exam 1

Question 1

What are “normal disfluencies” and how do they differ from Stuttering-Like Disfluencies (SLDs)?

Answer 1

SLD include part word repetition, prolongations and blocks with fragmentation (middle of the word)
Normal disfluencies are stuttering on the first sound of a word a phrase or a breath. →repetition

Question 2

With very young children, why might it be important to ask the parents to bring a recording of the child’s speech in the home environment to the evaluation?

Answer 2

The child may fail to exhibit the behaviors that concern parents on the day of the evaluation.
to make preliminary analysis of the child’s speech.

Question 3

What do you do if a child you are evaluating is producing no disfluencies?

Answer 3

introduce stressors to make them loose control and be more natural to start displaying disfluencies. E.g. time pressured tasks → rapid naming

Question 4

red flags for chronic stuttering

Answer 4

Male
Stable or increasing no of SLD within a year
Increasing severity ratings by SLP/parents
Stable or increasing occurrence of secondary behavior
Few repetitions
Rapid rates of repetitions
Strong reaction to stuttering by child/parents
Concomitant learning or communication problems
Late onset of stuttering (3-4 years and delays in phonological development)

Question 5

questions to ask in order to know if recovery is unlikely to occur?

Answer 5

how long? family history of stuttering/recovery?

Question 6

follow-up questions you might ask for chronic stuttering

Answer 6

Follow up questions could be forms on speech fragmentation

Question 7

What kinds of documentation should the SLP present in an IEP meeting?

Answer 7

• Document that the child meets the state and local eligibility criteria
• SLP should go well beyond a detailed documentation of the child’s overt stuttering behavior (frequency and form)
• Occurrence of coping behaviors (impact on social interaction & restricted participation

Question 8

What do we know about most adult PWS?

Answer 8

The vast majority does not seek treatment, but rather make through life by coping with the problem in more or less effective ways.
These people are not part of the research sample There are some techniques that have been effective

Question 9

What impact does the variability of stuttering have on adult evaluations?

Answer 9

result in assessments that are unrepresentative providing only a glimpse of the depth and breadth of the problem.

Question 10

How is the client’s desire for change important?

Answer 10

It is the key feature for successful treatment; it provides the indication of the progress we can expect once treatment is initiated.

Question 11

“two principles of assessment” for adult PWS described by Manning.

Answer 11

• What a client does because of stuttering? The more an individual who stutters alters his choices and narrow the options available in life the greater the influence handicapping effects of stuttering likely to be.
• What a client does when stuttering? the more a speaker reacts to his stuttering by trying to prevent it from occurring the greater the impact of the problem.

Question 12

Why is “loss of control” an important issue to discuss in an adult fluency evaluation

Answer 12

Clinician will stutter along with patient
identifying the speaker’s loss of control
pt will consider that it is possible to stutter and not be helpless
Severity= distressuncontrollabilityfrequency

Question 13

How are scales such as the LCB Scale, the S-24 Scale, and the PSI are useful?

Answer 13

Communication attitude and perspective (counseling), severity of stuttering to the client
Severity= distressuncontrollabilityfrequency

Question 14

How might a client’s coping strategies impact your assessment of that client’s stuttering problem?

Answer 14

It will give a false picture of the stuttering problem

Question 15

How might obtaining a fluency count during an evaluation for an adult PWS be misleading?

Answer 15

They could be using coping strategies, leading the clinician to believe that there are actually less disfluencies

Question 16

How would an evaluation with an adult PWS differ from an evaluation with a young child who is suspected of stuttering?

Answer 16

Counting disfluencies work for children but not for adults

Children haven’t developed the stutterer self image,

Question 17

Why is it important for clinicians to be able to answer the question “What causes stuttering?”

Answer 17

It is the way the clinician can demonstrate his competence in understanding concerning the problem, setting the stage for the client’s interpretation of him/her.
treatment choices

Question 18

What is the current thinking with regard to the cause of stuttering?

Answer 18

It is a multidimensional problem that has repeatedly and successfully defied unidimensional solutions. To suggest that we know the absolute cause of stuttering is intellectually, ethically and professionally dishonest.

Question 19

Know the contributions of some of the people who historically treated stuttering

Answer 19

• Wendell Johnson: The Diagnosogenic Theory
• Oliver Bloodstein: Communicate failure and anticipatory struggle theory C FAST
• Mary Tudor: told kids at an orphanage that they were stutterers and told the caregivers that they should treat them differently and some began to stutterer
• Gottwalk, Starkweather: The Demands and Capacities Model
• Brutten and Shoemaker
: The Two-Factor Theory

Question 20

What is the repressed need hypothesis?

Answer 20

It is a neurosis and PWS do so as a result of a repressed, neurotic, unconscious conflict (undressed psychological problem). Stuttering is seen as a symptom that is symbolic.

Question 21

What do we know about the parents of children who stutter?

Answer 21

• They do not have attribute that could have negative effects on CWS
• May have some higher level of anxiety than normal
• Are perceived as less accepting by their children
• Set lower goals for CWS than for non-stuttering
• Parents attitudes are not causally related to stuttering for counseling purposes
Less possessive and less to likely exert hostile control

Question 22

Diagnosogenic Theory of Stuttering

Answer 22

Wendell Johnson
Stuttering evolves from normal fluency breaks to which the parents overact to and mislabel as stuttering. Stuttering is created by the listener→ You cannot create stutterers,
Calling someone a stutter makes him or her a stutterer

Question 23

the Two-Factor Theory

Answer 23

People’s bad reaction to normal disfluencies created bad stuttering via classical conditionning

Question 24

the Covert Repair Hypothesis

Answer 24

(Kolk & Postma)
Cybernetic→auditory and tactile feedback helps people adjust their speech, and it doesn’t apply to pws because they are slower. Partly true because it doesn’t explain why stuttering is variable

Question 25

Demands and Capacities Model

Answer 25

Demands for speech performance could exceed the capacity for speech→brain is faster than mouth
→ Parents like that they have control of some of the demands

Question 26

Cerebral Dominance Theory

Answer 26

(Samuel Orton): One says pws are left handed (right hemispheric), neither side is dominant and both sides compete

Question 27

the Continuity Hypothesis

Answer 27

(bloodstein) Result from the child trying to avoid normal fluency breaks→ pressure on self

Question 28

Neurophysiological Model

Answer 28

De Nil: interplay among 3 levels of influence on stuttering: Processing (neurophysiological processes), output (motor, cognitive, language, social and emotional processes) and contextual (environmental influences).

Question 29

Why have there been so many different theories of stuttering?

Answer 29

Because PWS are a very heterogeneous group

The research available at different times, led people to believe different things → zeitgeist effect

Question 30

What have Genetic investigations of stuttering indicated?

Answer 30

• A strong family history is the single most reliable predictor of recovery
• Patients with a family history of stuttering may possess a strong neurophysiological loading for disruption of speech fluency
Hereditability, monozygotic twins separated at birth

Question 31

What have Brain imaging studies of PWS shown?

Answer 31

More right hemisphere activity for people who stutter PWS showed over-activation of the motor areas.

Question 32

Why is it necessary to know about historical theories of stuttering if we know now that they are incorrect?

Answer 32

These theories help us understand stuttering better and provide answers to our clients, they also help us shape treatment, as we can see what worked and what did not. E.g classical and operant conditioning.

Question 33

Provide the answer that you would give a client who asked the question: What causes stuttering?

Answer 33

Stuttering is not caused by one thing but by a multitude of facts
We don’t know why people stutter, but most people who stutter come with some type of predisposition
No one’s fault

Question 34

the factors that will influence you to decide that a particular child is stuttering

Answer 34

• Fragmentation (break ups) of words → greater fragmentation usually is a strong indicator of stuttering
• Awareness and anxiety (not always reliable)

Question 35

Know the contributions of some of the people who historically

Answer 35

• Oliver Bloodstein: Communicate failure and anticipatory struggle theory C FAST
• Mary Tudor: told kids at an orphanage that they were stutterers and told the caregivers that they should treat them differently and some began to stutterer
• Gottwalk, Starkweather: The Demands and Capacities Model
• Brutten and Shoemaker
: The Two-Factor Theory