalence higher in those w/ intellectual disabilities

Question 8

Who is at higher risk for stuttering?

Answer 8

African American/Carribean higher risk, hispanic and asian closer to US population

Question 9

What must be looked at with stuttering?

Answer 9

How culture responds to stuttering

Question 10

How to define/measure stuttering? What must be looked at? What is diagnostic criteria?

Answer 10

Speech with 5% dysfluency rate, part word repititions, speech sound prolongations and broken words (3%). Must look at umber of times a segment is repeated and muscular tension/effort. Look at duration of stutter (anything longer than 1 second is stuttering)
Will see excessive muscular tension, unusually long duration of prolongations, multiple units of repetitions. Diag criteria is frequency.

Question 11

What are dysfluency types?

Answer 11

Repetitions, Prolongations, Interjections, silent pause, broken words, incomplete phrase, revisions

Question 12

Repetitions

Answer 12

Speech is repeated
Part word (t t t take)
Whole word (what what what)
Phrase rep (i want to i want to)

Question 13

Prolongations

Answer 13

Durations of speech segments, often sound or syllable that is longer than expected
Sound/syll prolongations (lllllllet me do it)
Silent prolongations (pauses/block and posture face)

Question 14

Interjections

Answer 14

Elements of speech that dont add to meaning of what is sad
Sound/syll (um um)
Whole word (i had a well problem)
Phrase interjections (i had a you know problem )

Question 15

Silent pauses

Answer 15

I was going to the [pause] store

Question 16

Broken words

Answer 16

It was won[pause]derful

Question 17

Incomplete phrase

Answer 17

He wanted to- I think I won’t say any more

Question 18

Revisions

Answer 18

I will take a taxi, a cab

Question 19

What is an issue in measuring dysfluency?

Answer 19

Reliability! Must look at definition of stuttering, observer must know what it is, experience. Look for chained dysfluencies- do they happen in a row? Certain types of dysfluencies (part word rep more indicative of stuttering…)

Question 20

What can be done to control for stuttering variability?

Answer 20

Recording one or more conversational samples, recording an oral reading sample, recording a monologue, sample from home, listen once without counting dysfluencies, count on second, listen again and recount, count again if inconsistent, count dysfluencies in oral reading!

Question 21

What are some additional features associated with stuttering?

Answer 21

Motor behaviors- clenched jaw, wrinkling of forehead, hand clenching, hit self…
Management of airflow- Speak on limited shallow inhalation, run out of air, dysrythmic inhalation
Negative emotions- fear, frustration, negative statements about selves, impression that others are impatient/embarassed
Avoidance bx- whisper, unusual posture, pretend ignorance, pretend to think of answer, avoid certain people

Question 22

What can we do to help w/ avoidance bx in stuttering?

Answer 22

Talk about stuttering and emotional experiences associated, talk as much as possible

Question 23

What is neurogenic stuttering? Who does it affect?

Answer 23

Found mostly in adults, may be in kids with stroke, epilepsy, or TBI. Associated with strokes in absence of aphasia, drug toxicity, dementia, brain tumor…

Question 24

What is cluttering? What is associated with it? What is it characterized by?

Answer 24

Affects speech rate, but may involve lang and thought processes. Someone who clutters is likely to stutter, not vice versa. Characterized by rapid and irregular speech rate and indistinct articulation. Worsening of dysfluencies when relaxed and when reading a well known text. Confomitant lang problems- in conjunction w/ cluttering. Disorganized thought processes, motor coord, reading a writing difficulties…

Question 25

What is malingering?

Answer 25

Feigned stuttering for the purpose of receiving some type of external benefit.
Get out of work, avoid service/jail, lawsuits/scam

Question 26

How do we know its stuttering v cluttering?

Answer 26

If overall dysfluency rate exceeds 5% of words, child exhibits long silent and audible prolongations even though frequency below accepted criterion. Presence of associated motor behaviors, negative emotions and feelings, mismanagement of airflow and avoidance bxs…

Question 27

How do we know it’s cluttering v stuttering?

Answer 27

Overall rate of speech too fast, articulatory breakdown cause reduced intelligibility. Dysfluencies worsen when relaxed/reading. Voice prob, reading, writing prob. Unconcerned about problem.