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Stuttering > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Normal disfluencies ages

A

1 1/2 to 6 years old

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2
Q

Borderline stuttering ages

A

1 1/2 to 3 1/2

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3
Q

Beginning stuttering ages

A

3 1/2 to 6

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4
Q

Intermediate stuttering ages

A

6 to 13

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5
Q

Advanced stuttering ages

A

14+

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6
Q

Do all PWS pass through every stuttering level?

A

No. Can be at any level and advance. May move in and out or skip around.

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7
Q

To determine normal disfluencies vs stuttering

A

Look at frequency, duration, and type of disfluencies as well as the individual’s awareness

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8
Q

Van Riper track 1

A

Exhibit core behaviors between ages of 2-4

May progress on to disfluencies with more tension (maybe more blocks?)

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9
Q

Van Riper Track 2

A

Later onset of stuttering 3 1/2 - 4
Artic/Lang issues - more concomitant areas of concern

This may be the most common one that we see.

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10
Q

Van Riper Track 3

A

Come on with very severe blocks, a lot of tensions, secondary behaviors - no ease into it, comes on very suddenly - does not happen often

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11
Q

Van Riper Track 4

A

Psychogenic onset - traumatic experiences triggering onset of stuttering

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12
Q

Normal disfluencies are a part of development as children try to master speech and language. Examples of normal disfluencies…

A 
Part word 
Whole word 
Phrase repetitions 
Interjections 
May see some prolongations but these could also be a red flag for concern - look at frequency and duration to determine
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13
Q

Distinguishing features between normal disfluencies and stuttering

A

Amount of disfluencies - 1% usually ok, 15% red flag
Number of unit repetitions - more = more likely stuttering
Type of disfluencies - part word repetitions, prolongations, blocks are more indicative of stuttering

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14
Q

Normal disfluencies

A 
Single - syllable word repetition 
Multisyllabic word repetition 
Phrase repetition 
Interjection 
Revision - incomplete phrase
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15
Q

Atypical disfluencies

A 
Part-word repetition 
Prolongation 
Tense pause (blocks)
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16
Q

Do no stuttering children exhibit secondary characteristics

A

No.

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17
Q

Why are increases and decreases in disfluencies common throughout childhood?

A

Language acquisition demands
Pragmatics - social interaction with peers
Environmental stress - parents, moving, preschool demands

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18
Q

What kind of stuttering may be difficult to diagnose because the child will exhibit normal disfluencies and stuttering

A

Borderline stuttering

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19
Q

Children with borderline stuttering may exhibit…

A 
Part word repetitions 
Whole word repetitions 
Prolongations 
Frequency is 10% 
Stuttering behavior consist of more within word disfluencies
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20
Q

Does a child with borderline stuttering exhibit secondary characteristics?

A

No

21
Q

Underlying processes to borderline stuttering include

A

Resource allocation - a lot of development happening at the same time, where are the brain resources being placed?
Capacity to handle demands
Potential increasing frustration with communication

22
Q

Child with Beginning stuttering exhibits what types of behaviors? (Not their speech characteristics)

A

Increased tension during stuttering moments
Less patience and tolerance for stuttering moments
Development of escape behaviors may occur

23
Q

Beginning stuttering core behaviors

A

Repetitions sound more rapid and irregular
During repetition a schwa may be inserted
Prolongations may be a second or longer
Increased tension present - may be fleeting

24
Q

Do children with beginning stuttering exhibit secondary behaviors?

A

Pitch rise
Head turns
Eye closure

25
Q

Are children at the beginning stuttering level aware of the stuttered moments?

A

Yes.

Frustration is common and may question inability to get a word out

26
Q

In beginning stuttering, what is increased tension attributed to?

A

Anticipation of the stuttering event - tension helps brace the individual’s body for the stuttering moment

27
Q

In beginning stuttering, what is the increase in speed of repeated behaviors attributed to?

A

The child’s recognition in the delay to communicate the intended message

28
Q

In beginning stuttering, what is responsible for the increase in frequency of escape behaviors?

A

Conditioning
Ex. Child thinks, every time I squeeze my fist when I get stuck, then the word comes out better so I am going to do that - it doesn’t work and will have to also be addressed in therapy

29
Q

At what level to children begin to develop fear of stuttering as well as develop avoidance behaviors?

A

Intermediate

30
Q

At what level are core behaviors still present and more blocking is involved?

A

Intermediate

31
Q

With this level, use of escape behaviors are more prevalent than beginning stuttering and this time of avoidance behaviors occur.

A

Intermediate

Word and situation avoidance behaviors

32
Q

What are Van Riper’s 3 different word avoidance categorized.

A

Substitutions - Say a different word than what they want to say - come up with a different word to avoid the stutter

Circumlocutions - Talking around the word but never actually saying it

Postponements - A little pause before they say the word the are intending to say - getting themselves ready to say the word successfully or they know they have to say the word and that it will be problematic

33
Q

At what level to children begin to feel fear, embarrassment, and shame with stuttering?

A

Intermediate

34
Q

In intermediate stuttering, how are the escape behaviors changed?

A

Escape behaviors transform into avoidance behaviors

ex. I don’t want to raise my hand in class, I will not participate
I won’t order, my parents have to do it for me
Child starting to shut down a little bit in various situations

35
Q

At what level do treatment responsibilities fall on the client and beliefs about stuttering can be distorted?

A

Advanced

36
Q

What type of stuttering is common in the advanced level?

A

Core speech behaviors consist typically of blocks, with the blocking being more pronounced and include more struggle behavior as well

37
Q

How is the advanced level of stuttering characterized? What makes a person be placed in this level?

A

Age - older adolescents and adults

38
Q

Why are those is the advanced stage of stuttering more adept to control the environment to avoid stuttering?

A

Their fears and attitudes have been shaped by years of conditioning

39
Q

People in this level have developed a self-concept as an impaired speaker. Why?

A

Advanced

Self-concept is formed by perceptions of listeners’ reactions

40
Q

Stuttering assessment is a multi level process that includes..

A

Information gathering and personal encounter

Display your knowledge about stuttering and listen to the family/client concerns

41
Q

All client’s have a right to privacy and confidentiality. Why is this especially important for school aged children?

A

They have to trust you to be able to move forward in therapy. Even have to be careful when talking to parents - you tell the parents something that was said in therapy and then the child does not trust you anymore and no longer wants to share with you

42
Q

Clinicians need to develop a multicultural view on stuttering assessment and treatment including…

A

Becoming sensitive to communicative style differences

Learning how other cultures view speech and language disorders

43
Q

What are some multicultural issues related to stuttering?

A

Eye contact - ex. May be offensive to have eye contact with authority figures
Family interaction style - family may value their interaction style like a fast speaking rate
Physical touch - ex. Personal space! - Ask them and explain before you do it
Voluntary stuttering - may help with control, able to practice techniques ex. Some client’s may find this unacceptable. Client may think - Why are you making me do this when I already stutter?

44
Q

What is the purpose of a preschool assessment? And what purpose does the initial evaluation serve?

A

To clarify observations of disfluencies by parents or others. Is the child stuttering or is it just normal disfluencies? Also, parents may need information and reassurance from the clinician.

Initial evaluation will serve as the beginning point of the decision making process

45
Q

What are the preschool assessment procedures?

A
  • Obtain a good audio and video recording - at the very least have to audio but it is best to have both
  • have toys that are age appropriate
  • first part of the assessment should be free play. This allows time to observe and record disfluencies types and frequency, observe parent-child interaction, look at how the parent reacts when the child stutters, Speaking rate of the parent and child,Types of questions/vocab that the parent is asking - cognitive load, and Does the parent interrupt the child? Frequency?
  • provide structured speech tasks that slowly increase in difficulty
  • interview parents
  • clinician-child interaction
  • talk about stuttering - determine the child’s awareness - if aware, ask them why they are here today
  • calculate speech rate
  • find out about feelings and attitudes - may have to be from parent interview
46
Q

How do you do an assessment with a child who won’t talk?

A

Bring the parent in for the evaluation - rely on parent-child interaction

47
Q

Preschool assessment diagnosis:
Normal
Borderline
Beginning

A

Normal
- less than 10 disfluencies per 100 words
- most disfluencies are normal like (normal like disfluencies (NLD) or other disfluencies (OD) - Phrase reps, whole word reps, maybe some part word reps, interjections)
Borderline
- more than 10 disfluencies per 100 words
- exhibits core stuttering behaviors
Beginning
- presence of tension in the child’s speech - Likely see awareness, pitch rising, prolongations of 1 second or longer

48
Q

Preschool recommendations:
Normal
Borderline/beginning

A

Normal
- greater emphasis placed on parental concern’s than child’s disfluencies
- educate parents about stuttering development in conjunction with other aspects of child development
- offer strategies for interaction with their child
Borderline/beginning
- have parents keep note of fluency changes in children
- continue to educate parents
- parent directed therapies are good for this age

Stuttering (1 decks)

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