Final Flashcards
What is fluency?
Effortless flow of speech
- Features: Easy, forward flow.
- Good intonation and stress patterns
- Few hesitations
- Low effort
What is Stuttering?
Abnormally high frequency or duration of stoppages in the “forward flow” of speech
Core behaviors (which are related to severity and persistence)
Repetitions:
-Most frequent
-Sound, syllable, or single syllable
-Li li li li like this
Prolongations:
-Appear later than repetitions
-Present at onset
-Sound or air flow continues but articulation
stops (short as half a second are abnormal)
Blocks:
-Last core behavior to appear
-Inappropriately stop the flow of air or voice
and often the movement of their
articulators as well
-Respiratory, laryngeal, or articulatory
-As stuttering continues blocks become
more intense and worse
Secondary behaviors and examples of each
Avoidance (circumlocutions; word substitutions)
-Anticipated stuttering and recalls negative
experiences. Use escape behaviors
BEFORE the stutter to avoid it
Escape (eye blinks, head nods)
-Occur when speaker is stuttering and
attempts to terminate the stutter and finish
the word
What are the components stuttering in CALMS?
C-cognitive A- affective L- linguistic M- motor S- social
What is the cause of stuttering?
Multifactorial. Not one direct cause
Typical onset? Average % of natural recovery?
Develops during rapid expansion of speech and language skills.
- Sudden ~40%
- Intermediate (over 1-2 wks): 30%
- Gradual (3 or more weeks) 27%
Average % recovery: ~75%
What is the stuttering iceberg? How do SLPs assess ‘above the water’ and ‘under the water’ aspects of stuttering?
What you see or hear is at the tip of the iceberg and the thoughts, attitudes and perceptions are below the water and those are the things that others can’t see but they are still there
What is the SSI? What does it stand for?
Stuttering Severity Instrument
Provides percentile rand and ‘severity’ rating based on scores from: frequency, duration, and physical concomitants
There is a reader and non reader version. Participants are asked to read a passage or describe a picture (non readers) and a language sample is obtained to aid in scoring.
What is the root of all stuttering?
avoidance
Camperdown
It is a four-staged program. It gives clients more self-reliance in the establishment, transfer, and maintenance of their controlled fluency. It is a type of speech restructuring for adults who stutter and mainly zooms in on the steps of prolonged speech
Key characteristics of Neurogenic Stuttering
stuttering appears on function as well as content words, stuttering no restricted to word-initial syllables, absence of secondary behaviors, little adaptation in readings
Key characteristics of Psychogenic Stuttering
stuttering remains constant or increases while speaking under fluency-inducing conditions. May show dramatic improvement with trial therapy.
Key characteristics of Cluttering
excess of normal disfluencies, lack of intelligibility, especially during rabid bursts of speech. May slur syllables and leave out others entirely.
Treatment for Neurogenic Stuttering
pacing, masking, DAF, slow rate, and easy onset.
Treatment for Psychogenic Stuttering
Fluency shaping or tension reduction
Treatment for Cluttering
increasing awareness, improve linguistic skills
What are the components stuttering in ABC’s?
Affective
Behavioral
Cognitive
What are red flags for persistent stuttering?
Age of Onset: between ages 2-3.5 years
-Children who begin to stutter “later”
-Children with onset after 3.5 years are
more at risk
Gender:
-Boys have a greater risk
-Girl with stutter persists for a longer period
of time
Family History (Combined)
-Family history of stutterers
-Family stutterer stuttering persisted=
greater risk
What are indicators of natural recovery?
-Earlier age of onset (Before 3)
-Females
-High phonological skills (easier to
understand)
-Higher nonverbal intelligence
-Recovery of relatives who stuttered
-Slower speaker rate
-Good language skills
Defy the meaning of The Therapeutic Sequence: identify, explore/desensitize, modify
- Identify: Identification
- Explore: Desensitization
- Tools: Modification
- Pull-out, cancellation, shaping tools.
- Underlying all: MOTIVATION!
What is fluency shaping?
Change the way you speak
-Goal: stutter-free speech
What is fluency modification?
Change the way you stutter
-Normalize reactions
Examples of indirect therapy and when to use
-Used to help train parents
-Help parents change environment to
enhance child’s fluency
-Not ask the child to change how they are
talking
-Who to use with? More common with
children between the ages of 2-3.5 years.
Loose, relaxed repetitions. The CWS has a
likelihood of natural recovery
-Decrease the family’s concern, Remember to
tell them that the cause of stuttering is no
one’s fault
-WHY use indirect?: Modifying child’s daily
interactions/ environment will help achieve
fluency.
What is Specific parent feedback for Direct (Lidcombe)
-Parent feedback: Stutter-Free Speech,
Unambiguous stuttering, positive
reinforcement for stutter free speech
-Sutter- Free Speech
-Praise
-Request Self Evaluation
-Acknowledge
-Unambiguous
-Acknowledge
-Request Self CorrectionWhat is the 5:1 ratio?
A parent should comment for every 5th fluent phrase
What are other direct tx activities for preschoolers
- Model easy stutters
- “Catch” me
- Play with stutters
What is SSMP?
Three week long program occurs in two phases:
-Goal is to reduce fears and avoidance
associated with clients stutter
-Goal is to focus on managing their
stuttering with a focus point of transferring
these management skills of fear and
insecurities.
What is DAF/Speech Easy?
-DAF-This is an inconspicuous assistive
technological device aid that delays what the
listener hears by altering the auditory
feedback.
-Speech Easy has two main components
embedded within it; delayed auditory
feedback and frequency altered feedback.
Both of these components have been shown in previous literature to increase an individual’s fluent speech.
What is the Miracle question?
A therapeutic probe about patient’s preferred future
