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Fluency Disorders > Basic Principles And Theoretical Foundations Of Stuttering > Flashcards

Basic Principles And Theoretical Foundations Of Stuttering Flashcards

0
Q

From the ABC theory of stuttering, define the Affective components.

A

Stuttering is a complex, intricate disorder involving cognitive processes associated with emotions elicited by communication failures. Situational anxiety is a result of stuttering.

Includes: emotions, self-concepts, grief, temperament

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1
Q

Who is associated with the Affective, Behavioral, & Cognitive Components of stuttering?

A

Bennett

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2
Q

Define emotion.

A

The affect aspect of consciousness, a state of feeling.

Variable based on present environmental stimuli, variable, not always conscious, an immediate evaluation of the likelihood of survival

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3
Q

What is the process of emotional development?

A

Primary emotions, exposed emotions, and evaluative emotions

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4
Q

Define primary emotions.

A

Develop early in childhood.

Happiness, sadness, anger, fear

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5
Q

Define exposed emotions.

A

Develop along with self awareness

Embarrassment, empathy, envy

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6
Q

Define evaluative emotions.

A

Develops with the acceptance of societal rules and standards

Pride, embarrassment, shame, guilt

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7
Q

At what age are most of emotions in place?

A

3 years old

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8
Q

What are core emotions?

A

Emotions that are experienced repeatedly and are often difficult to acknowledge.

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9
Q

What may suppressed emotions lead to?

A

negative self-esteem.

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10
Q

Describe the cycle of stuttering and emotions.

A

Stuttering leads to negative emotions which leads to stuttering, which leads to more intense emotions, leading to stuttering which leads to more negative emotions…

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11
Q

What are two negative self-attributes that often develop with stuttering?

A

Interpersonal and interpersonal.

They often lead to more severe stuttering patterns, increased secondary behaviors, and social consequences.

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12
Q

What does a healthy, balanced emotional life require?

A

Experience a feeling, recognize, accept, and express it, and then let it go.

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13
Q

What are the three emotions of stuttering?

A

Anger, guilt, and shame

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14
Q

Define anger.

A

A strong feeling of displeasure, considered an emotion of choice, an emotion that may block the awareness of other painful emotions.

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15
Q

What are the side effects of anger?

A

Belief system becomes inflexible, feelings of helplessness, shifts responsibilities onto someone else

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16
Q

How to reduce anger:

A

Not victims of own emotions, creative problem solvers, adequate view of selves and others, and develop our emotional self reliance

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17
Q

Name 6 sources of guilt.

A
  1. Primary guilt (precedes and leads to stuttering- it is wrong)
  2. Secondary guilt (feeling of failure after stuttering- easy to fix, just slow down)
  3. Audience punishment guilt (feeling that stuttering is offensive or adversities to the listener)
  4. Therapy induced guilt (perception that therapy isn’t useful- not doing enough)
  5. Clinician induced guilt (therapist uses acceptance of stuttering- you’re a stutterer and need to accept it)
  6. Timing guilt (client asked to do something they are not ready for)
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18
Q

What are the three types of guilt SLPs need to watch for in the therapy room?

A

Therapy induced, clinician induced, and timing guilt

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19
Q

What can be done to help a client with his or her guilt?

A

Explore source of guilt, maintain self-esteem, learn from guilt, accept responsibility

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20
Q

Define shame.

A

Evaluation of oneself, rather than one’s actions
Characterized by external (avoiding eye contact, blushing, inability to speak, shrinking into body) and internal components (wishing to vanish, shrink, and/ or disappear)

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21
Q

What are two types of shame and define?

A

Healthy shame- helps maintain people’s adherence to social standards
Unhealthy shame- negative eval leading to neg self concept

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22
Q

What are the four categories of shame?

A
  1. Existential shame- individual suddenly sees himself as others do
  2. Class shame- comes from being different
  3. Narcissistic shame- pathological, pervasive negative self concept
  4. Situational shame- arises from some experience having a temporary effect
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23
Q

How is shame related to stuttering/ possibly caused by stuttering?

A

Family openness to discussion
Unresolved shame and a shame spiral
Resistive client who doesn’t want to relive moments of shame

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24
Q

Define self-concept and how is it related to stuttering?

A

One’s perception of oneself, based on info from significant others and from personal experiences.
Negative emotions and experiences lead to negative self-evaluations. Impacts interpretation of his ability to be an effective communicator.

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25
Q

What are the six stages of grief?

A

Denial, anger, bargaining, depression, and acceptance

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26
Q

Describe temperament and stuttering.

A

Some people who stutter have a reactive temperament- react more to uncomfortable or unfamiliar events, higher degree of sensitivity to changes in routines, perfectionism, may show more resistance to treatment in therapy

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27
Q

What are the components of temperament?

A

Activity(physical)
Rhythmicity (adherence to daily routine or schedule)
Approach (response in new situations)
Adaptability
Intensity (amount of energy put into responding to the environment- loud v. quiet, quick to fatigue)
Mood (consistent pattern of mood- pleasant v. irritable)
Persistence and attention (ability to sustain focus and complete tasks)
Distractibility
Threshold (sensory reaction to texture, odor, light, etc)

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28
Q

What are the behavioral components of stuttering?

A

Respiration, phonation, articulation, and feedback

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29
Q

What are the linguistic components of stuttering?

A

Phonetic, lexical, syntactic, pragmatic

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30
Q

What are the linguistic components that increase a person’s likelihood to stutter?

A

Phonetic- long >short words, initial position, stressed syllable of a multisyllabic word, and on less frequently occurring initial phonemes
Lexical features- less frequent words, open category words > closed category words (ever growing v. relatively fixed number)
Syntactic features- increased MLU and complexity
Pragmatic features- high number of people, high demand speech act, higher social stature of person, pressure/ emotional dynamics, convos in which cultural differences are present, in requests v. responses

31
Q

Define the cognition of stuttering.

A

The act or process of knowing including awareness and judgement.
Perceptions- listener and self
Attitudes toward communication- negative self talk, cognitive distortions, and maladaptive responses

32
Q

What are common listener perceptions of someone who stutters?

A

Anxious, insecure, afraid, less well adjusted

33
Q

What did the physiological theories of stuttering believe?

A

Stuttering came from a physical defect- tongue too slow to keep up with thoughts/ too thick/ too short/ too swollen/ too dry

34
Q

What type of treatment was done In alignment with the physiological theories?

A

Tongues heated and surgeries performed, adenoidectomy and tonsilectomies

35
Q

Describe the psychological theories of stuttering.

A

Stem from a weakness in psyche or resulted from: phobia reaction to articulation, lack of confidence in communication, belief that speech production is difficult, conflict in psychosocial development, latent hostility and guilt from talking to others

36
Q

Describe the organic theories.

A

20-30s: suggested biochemical imbalance, interaction of predisposing factors and environment, higher incidence in families, cerebral differences
Cerebral dominance

37
Q

What is the Cerebral Dominance theory?

A

An organic theory by Travis.
Based on frequency of people who stutter that were naturally left handed and forced to become right handed
One hemisphere dominant over the other to control the timing of speech movements
Some studies show pws hacks right brain activation for speech
Breakdown in synchronization of brain hemispheres leading to conflicts in speech control between hemispheres

38
Q

Who is associated with the Diagnosogenic theory?

A

Wendell Johnson

39
Q

Describe the Diagnosogenic theory.

A

Semantic theory- reaction to the meaning of stuttering.
Stuttering develops when parents misdiagnose normal disfluencies as stuttering- places blame on parents by suggesting children become self- conscious and try to speak without disfluencies
Stuttering caused by environmental factors
Speaker expects stutter to occur, dreads it, and becomes tense anticipating and trying to avoid it
Led to belief it shouldn’t be talked about
Pediatricians still say “ignore it, it’ll go away”– conspiracy of silence

40
Q

What are the clinical treatment implications of the Diagnosogenic theory?

A

Parents need to be counseled about develop,entail disfluencies, stuttering, and how to set up a home environment that best suits the CWS

41
Q

Who is associated with the Approach-avoidance theory?

A

Sheehan

42
Q

Describe the Approach-Avoidance Conflict theory.

A

Semantic theory- people want to talk, but want to be silent
When both desires are equal stuttering occurs; avoidance is greater than approach withdraw from conversation
Conflict continues, stuttering persists and secondary behaviors grow

43
Q

Describe Sheehan’s iceberg.

A

Demonstrates that much of what happens with stuttering occurs below the surface or is unknown to the observer. Only see the behaviors associated with stuttering, but not the emotions.

44
Q

Describe the Anticipatory Struggle Hypothesis.

A

developmental semantic theory, stuttering emerges from child’s frustration and failures when trying to talk
Child struggles to be understood or is penalized for the way he talks, it leads to tension and later anticipation and of having to speak
Leads to fragmented speech
Children thought to have traits of perfectionism or sensitivities

45
Q

What are important clinical implications Bloodstein’s Anticipatory- Struggle Hypothesis?

A

Parent and child counseling and environmental adaptations are important

46
Q

What is the Genetic Basis theory?

A

Presence of stuttering is familial, but not severity.
33-50% of PWS report having a family member who stutters
Greater correlation is drawn from combining genetics with certain environmental factors

47
Q

Define the Covert Repair Hypothesis.

A

A psycholinguistic theory, deficit in phonological encoding of an utterance, explains repetitions, prolongation a, and blocks.
PWS detect superfluous errors and take time attempting to correct errors that do not exist.

48
Q

Who is associated with the Covert Repair Hypothesis?

A

Postma and Kolk

49
Q

Who is associated with the Demands and Capacities Model?

A

Starkweather

50
Q

Describe the Demands and Capacities Model.

A

Disfluencies and stuttering emerge when the capacities of the child for fluency aren’t equal to the demands of the environment for speech performance

51
Q

What are the treatment implications of the Capacities and Demands Theory?

A

The child’s environmental demands related to his or her capacities need to be assessed. Treatment would focus on increasing capacities for fluent speech and decreasing demands until CWS catches up.

52
Q

What are two types of environmental demands?

A

Internal- increasingly complex thoughts

External- parents interrupting or using big words, rushed household

53
Q

What are the child’s capacities?

A

Qualities that make the child develop more fluent speech.

Develop in spurts, environment tends to advance- when environment doesn’t, could be when stuttering tends to decrease.

54
Q

What are the four areas of behavior?

A

Motor, linguistic, socio-emotional, and cognitive

55
Q

Describe motor demands and capacities.

A

Demand- faster speech movements made, greater muscle activity. Trade off between speed and precision.

Capacity- ability to move the vocal tract rapidly and smoothly, especially in regards to timing

56
Q

Describe linguistic demands and capacities.

A

Demands- can occur in all areas of language

Capacities- word finding, formulation of sentences, socially appropriate interactions, generation of phonologically appropriate syllables

57
Q

Describe socio-emotional demands and capacities.

A

Demands- emotions like excitement and anxiety lead to increased levels of muscle activity

Capacities- ability to move slowly and smoothly when excited, anxious or angry. In children, the ease of separation and level of shyness

58
Q

Describe cognitive demands and capacities.

A

Demands- more complex thoughts may detract from motor performance

Capacities- knowledge that some things happen better when you don’t try so hard. Perceptions, beliefs, and attitudes toward stuttering, speech, and socialization are of vital importance

59
Q

Describe the Multidimensional Models of Stuttering.

A

Stuttering is composed of complex timing and spatial relations.
Variability of emotional, perceptual, and/or physiological events.

60
Q

Who is associated with the Dynamic Multifactorial Model?

A

Smith and Kelly

61
Q

Describe the Dynamic Multifactorial Model.

A

Multiple factors impact fluency by directly or indirectly affecting the speech motor processes.

62
Q

Who is associated with the Synergistic Approach?

A

Bloom and Cooperman

63
Q

What are the three components of the Synergistic Approach?

A

Speech-language, attitudes and feelings, and environment

64
Q

What are the three components of the Speech-Language aspect of the Synergistic Approach?

A

Physiological, attitudes and feelings, and learned

65
Q

What are the three components of the Attitudes and Feelings domain of the Synergistic Approach?

A

Self-Esteem, locus of control, and assertiveness.

66
Q

What are the three components of the Environmental domain of the Synergistic Approach?

A

Communication, family, and cultural

67
Q

Describe the physiological subcomponent of the Synergistic Approach.

A

They’re the physical factors. Genetics, central nervous system (reduced ability to generate temporal patterns), peripheral nervous system (respiration, phonation, and articulation)

68
Q

Describe the psycholinguistic subcomponent of the Synergistic Approach.

A

Language factors.
Syntactic-semantic structures can affect fluency, linguistic complexity, pragmatic complexity, individual differences in stuttering patterns, interacts with physiological factors

69
Q

Describe the learned factors subcomponent of the Synergistic Approach.

A

Multidimensional and synergistically learned elements

70
Q

Describe the Self-esteem subcomponent of the Synergistic Approach.

A

How much we like and approve of our self-concept.

71
Q

Describe the Locus of Control subcomponent of the Synergistic Approach.

A

Internal- events are within our control
External- events controlled by resultant factors other than ourselves
Demonstrated in children (loving family, independence), adolescents (greater peer contact), and adults (positive and active role in healthy behaviors)

72
Q

Describe the assertiveness subcomponent of the Synergistic Approach.

A

Assertive- ability to stand up for oneself
Nonassertive (passive)- behavior that allow ones’s own rights to be violated by others
Aggressive- standing up for oneself, but violating another’s rights in the process

73
Q

Describe the Communication subcomponent of the Synergistic Approach.

A

Teaching our clients to be effective communicators: attending, exploration, listening and empathetic responses, summarizing, encouraging the use of ‘I’ statements

74
Q

Describe the Family subcomponent of the Synergistic Approach.

A

Understanding and improving the interactive communication patterns and communicative skills of the family
Used of counseling, family therapy, and understanding the dynamics and interactions of the family

75
Q

Describe the Cultural subcomponent of the Synergistic Approach.

A

Understanding and respecting the cultural diversity toward communication, learning, and values of our clients.
Clinicians must understand and respect the ethnicity of their clients, cultural influences of their clients

Fluency Disorders (4 decks)

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