fluency Flashcards
____ refers to the forward continuous flow of speech
fluency (pg.242)
____ refers to the interruption in the forward movement, and these can be either typical or atypical
disfluency (pg.242)
_______ can include phrase repetitions, multisyllabic word repetitions, phrase revisions and nongrammatical interjections
typical disfluencies (pg.242)
______ are more commonly see in individuals who stutter
atypical disfluencies (pg.242)
_______ can be defined as an abnormally high frequency and/or duration of stoppages in the forward flow of speech
stuttering (pg.242)
a. core stuttering behaviors
b. secondary behaviors
include atypical speech disfluencies occurring at a higher frequency than typical disfluencies
a. core stuttering behaviors (pg.242)
a. core stuttering behaviors
b. secondary behaviors
- are understood as attempts to control the core stuttering movements
- include a variety of adjustments in word choice. changes in speech and motor behaviors
- can be classified as either escape behaviors or avoidance behaviors
b. secondary behaviors (pg.242)
a. escape behaviors
b. avoidance behaviors
attempts to stop the moment of stuttering and finish a word or sentences (e.g. eye blinks, head nods)
a. escape behaviors (pg.242)
a. escape behaviors
b. avoidance behaviors
learned behaviors that are associated with the anticipation of a moment of stuttering (e.g. they may choose to substitute a different sound or word)
b. avoidance behaviors (pg.242)
what are common feelings that individuals who stutter report include, _____, ______, and ______
shame, embarrassment, and guilt (pg. 242)
True/false: when an individual allows stuttering to interfere with important life issues, it can be described as a handicap
true (pg.242)
what is the most common type of stuttering?
developmental stuttering (pg.242)
stuttering typically emerges between the ages of ____ and ___ years with more males than females exhibiting stuttering
2, 5 (pg.242)
about ___ % of children who exhibit stuttering at an early age will recover from stuttering
80 (pg.242)
stuttering is more likely to occur upon ______ of words phrases and sentences
initiation (pg.242)
stuttering is more likely to be found in longer, _______ complex utterances than in shorter ones
grammatically (pg.243)
what conditions that increase stuttering
- pressure around time
- speaking in situations that the PWS perceives as threatening or stressful
- speaking on the telephone
(pg. 243)
what are conditions that can diminish stuttering
- singing, speaking or reading in unison
- delayed auditory feedback
- speaking in less stressful situations
(pg. 243)
a. consistency effect
b. anticipation effect
c. adaptation effect
in successive speaking attempts of the same material, PWS are likely to stutter on the same word
a. consistency effect (pg.243)
a. consistency effect
b. anticipation effect
c. adaptation effect
PWS are also able to predict those words on which they are most likely to stutter
b. anticipation effect (pg.243)
a. consistency effect
b. anticipation effect
c. adaptation effect
the overall amount of disfluency decreases with repeated successive readings
c. adaptation effect (pg.243)
it is well observed that stuttering has been observed in some ________
families (pg.243)
studies of ____, children who were adopted at a very early age, siblings, and family lines have all contributed to the understanding of stuttering as having some hereditary components
twins (pg.243)
True/false: it is important to note that heredity is not a single likely cause in all causes of stuttering
true (pg.243)
neurophysiology has also been studied extensively in PWS. there is evidence of increased _____ hemisphere activation in PWS over typical speakers
right (pg.243)
True/false: the development of stuttering is aligned with the development of language in young children
true (pg.243)
True/false: individuals who stutter may have heightened sensitivity to the environment
true (pg.243)
risk factors that have been described for persisting in stuttering include…
- being a male
- positive family history of stuttering
- weak phonological abilities
(pg. 244)
who proposed a comprehensive and integrated theoretical model of stuttering that attempts t account for the many different finding that have been consistently observed
Guitar (pg. 244)
what are the 2 components of Guitar’s model?
- induced the earliest developmental symptoms of stuttering (associated with with those constitutional factors that have led to the disruptions in speech)
- includes those features that are reactions to the primary features (associated with the individuals reactive temperament)
(pg. 244)
True/false: the prevalent thinking at this time considers multiple factors as being necessary for stuttering to occur
true (pg.244)
a. developmental stuttering
b. cluttering
c. neurogenic stuttering
d. psychogenic stuttering
age of onset:
-2-6 years
key casual factors:
-neurological factors, plus environmental conditions
speech:
-prolongations, repetitions, blocks, secondary behaviors are present; variable fluency under different conditions
self-awareness:
-very aware, especially 1 to 2 years after the onset
a. developmental stuttering (pg. 245)
a. developmental stuttering
b. cluttering
c. neurogenic stuttering
d. psychogenic stuttering
age of onset:
-2-6 years, more noticeable as language and speech skills develop
key casual factors:
-neurological causes
speech:
-high frequency of disfluency, rapid and irregular speech rate
self-awareness:
-often unaware or not concerned
b. cluttering (pg.245(
a. developmental stuttering
b. cluttering
c. neurogenic stuttering
d. psychogenic stuttering
age of onset:
-usually after early childhood association with a neurologic even or condition
key casual factors:
-stroke, traumatic brain injury, tumor, and other neurologic conditions
speech:
-few or no secondary behaviors, attempts to modify speech are less successful
self-awareness:
-varies; less likely to be embarrassed
c. neurogenic stuttering (pg. 245)
a. developmental stuttering
b. cluttering
c. neurogenic stuttering
d. psychogenic stuttering
age of onset:
-usually after early childhood and more common in adolescents and adults
key casual factors:
-develops in reaction to stressful or emotional situation or a traumatic event
speech:
- stuttering behaviors may be atypical and unusual; short-term therapy may produce a dramatic improvement
self-awareness:
-variable; may show exaggerated concern
d. psychogenic stuttering (pg.245)
a. normal
b. borderline
c. beginning
d. intermediate
e. advanced
observed in many typically developing children early in their language development years:
- disfluencies occurring on less than 10% of words
- mild easy disfluencies
- do not show secondary behaviors
a. normal (pg.245)
a. normal
b. borderline
c. beginning
d. intermediate
e. advanced
occurs in younger children. it is difficult to differentiate from the normal disfluency stage but the distinguishing characteristics at this are:
- occurrence of disfluency is greater than 10%
- may begin to use some of the more atypical speech disfluencies
- there may be greater than 2 units of repetition
- these children show little awareness or concern
b. borderline (pg.246)
a. normal
b. borderline
c. beginning
d. intermediate
e. advanced
occurs when the child’s disfluencies become more stuttering-like and he or she begins to show more secondary behaviors in speech
c. beginning (pg.246)
a. normal
b. borderline
c. beginning
d. intermediate
e. advanced
evident when the child is afraid of his or her stuttering and begin to use various methods of avoidance
- show blocks, repetitions, and prolongations
- show anticipation before stuttering
- experience embarrassment
d. intermediate (pg.246)
a. normal
b. borderline
c. beginning
d. intermediate
e. advanced
refers to older adolescents and adults who stutter. this is an age difference more than a type difference from the intermediate stage
e. advanced (pg. 246)
some individuals at this advanced stage have developed sophisticated forms of avoidance and have no obvious blocks. these individuals are sometimes called ______ and may experience the same attitudes and feelings as other PWS
covet stuttering (pg.246)
a. assessment of preschool children
b. assessment of school-age children
c. assessment with adolescence and adults
- determine whether or not the children has a speech disorder or exhibiting normal disfluencies
- using developmental model described above, it is most likely that a child at this stage, if stuttering will be at either the borderline or beginning level of stuttering
a. assessment of preschool children (pg.247)
a. assessment of preschool children
b. assessment of school-age children
c. assessment with adolescence and adults
- determine whether or not the children has a speech disorder or exhibiting normal disfluencies
- using developmental model described above, it is most likely that a child at this stage, if stuttering will be at either the borderline or beginning level of stuttering
- obtaining a history, elicit a speech sample for determining the types of disfluencies present and their frequency
a. assessment of preschool children (pg.247)
a. assessment of preschool children
b. assessment of school-age children
c. assessment with adolescence and adults
- focused on the level of stuttering present, the type and severity of disfluencies and secondary behaviors
- critical to obtain a complete parent interview and also an interview with the child’s teacher
- essential to determine any effect on school performance
b. assessment of school-age children (pg. 247)
a. assessment of preschool children
b. assessment of school-age children
c. assessment with adolescence and adults
- focused on determining the effect of stuttering on the individual’s daily activities, communication and quality of life
- additionally, degree of severity, frequency and type of stuttering and secondary behaviors are all assessed
- it is critical to bring in the patient’s own perspective on their stuttering problem
c. assessment with adolescents and adults (pg.247)
stuttering treatment decision-making is always informed by a number of important variables including:
- specific client/patient/ family variables (e.g. age, culture, educational background)
- clinical variables ( e.g.severity, speech-langague or developmental concerns)
- environmental variables (e.g. family issues, setting for service delivery)
(pg. 248)
in general, therapy approaches for PWS can be described by 3 characteristics
- degree of focus on the client or the environment
- degree of focus on achieving natural effortless speech and whether the method utilized is targeted at fluency shaping of stuttering modification
- degree of focus on counseling and interpersonal issues
(pg. 248)
True/false: it is sometimes important to consider the unique features presented and the client’s background for best practice in management of stuttering
False: it is ALWAYS important to consider the unique features (pg.248)
what are factors that increase the risk for advancing to more significant difficulties in young children with normal or beginning stuttering?
- increased stress around speech for the child or parents
- any negative feedback to the child about speech or stuttering
(pg. 248)
a. indirect treatment
b. direct treatment
- goal is to reduce likelihood that the child will advance to beginning or intermediate stuttering
- include parent education and counseling, modeling and reinforcing relaxed speech, slower rates and less linguistic complexity
a. indirect treatment (pg.248)
a. indirect treatment for young children
b. direct treatment for young children
- includes skills in teaching the child how to respond to disfluencies, developing the ability to demonstrate fluency skills and/or using operant methods or other feedback to reinforce fluent productions
- include modeling natural, relaxed speech and providing adequate time for children to respond or initiate
b. direct treatment (pg.248)
what program used a randomized control trial to demonstrate the effectiveness of direct treatment for PWS
Lidcombe (pg.249)
a. traditional approach for school-aged children
b. fluency shaping for school-aged children
-includes a focus on reducing tension at the moment of stuttering, developing health communication attitudes and equipping the child who stutters for a variety of speaking situations
a. traditional approach (pg.249)
a. traditional approach for school-aged children
b. fluency shaping for school-aged children
- the goal of the client is to replace stuttered speech with fluent speech
- includes
- rate modification
- easy onset
- light contact of articulators
- continuous phonation
b fluency shaping (pg.250)
True/false: building a trusting relationship and allowing open discussion of thoughts and feelings about these experiences become an important part of treatment for children?
false: it is important for treatment of adults (pg.250)
what are 3 factors that are unique to the treatment of adults who stutter?
- assuring that the individual’s beliefs and attitudes about stuttering are addressed
- development of client competence in self-managament of therapy, including self-measurement of change
- development of highly specific strategies for generalizing desired speech changes to situations, especially those that are self-identified as most challenging
(pg. 251)
