Ch. 3: When and How Does Stuttering Begin? How Does It Develop?

Question 1

Questions regarding stuttering onset

Answer 1

When does it happen?
Who is affected?
How does it happen?
What happens?

Question 2

Age at onset

Answer 2

Range: 16 - 60 months

Mean: 33.40 months
for boys: 33.60
for girls: 32.95

Question 3

Mean or Median* Age (months) at Onset

Answer 3

See Powerpoint

Question 4

When–chart in powerpoint

Answer 4

When – 56% of onsets occur between 24 to 36 months of age; 84% from 18 to 42 months

Question 5

What: Nature of onset period

Answer 5

Sudden (1-3 days): 40%
Intermediate (1-2 weeks): 33%
Gradual (>2 weeks): 27%

Question 6

How: Manner of onset

Answer 6

The majority of onsets are sudden or intermediate, not gradual
See Powerpoint

Question 7

What happens? Disfluencies near onset

Answer 7

Stuttering-Like Disfluencies (per 100 syllables)

Stuttering Children : 10.37
Normal Children: 1.33

Question 8

What: Secondary Characteristics

Answer 8

• 52% of children exhibit at least one right at onset of stuttering:
  
  • Facial contortions or grimacing
  • Eye closing
  • Head tilting
  • Respiratory irregularities: deep gasps of breaths
  • Others

-Also called accessory behaviors, concomitant behaviors, etc.

Question 9

What: Stuttering severity at onset

Answer 9

-Mild: C=35%, P=45%
Mod: C=45%, P=27%
Severe: C=20%, P=28%

Question 10

What: Reported stress at onset

Answer 10

Illness: 14%
Emotional upset: 40%
Behavioral stress: 36%
Rapid lang. develop.: 40%
Advanced language skills and internal drive to use it but not able to, theory about why they might stutter due to this factor. 
Word finding words: 43%

Question 11

What: Child’s Awareness & Reactions. Assessed through:

Answer 11

• Parents’ reports
• Children’s response to clinician probing
• Puppet task: Child’s identification with fluent or non-fluent puppet

Question 12

What: Awareness

Answer 12

Some children exhibit awareness of, and reactions to, their stuttering soon after onset. Studies with the puppet method have indicated sharp rise in awareness between ages 4 and 5.

Question 13

Development of Stuttering

Answer 13

Natural recovery: most kids recover without treatment, 80%

	  Persistency: 20%

Question 14

Recovery Data for Longitudinal Studies*

Answer 14

See Powerpoint

Question 15

Long-term trends of stuttering (Weighted SLD) in a large N of Recovered, Persistent, and Control Children

Answer 15

See Powerpoint

Question 16

Rates of Persistency/Natural Recovery

Answer 16

See Powerpoint

Question 17

Persistence and Recovery: Gender

Answer 17

Persistent:
Males: 30%
Females: 18%

Recovered:
Males: 70%
Females: 82%

Male/Female Ratio:
Persistent: 3.67 m/f
Recovered: 1.89 m/f

(4 to 1 ratio m/f is looking at the people who did not recover)

Question 18

Risk for persistency: Primary factors

Answer 18

• Family History: #1 risk factor
• Gender: male is a risk factor
• Stuttering trends: how has it developed, dropped off, gotten worse, stayed the same
• Duration of stuttering: how many years
• Age at onset: younger age is a better prognosis
• Disfluency length: longer the disfluency, more repetitions, long prolongations or blocks
• Disfluency type; Prolongations/blocks: prolongations and blocks sooner is a red flag

Question 19

Risk for Persistency: Lesser factors

Secondary

Answer 19

Severity: 
Secondary characteristics. 
Phonology
Expressive language
Acoustic features

Question 20

Risk for Persistency: Lesser factors

Tertiary

Answer 20

Concomitant disorders.

Awareness; Emotional reactions

Question 21

A family history of ______ gives a child a ____% chance of following the same trend. A family history of _____ gives a child a ____% chance for the same trend. (Based on Ambrose, Cox, & Yairi, 1997).

Answer 21

A family history of persistency gives a child a 65% chance of following the same trend. A family history of recovery gives a child a 65% chance for the same trend. (Based on Ambrose, Cox, & Yairi, 1997).

Question 22

The development of stuttering: Preschool Age Children Repetitions

Answer 22

• Part word repetitions, small units, large number
• Prolongations: consistent sound
• Silent Blocks: laryngeal tension
• Respiratory Irregularities: gasping
• Head and Neck Movement: eye blinking, wide mouth
• Awareness Task with puppets

Question 23

In some cases, _____ recovery trends occur soon after _____. See changes in means of scores over the first 6 months (16 children) (See PowerPoint).

Answer 23

In some cases, natural recovery trends occur soon after onset. See changes in means of scores over the first 6 months (16 children).