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Fluency Disorders > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

What are the 3 types of stuttering?

A
  • Repetitions
  • Prolongations
  • Blocks
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2
Q

What are prolongations?

A

sound where there is a lot of tension or sound is lengthened

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3
Q

What are blocks?

A

where the system locks up, often happens on bilabial sounds

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4
Q

What are secondary behaviors?

A

Learned behaviors as a result from struggling behaviors

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5
Q

What are some secondary behaviors?

A

eye blinks, head nods/movements, foot stomping

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6
Q

When is a person who stutters considered severe?

A

If they are disfluent in 20% of their words

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7
Q

When are most people disfluent?

A

At the beginnings of words/sentences/breath groups

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8
Q

TRUE or FALSE: You can cure the person who stutters by treating their surface behaviors?

A

FALSE - you have the change the person not just the surface behaviors

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9
Q

Why are there so many varying theories about the etiology of stuttering?

A

because pinpointing etiology is very hard and the theories typically focus on a particular aspect of stuttering

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10
Q

Who created the Diagnosogenic Theory?

A

Wendell Johnson

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11
Q

What is the Diagnosogenic Theory?

A

that all children go through a period of disfluency and have disfluencies
-stuttering evolves from a mis-labeling of stuttering that creates the stuttering problem

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12
Q

What is the “Monster Study”?

A

Mary Tudor told a group of students who didn’t stutter that they were disfluent and told the teachers that if they had any kind of disfluency that they needed to be stopped and disciplined/corrected
-As a result of this study: she found that labeling someone as “stuttering” cause a change in behavior to make these children act like children who stutter

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13
Q

What are the Learning Theories/Anticipatory Struggle?

A

Thinking of stuttering as a learned behavior

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14
Q

Who created the Cerebral Dominance Theory?

A

Samuel T. Orton and Leo Edward Travis

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15
Q

What is the Cerebral Dominance Theory?

A

The belief that left-handedness caused stuttering because the brain was getting mixed signals as far as motor programming
-Later they thought that maybe it wasn’t handedness but sidedness -studies supported and then refuted this belief

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16
Q

What is the Wada Test?

A

In the 1960s it was a look at the Cerebral Dominance Theory and looking at how it actually suggested a lack of cerebral dominance

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17
Q

What did the Dichotic Listening Tasks do?

A

Gave researchers a way of looking at cerebral dominance related to stuttering

  • Two different signals presented to opposite ears and listener repeated back
  • Results: mixed, inconclusive
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18
Q

What were the results of the Brain Imaging Research?

A

inconclusive - studies are showing different results, some showing activation in right hemisphere and others showing both hemisphere, some showing no difference

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19
Q

What are the difficulties of the Brain Imaging Research?

A
  • Most of the studies that do show differences have been done on adults so we are not sure if the results are because of stuttering or the cause of
  • Don’t seem to see any structural difference in people who stutter
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20
Q

What is the Multi-factorial Dynamic Model?

A

The theory that there are many different factors of stuttering and the different factors come together that cause stuttering
-Weighting or impact of stutters are different (different degrees of factors)

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21
Q

What do most believe is the cause of stuttering?

A

That it is a multi-factoral dynamic disorder that doesn’t have one single cause but varying degress of factors that mainfest differently in every individual

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22
Q

What do you say when a parent ask “why does my child stutter?”

A

You tell them that there are many different reasons for stuttering, discuss the multi-factoral model and give them information about the Demands-Capacities Model (-Tell the parents to help the child maximize their capacities for fluent speech, this will not necessarily make your child fluent but helps the child)

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23
Q

What is the Demands-Capacities Model?

A

Basically every child has certain capacties for producing fluent speech and if the capacities exceed the demands placed on the child then the child will be fluent.
On the other hand if the demands are higher than the capacities then the child will be disfluent

24
Q

What are examples of capacities?

A

born, physiological, amount of sleep, eating habits, physical health (parents play a role of feeding into capacities)
-Goal is to maximize capacities but some is limited possibly due to neurological aspects

25
Q

What are examples of demands?

A

time pressure, siblings fighting for attening, having to perform

26
Q

Is the Demands-Capacities Model proven?

A

No - it is not very testable for research or how stuttering is caused however it is a USEFUL tool clinically

27
Q

Why should you explain the demands-capacities model to parents?

A

Because it is a useful tool to give parents something that they can do to allow parents to be active in their child’s life

28
Q

How does the Demands-Capacities Model help the clinician?

A

-Tells them to consider each client as a unique individual and that stuttering will be unique

29
Q

What is the Delayed Auditory Feedback Theory?

A

That delayed auditory feedback creates stuttering because when a fluent person put this device on it caused them to be disfluent
-In order to overcome feedback you have to slow down when you speak and rely on proprioception and this seems to produce more fluent speech

30
Q

Is the Delayed Auditory Feedback theory proven?

A

No - it turns out it only works for some people and for a limited amount of time

31
Q

The Delayed Auditory Feedback theory created the idea of using a similar device on a person who stutters ear that will delay the feedback (white noise)
What is the problem with this?

A
  1. Could create hearing loss

2. Only temporary and system gets used to the distraction and then stuttering comes back

32
Q

Can the white noise delayed feedback device be helpful?

A

Yes as a training tool - because it helps the person understand what it would be like to be fluent

33
Q

What are the problems with these delayed auditory feedback devices?

A
  1. Marketed as a CURE for stuttering
  2. Extremely expensive and require a large down payment that is non-refundable
  3. Comes with no training
  4. Actually can make the person who stutters experience more fears rather than improving their lifestyle because they are afraid of “what if it stops working”
34
Q

What are periods of normal disfluencies?

A

The period of time that most kids experience some disfluency between the ages of 2-5

35
Q

What is the recovery rate from stuttering of most children?

A

80%

36
Q

In early childhood what is the ratio of incidence in boys to girls?

A

4:1 (boys/girls)

37
Q

Are girls or boys more likely to recover from stuttering?

A

Girls (in the first year of onset)

38
Q

What are the two decisions each clinician has to make when a child comes in who may be stuttering?

A
  1. Is the child actually stuttering?

2. If it is stuttering, is this going to be a chronic problem?

39
Q

What are some differences between “Normal Disfluencies” and “Stuttering”?

A

Normal Disfluencies:

  • Disfluencies tend to happen individually
  • Whole word repetitions common
  • Phases/periods of time of disfluencies
  • Can come and go

Stuttering:

  • Disfluencies occur in clusters
  • Disfluencies will last longer
  • Prolongations, blocks, part word repetitions common
  • Durations of disfluencies last longer
  • “Fragmentation” of words
  • Can come and go
  • Highly variable
40
Q

Why do you have to be careful when doing an assessment of a child?

A

Because disfluencies can come and go and you may not be listening or assessing the child’s normal disfluencies

41
Q

What is VITALLY important when assessing young children?

A
  • to get a speech sample that has lots of examples of disfluencies and preferably a couple of samples in different settings
  • must transcribe and count disfluencies/types
42
Q

Why is it less important to count disfluencies in older children and adults?

A

Because the main reason you count disfluencies is to determine if it is going to be a chronic problem. In older children/adult we have already determined that it is going to be a chronic problem

43
Q

What are the things that you need to assess?

A
  1. Speech sample
  2. Discussion with parents
  3. Background/Family history
44
Q

What is important to note about severity?

A

That it is NOT an indicator of a chronic problem

45
Q

What are some red flag indicators of stuttering?

A
  • Family history of stuttering if members did not recover (especially in boys)
  • Many reactions of disfluencies from parents
  • If other types of demands exceed the child’s capacities for fluent speech
  • If child has other cognitive/psychological/speech-language problem
46
Q

What are some green/positive indicators of recovery from stuttering?

A
  • Family history but members recovered
  • Decreasing # of SLDs within a year of stuttering
  • Decreased severity rating by parents (if child is within one year of onset)
  • Many part word repetitions
  • Slower rate of repetitions
  • Impact of child/fewer reactions
47
Q

If you are not sure if stuttering will be a chronic problem what do you do?

A
  • There are varying opinions on this. Some say that therapy won’t hurt and to go ahead and do some intervention and that early intervention is very important. Some say that it is not ethical if you are not sure.
  • Talk with the family and see how they are feeling. If the parents want to do intervention then do that - if not wait and see
  • If you decide not to do therapy then give the family lots of information and be sure to follow up with them and have them call you if things change
48
Q

What is the best place to start for intervention?

A

Make speaking fun for the child not something to be feared. Don’t making speaking difficult for the child.

49
Q

What are the basic points of child fluency assessment?

A
  1. Get an adequate sample from home
  2. Fluency assessment (get numbers if needed)
  3. Lengthy interview with parents (how it affects child/family/parents)
  4. Case history
  5. Decision may not be ready at the end of the eval and sometimes answers/decisions won’t be ready for a period of time
  6. Give parents as much information as possible so they can monitor the child’s fluency aslo`
50
Q

What is something to be sure and look at?

A

How things have changed:

  • If it’s within the first year this is a good sign
  • If it’s beyond a year and the preceding years the recovery rates get worse
  • Once you get to ages 3,4,5 spontaneous recovery just do not occur
51
Q

What do you look at in a speech sample to determine if the child is actually stuttering?

A
  • Types of disfluencies: sound/syllable repetitions, blocks, prolongations, and whole-word repetitions
  • SLD (Stuttering like disfluencies): sound syllable repetitions, blocks, prolongations, and whole-word repetitions
  • Struggle behaviors: something to consider but doesn’t make it stuttering
  • Weaker indicators: frequencies, struggle behaviors
  • Stronger indicator: disfluencies occur in clusters
52
Q

If you believe it is stuttering then you do an Evaluation. How do you do an early child evaluation?

A
  • Ask parents to get recordings of their most natural environment with their most natural disfluencies
  • Get a 500-syllable speech sample (elicited by playing with them)
53
Q

How can scales such as attitude, behavior, or avoidance help you as a clinician?

A

It is good for a starting point to discuss with the child and helping you know where to get with clients

54
Q

Do traumatic events cause stuttering?

A

NO - these events can temporarily make stuttering worse but CANNOT cause stuttering

55
Q

What does an adult assessment look like?

A
  • More simple and not an exact set of things that you have to do
  • Ask the adult what they are wanting to accomplish (making sure you are understanding the whole impact)
  • Pantomime or imitate the client’s disfluencies (tell them you are going to do this)
  • Ask them to repeat some of the disfluencies they experience
  • Take a case history, speech sample
  • Assessment is on-going and blends in with treatment

Fluency Disorders (1 decks)

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