FLUENCY Flashcards
Define fluency disorder.
interruption in flow of speaking by atypical rate, rhythm, and disfluencies
List the 3 main types of fluency disorders.
- stuttering
- cluttering
- neurogenic stuttering
Does stuttering affect all parts of communication (i.e., respiration, phonation, articulation)?
Yes. Stuttering involves involuntary breakdowns affecting all parts of communication.
Define stuttering.
disruption in flow of speech characterized by repetitions, prolongations, and blocks
What is stuttering characterized by in addition to dysfluencies? (4)
- negative reactions
- avoidance behaviors
- escape behaviors
- tension
List the types of disfluencies. (3)
- repetitions
- prolongations
- interjections
Define repetitions.
saying the same element of speech more than once
Define part-word repetitions.
repetitions of a part of a word or sound or syllable (S-S-S-Saturday or Sa-Sa-Sa-Saturday)
Define whole-word repetitions.
repetitions of entire word more than once (I-I-I-I am fine)
Define phrase repetitions.
repetition of more than one word (I am-I am- I am fine)
Define prolongations.
extension of syllables and silent postures
Define audible sound prolongations.
sounds produced for a duration longer than typical (Mmmommy)
Define blocks.
unfilled pause with relaxed hesitation or tense silence
Define interjections.
extraneous elements introduced into speech sequence
List 3 types of interjections.
- sound/syllable: um or uh
- word: like
- phrase: you know
Define pauses/blocks.
silent intervals in the speech sequence at inappropriate junctions or of unusually long duration
Define revisions.
changes in wording that do not change the overall meaning of utterance (today is… it’s really cloudy today)
Define incidence.
number of new cases identified in a specific time period
Define prevalence.
number of individuals who are living with the disorder in a given time period
List 4 stuttering-like disfluencies (SLD).
- monosyllabic WWR (like-like)
- SSR (l-l-l-like)
- ASP (llllllllike)
- Blocks [tense] cat
List 3 non-stuttering-like behaviors (NSLD).
- interjections (uh)
- phrase repetitions (my cat Winston… my cat Winston is the cutest cat)
- revisions (today is… it’s really cloudy today)
Define secondary behaviors and list 2 broad categories.
motor behaviors associated with stuttering - body movements, facial grimaces
1. escape
2. avoidance
List escape behaviors.
hand and foot movements (tapping foot)
rapid eye blinking
When do escape vs. avoidance behaviors occur?
Escape behaviors occur during the stutter, avoidance behaviors occur before the stutter
List avoidance behaviors.
changing the word from a frequently stuttering sound or word
sending a text instead of calling
What is the loci of stuttering?
the locations in a speech sequence where stuttering is typically observed
For adults and school-age children, stuttering is more likely to occur on the following (4)
- consonants
- first factor (first sound or syllable of word, first word in phrase or sentence)
- longer and less frequently used words
- content words (nouns, verbs, adjectives)
For preschool children, stuttering is more likely to occur on
function words (pronouns, conjunctions)
Define adaptation effect
reduction in stuttering with repeated reading/exposure to the same material
Define consistency effect
PWS tend to stutter on the same words when reading the same passage several times (developmental stutterers only)
- indicator of the strength or the stimuli that evoke stuttering
Define adjacency effect.
occurrence of new stuttering on words that surround previously stuttered words
Define audience size effect.
frequency of stuttering increases with an increase in audience size
List the 5 theories of stuttering.
- environmental
- genetic
- interactive
- neurophysiological
- psychological
Outline the assessment of Stuttering.
- case history
- measurement of types and frequency of dysfluencies in conversational speech and oral reading
- evaluation of the variability of dysfluencies
- assessment of negative emotions, avoidance reactions and associated motor behaviors
- measurement of speech and articulatory rate
- application of chosen diagnostic criterion
what are the neurophysiological factors of stuttering?
gray and white matter differences
neural network connectivity differences
lateralization of hemisphere functions
more white matter connections
reduced blood flow
what are the causes of stuttering?
genetic component
neurophysiological
environmental
Define neurogenic stuttering.
form of fluency disorder associated with a variety of neurological diseases or disorders, including vascular disorders that cause strokes, TBI, and degenerative neurological disorders that may result in dementia
Define cluttering.
a disorder of fluency characterized by rapid or irregular rate, atypical pauses, imprecise, jerky, and disorganized speech
List characteristics of cluttering.
irregular rate of speech
excessive normal dysfluencies
excessive repetitions
decreased speech intelligibility
little to no awareness
Cluttering may co-occur with the following:
- stuttering
- language, articulation, attention disorders
What are the 3 stuttering types?
- childhood onset stuttering
- psychogenic stuttering
- neurogenic stuttering
ETIOLOGY of stuttering.
unknown cause, multiple systems play role (genetic, environmental, abnormalities in phonation system)
Stuttering treatment in young children
parent education
indirect strategies
direct strategies
overall communication
Stuttering treatment in adults.
- Patient education
- Strategies including
2a: Stuttering Modification
2b: Speech Modification - Overall communication
What are the elevated risks for stuttering that a child can have? (5)
- family history of stuttering
- age of onset of stuttering after 3.5 years old
- stuttering for 6-12+ months
- male
- advanced, delayed, or disordered language
typical disfluencies include:
- multisyllabic whole-word and phrase
repetitions - interjections
- revisions
unlike children who stutter, children with typical disfluencies have no… (4)
no physical tension
no secondary behaviors
no negative reactions or frustration
no family history
children who stutter have other behaviors including… (5)
- physical tension
- secondary behaviors
- negative reactions
- avoidance behaviors
- family history
What happens during the Lidcombe Program?
home program in which parent reinforces fluency by praising each instance of fluent speech
most valuable information during assessment of stuttering?
repetition units
speech modification strategies
techniques aimed at making changes to the timing and tension of speech production
- easy onset
- light contacts
- rate control
- continuous phonation
- prolonged syllables
stuttering modification strategies
van riper! - identification - desensitization - modification - generalization
identify core stuttering behaviors
recognize physical behaviors
locate point of physical tensions and struggle during disfluency
reduce physical tension
3 examples of stuttering modification strategies
- preparatory set
- pull-out
- cancellation
what are 5 strategies for reducing negative reactions (personal and environmental) associated with stuttering?
- awareness
- desensitization
- cognitive restructuring
- self-disclosure
- support
