Chapter 3

Question 0

Most begin at which age range? What percentage?

Answer 0

• 56% of onsets occur between 24-36 months (more than 1/2 between 2-3 years)
• 84% of onsets occur between 18-42 months (most are between 1.5 years and 3.5 years)

Question 1

age at onset of stuttering

Answer 1

Range: 16-60 months
Mean: 33.40 months
Boys: 33.60
Girls: 32.95
(very close for onset for boys and girls)

Question 2

Manner of Onset

Answer 2

Early-> gradual onset
later clinicians (1970s-1980s) -> possibility of sudden onset as well

Question 3

stuttering reported as ________ iterations of syllables, words, phrases

Answer 3

2-4

Question 4

mean # of iterations for CWS is..?

mean # of iterations for NFC is..?

Answer 4

slightly less than 2.

slightly less than 1.

Question 5

secondary characteristics of stuttering

Answer 5

• facial contortions
• eye closing
• head tilting
• respiratory irregularities
• others

Question 6

what percent of children have secondary characteristic(s)?

Answer 6

53%

Question 7

what stress factors were reported at onset?

Answer 7

• emotional stress - 40%
• behavioral stress - 36%
• rapid language development - 40%
• word finding difficulties - 43%

Question 8

children who persist in stuttering are at risk for ______

Answer 8

SSD

Question 9

Stuttering and language disorders

Answer 9

• There really isn’t a connection between the two

- may be lower than NFC but still within the normal range

Question 10

Bloodstein’s developmental sequence

Answer 10

Phase 1:
Phase 2:
Phase 3:

Question 11

Van Riper’s Developmental tracks

Answer 11

Track I:
Track II:
Track III:
Track IV:

Question 12

Why should parental role and/or vulnerabilities in in the speech fluency system due to developmental processes be considered when looking at fluency?

Answer 12

Because it typically begins in early years of life, when

1. children are under the heavy influence of their immediate environment.
2. anatomical structures for speech are growing quickly.
3. speech and language skills are expanding sharply.

Question 13

What are two manners of onset?

Answer 13

• sudden onset

- gradual onset

Question 14

What may sudden onset of stuttering indicate?

Answer 14

possible involvement of organic or psychogenic agents

Question 15

what may a gradual onset of stuttering indicate?

Answer 15

possible learning explanations, because habit-forming processes take time.

Question 16

Why are scientific studies of stuttering difficult?

Answer 16

• there are no warning signs that onset is about to occur.
• investigators cannot predict the right place and time to objectively document the very earliest stuttering or secure data even shortly thereafter.

Question 17

Retrospective reports by caregivers of past observations.

- Problems with this type of study?

Answer 17

1. missed cases because only children who have stuttered for a set minimum period of time are identified and recruited for the study.
2. often data are obtained from parents long after the unset of stuttering.

Question 18

available research and clinical evidence indicates that most stuttering occurs at which age?

Recent studies indicate onset by which age?

Answer 18

prior to 5 years of age.

Recent: prior to 3 years of age.

Question 19

does gender influence the age of onset for stuttering?

Answer 19

no

Question 20

historically, people believed that stuttering began how?

** traditional view **

Answer 20

• gradually
• with easy repetitions
• no tension
• child unaware of stuttering
• starts with easy disfluency gradually and turns into full-fledged stuttering.

Question 21

why was the “traditional” view of how stuttering begins questioned?

Answer 21

• in the early 1970’s and 80’s there were studies showing sudden onset of stuttering.
• Van Riper in 1971
• Preus in 1981

Question 22

current studies show that _________ onset is the least common.

Answer 22

Gradual

Question 23

Resent studies/research has shown what about the severity of early stuttering?

Answer 23

• that early stuttering was often:
  1. moderate to severe
  2. associated with some degree of force, even severe tension

Question 24

Resent research shows that in early stuttering, children are typically __________ of their disfluencies
(aware or unaware)

Answer 24

aware

Question 25

Yairi (1983) study stated that most parents noted which types of disfluencies at onset?

Answer 25

• 95% recalled syllable repetitions

- 40% also recalled word repetitions.

Question 26

Yairi and Ambrose (1992b) study found that children also had other types of disfluencies at onset, including…?

Answer 26

• 36% had sound prolongations.
• 23% had conspicuous silent periods
• 14% had blocks

Question 27

What did Yairi and Lewis (1984) do in order to not rely so much on retrospective reports?

Answer 27

1. identified children within 2 months of onset.
2. restricted their age range (25-39 months of age)
3. recorded speech for direct observation and analysis.

Question 28

what is the mean # of iterations for children who stutter?

What is the mean # of iterations for children who do not stutter?

Answer 28

Stutter: less than 2

No stutter: just a fraction about 1

Question 29

What are concomitant behaviors?

Answer 29

• nonspeech body movements that accompany stuttering events.

- aka “secondary” characteristics.

Question 30

Can physical concomitants (secondary characteristics) be present at onset?

Answer 30

yes

Question 31

Yairi and Ambrose suggested that

if a child possesses predisposing factors to stutter, aggravating _________ or __________ stresses may trigger onset

Answer 31

physical

emotional

Question 32

Child temperament and stuttering

Answer 32

• Some studies indicate a difference between CWS and NFC.
  1. CWS may be hypervigilant, less adaptable to change, and have
  irregular biological functions.
• Other studies indicate no difference between CWS and NFC.

Question 33

disorders that may present concomitantly with stuttering are…?
- historically believed -

Answer 33

• articulation/phonology (for children who persist in stuttering)
• language skills (current data does not support a connection between stuttering and language impairment)

Question 34

what is the most common period of stuttering onset?

Answer 34

18 to 42 months

Question 35

4-phase developmental sequence by Bloodstein

Answer 35

phase one: preschool ages.
Phases 2 and 3: school ages.
phase 4: adolescence and adulthood.
** this is a traditional model of developmental progression **

Question 36

Bloodstein’s Phase 1

Answer 36

1. repetitions of syllables and words occurring on functional short words at initial phrase positions
2. up-and-down cycles in the stuttering with possible complete amelioration for day or weeks followed by resumption of stuttering.
3. little evidence of awareness and concern.

Question 37

Bloodstein’s Phases 2 and 3

Answer 37

1. stuttering becomes chronic.
2. children identify themselves as stutterers.
3. stuttered speech increases in complexity and severity to include sound prolongations and blocks.
4. stuttering occurs throughout the sentences and on other types of words.
5. fears and anticipation of stuttering emerge.

Question 38

Bloodstein’s Phase 4

Answer 38

by this phase, strong emotional reactions take over as individuals exhibit avoidance of speaking prior to stuttering and shame and embarrassment afterward.

Question 39

differential developmental models

Answer 39

• Van Riper’s developmental system (1971)

Question 40

Van Riper’s developmental system

- 4 variables or risk factors

Answer 40

1. age at onset: early-late
2. type of onset: gradual-sudden
3. pattern of stuttering: repetitions-blocks-tension
4. concomitant speech-language problems

Question 41

Van Riper’s developmental system

- Tracks -

Answer 41

Track I: early and gradual onset with repetitions a the dominant system -> better chance for recovery than Track III.
Track II: Children with delayed speech.
Track III: sudden onset, blocks, prolongations, and physical tension.
Track IV:

Question 42

Van Riper

Track I

Answer 42

• high incidence
• early onset
• gradual, episodic, previously fluent
• starts with easy repetitions
• normal speech rate, good articulation.
• lack of awareness of speech disruption
• high recovery
• persistent cases progress to fast, irregular repetitions, prolongations, and tension; awareness, fear, and avoidance later on

Question 43

Van Riper

Track II

Answer 43

• medium incidence
• later onset than track I, as phrases and sentences emerge.
• gradual, chronic, not ever very fluent
• part and whole-word repetitions, pauses, revisions
• rapid rate, poor articulation, mumbled speech
• lack of awareness of speech disruptions
• hesitations, revisions, and false starts are added to hurried, irregular repetitions