Fluency

Question 1

Types of Dysfluencies

Answer 1

1. Interjections
2. Revision
3. Phrase Rep
4. Multisyllabic whole word rep
5. Monosyllabic whole word rep
6. Broken word
7. Sound prolongation
8. Sound/syllable repetition
9. Dysrhythmic phonation
10. Abandoned utterance can result in Circumlocution
11. Schwa insertion
12. Tense pause/block

Question 2

Accessory/Secondary Behaviors

Answer 2

1. Between word phenomenon
2. Normal dysfluencies
   - word reps
   - phrase reps
   - interjections
   - revisions

Question 3

Cognitive & Affective Aspects of Stuttering

Answer 3

1. Avoidance behaviors
2. Almost always can feel it coming
3. Ask “how does your stutter make you feel?”

Question 4

Assessment of Fluency

Answer 4

1. Dynamic
2. S&L Sample
3. Record of where, when & who they stutter around
4. What sounds, words, situations they avoid?
5. SSI - can’t be standardized
6. Count words then dysfluencies
7. More than 5% dysfluent?

Question 5

Stuttering Modification Basics

Answer 5

Van Riper

Focuses on more FLUENT stuttering than increased fluency.

Question 6

Stuttering Modification Techniques

Answer 6

1. Fake/Voluntary Stuttering
2. Cancellation
3. Pull-Out
4. Bounce (for block or prolongation)
5. Preparatory Step

Question 7

Stuttering Modification Characteristics

Answer 7

• Emotional
• Reduce tension & fear surrounding stuttering
• Doesn’t care about % fluent
• Wants client to know they have control over stutter
• Promotes relaxation
• Voluntary Stutter
• Focus on affective cognitive features of stuttering

Question 8

Fluency Shaping Techniques

Answer 8

1. Easy Onset - vowels
2. Soft Contact - consonants
3. Continuous Phonation
4. Short Phrases
5. Slow Rate!

Question 9

Fluency Shaping Characteristics

Answer 9

Physical motor patterns that can be changed
Reduce stuttering 
Cares about % fluent
Motor, muscle, memory
Intense therapy live in program
Use physical techniques	
Counting, measuring, stopping, stuttering,
Uses concrete (computer feedback)
Easier to collect data

Question 10

Stuttering Modification & Fluency Shaping both…

Answer 10

Both focus on client becoming independent, self-monitoring & self-correcting.

Question 11

Fluency Facts

Answer 11

• Uncommon to see it begin after 12 yrs old
• More common in males
• 5% of kids before the age of 5 stutter, but only 1% will continue to stutter
• Cyclical - stutter for life
• Not cured, but we provide tools to use.
• No evidence for cause
• 3x more likely if family hx

Question 12

Concomitant Features

Answer 12

Any physical feature that appears when dysfluency is present.
Ex: nose flaring, stomping, blinking, twitching

Question 13

Delayed Auditory Feedback

Answer 13

Playing someone’s own speech back to them with a second delay reduces most dysfluencies.
Temporary & used for client buy-in.

Question 14

Cluttering

Answer 14

Rapid but disoriented articulation, possibly combined with high rate of dysfluencies, disorganized lang. & thoughts.

• Reduced awareness
• Often misdiagnosed
• Treated in same way as stutterer.
• Doesn’t vary with environment
• Not sure what they want to say
• Slowed rate helps a lot.

Question 15

Neurogenic Stuttering

SAND (Stuttering assoc. with Acquired Neurological Disorders

Answer 15

Early childhood onset but associated with neurological disorders (aphasia, AOS, PD, Dementia, Drug toxicity, seizures)
Don’t usually have concomitant features.

Question 16

Incidence vs. Prevalence

Answer 16

Incidence: # of NEW cases within a certain period.
Prevalence: # of TOTAL people living with diagnosis.

Question 17

SAND vs. developmental stuttering

Answer 17

Developmental stutter on nouns.
SAND stutter on functor & substantive words.
Developmental is always in initial position vs. SAND in medial/final position.
Developmental can repeat dysfluent utterance adequately but SAND are still dysfluent.
BOTH know what they want to say.