Fluency Disorders

Question 1

Stuttering tends to be more prevalent among which of the following groups?
a. Boys
b. Girls
c. The same for each
d. Twins
e. There is no difference

Answer 1

a. Boys

Question 2

Many preschoolers who begin to stutter stop within the first year or two of onset without having received any professional treatment. This is called:
a. Spontaneous recovery
b. Normal dysfluency
c. Consistency effect
d. Adaptation effect
e. Spontaneous correction

Answer 2

a. Spontaneous recovery

Question 3

A child exhibited five dysfluencies per 100 words. This indicates that this individual:
a. Is speaking within normal limits
b. Is speaking with a fluency rate above average
c. Should be enrolled in treatment
d. Is showing mild stuttering characteristics
e. Is showing mild to moderate stuttering characteristics

Answer 3

a. Is speaking within normal limits

Question 4

Stuttering moments are more common in preschool children in which of the following circumstances?
a. Giving their age, using unfamiliar words, and using content words
b. On function words in phrases and in the initial sounds in a sentence
c. The first time using a novel word and giving their address
d. On the initial consonants and vowel in novel words
e. At the end of the word in novel sentences

Answer 4

b. On function words in phrases and in the initial sounds in a sentence

Question 5

Of the following speech and language disorders, which have been associated with stuttering or dysfluent behaviors?
a. Linguistic complexity, aphasia, syntax, and spastic dysphonia
b. Pragmatics, spastic dysphonia, and apraxia of speech
c. Language complexity, voicing, cluttering, and spastic dysphonia
d. Aphasia, bradylalia, apraxia of speech, and spastic dysphonia
e. Aphasia, learning disabilities, attention deficit/ hyperactivity disorder (ADHD), and apraxia of speech

Answer 5

d. Aphasia, bradylalia, apraxia of speech, and spastic dysphonia

Question 6

The parents of a 6-year-old are worried that he is going to stutter. On the basis of current data, the clinician can tell them that the risk that the patient will developing stuttering at this time is:
a. 50%
b. 25%
c. 100%
d. 1%
e. 75%

Answer 6

b. 25%

Question 7

Analysis of epidemiology research on stuttering indicates that ________________ is the variable that affects the true understanding of the prevalence and incidence of stuttering.
a. Duration
b. The number of new cases
c. Normal fluency development
d. Child development
e. None of the above

Answer 7

a. Duration

Question 8

An interruption in the flow of speech that is considered to be based on disease, physiological processes, or organic processes is called:
a. Dysfluency
b. Repetitions
c. Tachylalia
d. Bradylalia
e. Blocks

Answer 8

a. Dysfluency

Question 9

Of the following descriptions, which, according to Daly (1993), is not a quantitative symptom of cluttering?
a. Acceleration of speech rate between and within multisyllabic words
b. Appropriate attention span but poor concentration
c. Vowel stops, or pauses,
before vowel-initial words
without fear or muscular tension
d. Six to eight units of repetition of single syllables, short words, and phrases, without apparent concern
e. Articulation errors, including /r/ and /l/ phonemes, reduction of consonant cluster, or signs of oral apraxia

Answer 9

b. Appropriate attention span but poor concentration

Question 10

Of the following descriptions, which, according to Daly (1993), is a qualitative characteristic of cluttering?
a. Writing errors, including poor integration of ideas and motor incoordination
b. Reading errors, including skipping small words, revising text, or poor concentration
c. Vocal monotony (lack of speech melody or intonation)
d. Short attention span and poor concentration
e. Disorganized speech, including abrupt topic shifts, incomplete phrases, and deficient word retrieval skills

Answer 10

e. Disorganized speech, including abrupt topic shifts, incomplete phrases, and deficient word retrieval skills

Question 11

A 20-year-old patient presented repetitions and prolongations on final, initial, and medial syllables; poor response to the adaptation effect; annoyance but not anxiety; dysfluency on a variety of phonemes; and no secondary features. The patient probably has:
a. Qualitative cluttering
b. Quantitative cluttering
c. Neurogenic stuttering
d. Dementia
e. Classic stuttering

Answer 11

c. Neurogenic stuttering

Question 12

During the evaluation process for stuttering, Mary Elizabeth was requested to read the Rainbow Passage several times. During an analysis, the clinician noted that every time Mary Elizabeth approached the words grandfather, swiftly, thinks, minus, frock, and banana, she became dysfluent. This behavior is an example of:
a. Word-finding difficulties
b. The consistency effect
c. Language and psychological effects on stuttering
d. A neurological condition
e. The adaptation effect

Answer 12

b. The consistency effect

Question 13

Tameka is undergoing an evaluation, and the clinician has her read a prose passage five times during the evaluation. Each time, the number of her dysfluencies decreases. These diagnostic findings indicate:
a. The adaptation effect
b. The consistency effect
c. Reading and the psychological effects on stuttering
d. A neurological condition
e. A psychological condition

Answer 13

a. The adaptation effect

Question 14

When a person adapts easily to a communicative situation, this adaptation may in fact be:
a. Psychological
b. Environmental
c. Physiological
d. Neurological
e. None of the above

Answer 14

a. Psychological

Question 15

When a person shows evidence of difficulty with adaptation, this difficulty may in fact be:
a. Psychological
b. Environmental
c. Physiological
d. Neurological
e. None of the above

Answer 15

d. Neurological

Question 16

When consistency in dysfluent behaviors is elevated, the basis for this behavior may in fact be:
a. Psychological
b. Environmental
c. Physiological
d. Neurological
e. None of the above

Answer 16

b. Environmental

Question 17

When there is very little consistency in dysfluent behaviors, the basis for this behavior may in fact be:
a. Psychological
b. Environmental
c. Physiological
d. Neurological
e. None of the above

Answer 17

d. Neurological

Question 18

Stuttering syndrome involves all the following except:
a. Attitudes and perceptions
b. Cultural variations
c. Dysfluencies
d. Secondary mannerisms
e. Poor self-concept

Answer 18

b. Cultural variations

Question 19

Smooth transition between the first two sounds of a phrase or after each pause is called:
a. Continuous phonation
b. Easy relaxed approach-smooth movements
c. Easy-onset phonation
d. Slow and easy talking
e. None of the above

Answer 19

b. Easy relaxed approach-smooth movements

Question 19

The mother of a dysfluent child says, “I think that we waited too long to bring our child in for therapy.” The clinician responds with the statement, “Well, the important thing is that she is here now and we will work together to help her.” The clinician’s response is an example of which counseling technique?
a. Content responds
b. Affect response
c. Sharing self
d. Reframing
e. Affirmation

Answer 19

d. Reframing

Question 20

Of the following methods, which is not a stuttering modification technique?
a. Stuttering slowly, without hurry or tension
b. Stuttering with slow, relaxed, fluent endings
c. Stretching of vowels and consonants
d. Using good eye contact and work for overall comfort and effective communication
e. Using counseling to deal with stuttering

Answer 20

c. Stretching of vowels and consonants

Question 21

Which treatment method should be used with children who do not show shame and avoidance about their stuttering and with children who have had previous treatment but have residual stuttering in transfer?
a. Fluency shaping
b. Stuttering modification
c. Continuous phonation
d. Easy relaxed approach smooth movements
e. None of the above

Answer 21

b. Stuttering modification

Question 22

Of the following methods, which is not a fluency shaping technique?
a. Slow and gentle talking
b. “Proprioceptive” awareness of speech movements
c. Easy phonation
d. “Play” with stutter before releasing
e. Decreased rate of speech

Answer 22

d. “Play” with stutter before releasing

Question 23

The easy relaxed approach smooth movements is associated with which of the following individuals?
a. Janis Costello
b. Bruce Ryan
c. Hugo Gregory
d. Susan Meyers and Lee Woodford
e. Edward Conture

Answer 23

c. Hugo Gregory

Question 24

If a bilingual and bicultural adult is dysfluent in only one language, it is likely that this person is:
a. A monolingual individual who stutters
b. A bilingual and bicultural individual who stutters
c. Suffering from an adult language disorder
d. Suffering from an adult language delay
e. Suffering from a neurological condition

Answer 24

b. A bilingual and bicultural individual who stutters

Question 25

Speech fluency assessments of bilingual and bicultural school-aged children who stutter should include:
a. Both languages
b. The preferred language of the home
c. The dominant language
d. The language of instruction
e. The child’s preferred language

Answer 25

a. Both languages

Question 26

Van Riper’s preparatory set technique is based on which theory?
a. Repressed needs theory
b. Breakdown theories
c. Anticipatory struggle theories
d. Multifactorial theories
e. Dysphemia

Answer 26

c. Anticipatory struggle theories

Question 27

Techniques such as slow articulatory rate, continuous phonation, and gentle voice are known as:
a. Management of fluency
b. Fluency shaping
c. Fluency inducing
d. Stuttering modification
e. Fluency circling

Answer 27

b. Fluency shaping

Question 28

In prevention, training parents to talk less often and with simpler language, to interrupt less often, and to ask fewer questions is best described as:
a. Contingency management
b. Fluency shaping
c. Reduction of speech-associated anxiety
d. Vocal control treatment approach
e. An example of stuttering modification

Answer 28

c. Reduction of speech-associated anxiety

Question 29

A patient underwent evaluation for stuttering. The patient exhibited primarily articulatory groping behavior. The speech-language pathologist (SLP) diagnosed apraxia of speech. Because the patient demonstrated articulatory groping behavior, it is likely that the patient exhibited which of the following speech dysfluency characteristics?
a. Prolongations
b. Blocks
c. Hesitations
d. Revisions
e. Interjections

Answer 29

b. Blocks

Question 30

Contemporary viewpoints about stuttering are represented by the following broad categories:
a. Breakdown, repressed need, and anticipatory struggle hypotheses
b. Breakdown, regressed need, and anticipatory struggle hypotheses
c. Breakdown, disorganization, and disintegration hypotheses
d. Breakdown, repressed need, and environmental hypotheses
e. Breakdown, multifactorial, and anticipatory struggle hypotheses

Answer 30

a. Breakdown, repressed need, and anticipatory struggle hypotheses

Question 31

Clinicians sometimes assist clients in coping with external and environmental pressures that presumably precipitate their speech disruptions, especially in relation to family dynamics and changes. The approach for such treatment is rooted in which theoretical belief?
a. Breakdown theories
b. Repressed need theories
c. Anticipatory struggle theories
d. Environmental theories
e. Multifactorial theories

Answer 31

c. Anticipatory struggle theories

Question 32

Of the following statements regarding stuttering and avoidance behaviors, which is generally true?
a. All people who stutter exhibit avoidance behaviors
b. Approximately 70% of individuals who stutter exhibit stuttering behaviors
c. Revisions, circumlocutions, and hesitations are examples of avoidance behaviors
d. Repetition of whole words, prolongations, and revisions are examples of avoidance behaviors
e. Only individuals with language difficulties avoid stuttering moments

Answer 32

c. Revisions, circumlocutions, and hesitations are examples of avoidance behaviors

Question 33

A patient presents with aspects of stuttering that are linguistically based. This patient would probably exhibit all the following dysfluency behaviors except:
a. Whole word repetitions
b. Blocks
c. Phrase repetitions
d. Interjections
e. Revisions

Answer 33

b. Blocks

Question 34

A preschool-aged child exhibits speech fluency characteristics that include more repetitions and prolongations with a few revisions, dysfluencies that are very relaxed, more than 10 dysfluencies per 100 words and rare reaction to his dysfluencies. It is likely that for this child, the SLP will diagnose:
a. Normal fluency behavior
b. Borderline stuttering
c. Intermediate stuttering
d. Advanced stuttering
e. Language difficulties

Answer 34

b. Borderline stuttering

Question 35

Of the following characteristics, which statement is true with regard to beginning stuttering?
a. Rise in pitch rise may be present toward the end of a repetition or prolongation
b. Fixed articulatory postures are not evident
c. Escape behaviors and secondary mannerisms are never present
d. Awareness of difficulty and feelings of frustration are present
e. Muscle tension does not appear in stuttering

Answer 35

a. Rise in pitch rise may be present toward the end of a repetition or prolongation

Question 36

Of the following characteristics, which statement is true with regard to intermediate stuttering?
a. Blocks, repetitions, and prolongations are seldom noted
b. Escape and secondary behaviors are used to terminate blocks
c. Individuals anticipate blocks and use control mechanisms to combat them
d. There is little fear before stuttering, but there is some shame
e. Rise in pitch may be present toward the end of a repetition or prolongation

Answer 36

b. Escape and secondary behaviors are used to terminate blocks

Question 37

Of the following characteristics, which statement is true with regard to advanced stuttering?
a. Most frequent core behaviors are short, and there are frequent blocks and little tremor of lips, tongue, or jaw
b. Avoidance behavior is minimal
c. Repetitions and prolongations are definitely evident
d. Emotions of fear, embarrassment, and shame are very strong
e. Rise in pitch may be present toward the end of a repetition or prolongation

Answer 37

d. Emotions of fear, embarrassment, and shame are very strong

Question 38

A child produced the utterance “Tucker … Tucker is a good dog.” This is an example of:
a. Part-word repetition
b. Single-syllable word repetition
c. Multisyllabic word repetition
d. Phrase repetition
e. Revision

Answer 38

c. Multisyllabic word repetition

Question 39

The phrase “I want my … where is my mommy?” Is an example of which type of dysfluent behavior?
a. Prolongation
b. Revision-incomplete phrase
c. Tense pause
d. Interjection
e. Circumlocution

Answer 39

b. Revision-incomplete phrase

Question 40

Martin is a 3-year-old African American boy who is highly verbal and speaks African American dialect.
He exhibits 9 dysfluencies per 100 words, has typically one-unit repetitions, and is also exhibiting interjections, revisions, and word repetitions. It is likely that Martin’s speech fluency is:
a. Mildly affected
b. Borderline affected
c. Not an issue, but he exhibits a language delay not difference
d. Within normal limits
e. Mild to moderate fluency disorder

Answer 40

d. Within normal limits

Question 41

Cultural implications may be important considerations in the assessment and treatment of stuttering. Of the following situations, which are potential concerns for the SLP?
a. Child-rearing practices
b. Rules for interaction
c. Nonverbal communication
d. All the above
e. None of the above

Answer 41

d. All the above

Question 42

During the assessment of speech fluency, SLPs often measure the time of the longest block. This measurement is commonly referred to as:
a. Longevity
b. Severity rating
c. Duration
d. Calibration
e. Tension measurement

Answer 42

c. Duration

Question 43

During an assessment of speech fluency, a 5-year-old patient demonstrated a speaking rate of 175 syllables per minute. According to the work of Pindzola and colleagues (1989), this rate of speech is:
a. Within the range for the child’s age group
b. Below the range for the child’s age group
c. Above the range for the child’s age group
d. Two standard deviations below the mean for his age group
e. None of the above

Answer 43

a. Within the range for the child’s age group

Question 43

The most commonly used measure for assessing the severity of stuttering is:
a. Lidcombe Program’s Severity Rating Scale (Onslow et al., 1990)
b. Stuttering Severity Instrument-3 (Riley, 1994)
c. Scale for Rating Severity of Stuttering (Johnson et al., 1952)
d. All the above
e. None of the above

Answer 43

b. Stuttering Severity Instrument-3 (Riley, 1994)

Question 44

During an assessment of speech fluency, a 25-year-old man had a speaking rate of 235 syllables per minute.
According to the work of Andrews and Ingham
(1971), the patient’s speaking rate is:
a. Within the range for his age group
b. Below the range for his age group
c. Above the range for his age group
d. 1.5 standard deviations below the mean for his age group
e. None of the above

Answer 44

c. Above the range for his age group

Question 45

Of the following statements, which is not true?
a. Feelings, emotions, beliefs, and attitudes about communication are all components of stuttering
b. The experience of stuttering and the reactions of other people to stuttering have a notable effect on the stuttering
c. Of importance is that feelings, emotions, beliefs, and attitudes can be addressed only in treatment
d. A number of researchers have indicated that a preschool-aged child’s sensitivity or reactivity to a new situation may be a prediction of chronicity
e. Clinical reports and the results of some studies indicate that persons who stutter may have unusually sensitive temperaments

Answer 45

c. Of importance is that feelings, emotions, beliefs, and attitudes can be addressed only in treatment

Question 46

Of the following behaviors, which should not be considered a component of stuttering?
a. Revisions
b. Avoidance behaviors
c. Part-word repetitions
d. Blocks
e. Syllable repetitions

Answer 46

a. Revisions

Question 47

When assessing individuals who stutter, clinicians should determine the frequency of stuttered moments, types of stuttering, duration of stuttering, and:
a. Secondary mannerisms
b. Severity
c. Escape behaviors
d. Type of treatment
e. None of the above

Answer 47

b. Severity

Question 48

It is important in a diagnostic assessment to address speech naturalness, speech rate, and concomitant or associated behaviors. The importance is rooted in the patient’s:
a. Gender
b. Cultural background
c. Age
d. Socioeconomic level
e. All the above

Answer 48

b. Cultural background

Question 48

A preschool child is exhibiting borderline stuttering characteristics. He is showing excellent to above receptive and expressive language skills, and his cognitive skills are well within normal limits. His mother is extremely anxious and worried and often cries when the child is dysfluent. There is no family history of stuttering, and there is great discord between the parents as to what the next steps should be. It is likely that the clinicians’ recommendations for this family might be:
a. To wait and see whether there is spontaneous recovery; therefore, no formal recommendations are made
b. To place the family in treatment for incipient stuttering because there are some dysfluencies
c. To develop a prevention plan that would involve the child and the parents
d. To refer back to the pediatrician and recommend a family therapist
e. To work directly with the child and ignore the parents

Answer 48

c. To develop a prevention plan that would involve the child and the parents

Question 49

An 18-year-old male immigrant from Russia exhibits the following characteristics: He speaks Russian and English fluently; he is severely dysfluent during all conversations with the clinician while speaking English, conversations with the father in Russian, narrative discourse in Russian and English, and reading in Russian and English; he avoids conversational situations as much as possible; he has secondary mannerisms associated with dysfluent behaviors; and he has no concomitant speech-language difficulties. This patient is an example of an individual exhibiting:
a. Monolingual stuttering
b. Language-dominant stuttering
c. Bilingual stuttering
d. Linguistic stuttering
e. Psychological stuttering

Answer 49

c. Bilingual stuttering

Question 50

A 3-year-old boy comes from a family with very high expectations. He is enrolled in private preschool and does very well in school. His pediatrician, parents, and teachers have expressed some concerns, however, and he was evaluated by an SLP. The boy’s mother appears to be a very tense person. He exhibited the following characteristics: cognitive skills that were within normal limits; above-average receptive and expressive language skills; repetitions and prolongations at a rate of 15 per 100 words; two revisions; and one incomplete phrase. The diagnostic finding for the preschooler is:
a. Within normal limits
b. Borderline stuttering
c. Mild stuttering
d. Moderate stuttering
e. Severe stuttering

Answer 50

c. Mild stuttering

Question 50

An 18-year-old male immigrant from Russia exhibits the following characteristics: He speaks Russian and English fluently; he is severely dysfluent during all conversations with the clinician while speaking English, conversations with the father in Russian, narrative discourse in Russian and English, and reading in Russian and English; he avoids conversational situations as much as possible; he has secondary mannerisms associated with dysfluent behaviors; and he has no concomitant speech-language difficulties. An appropriate treatment approach for a bilingual stutterer would probably include:
a. Using an indirect treatment approach and conducting more counseling on dealing with the speech fluency issues and coping with the stuttering
b. Using a technical approach to address speech fluency in English, because it will allow for automatic transfer to the other language
c. Addressing the severe speech fluency issues in both languages and, at the same time, working on feelings, attitudes, and acceptance
d. Using an approach in which the dysfluencies are addressed, and the secondary mannerisms and attitude issues will automatically disappear
e. Using a fluency-shaping approach by asking him to respond to your model of slow and easy talking

Answer 50

c. Addressing the severe speech fluency issues in both languages and, at the same time, working on feelings, attitudes, and acceptance

Question 51

A 3-year-old boy comes from a family with very high expectations. He is enrolled in private preschool and does very well in school. His pediatrician, parents, and teachers have expressed some concerns, however, and he was evaluated by an SLP. The boy’s mother appears to be a very tense person. He exhibited the following characteristics: cognitive skills that were within normal limits; above-average receptive and expressive language skills; repetitions and prolongations at a rate of 15 per 100 words; two revisions; and one incomplete phrase. If treatment is recommended for a preschooler with mild stuttering, the appropriate course of action would be:
a. No treatment at this time
b. Prescriptive counseling for the parents only
c. Prescriptive counseling for the parents and demonstrations of appropriate interaction with the preschooler
d. Treatment for the child only
e. Prescriptive counseling for the parents and stuttering modification for the child

Answer 51

c. Prescriptive counseling for the parents and demonstrations of appropriate interaction with the preschooler

Question 52

A 3-year-old boy comes from a family with very high expectations. He is enrolled in private preschool and does very well in school. His pediatrician, parents, and teachers have expressed some concerns, however, and he was evaluated by an SLP. The boy’s mother appears to be a very tense person. He exhibited the following characteristics: cognitive skills that were within normal limits; above-average receptive and expressive language skills; repetitions and prolongations at a rate of 15 per 100 words; two revisions; and one incomplete phrase. When making clinical decisions about preschoo-lers, clinicians should take under consideration indicators of the need for treatment. The following
are
clinical indicators for enrollment in treatment except:
a. A family history
b. Change in the speech disruptions and evidence of more tension
c. Appropriateness of the child’s speech language skills
d. Emotional reactions by the child
e. The child’s lack of concerns about his speech

Answer 52

e. The child’s lack of concerns about his speech

Question 53

A 3-year-old boy comes from a family with very high expectations. He is enrolled in private preschool and does very well in school. His pediatrician, parents, and teachers have expressed some concerns, however, and he was evaluated by an SLP. The boy’s mother appears to be a very tense person. He exhibited the following characteristics: cognitive skills that were within normal limits; above-average receptive and expressive language skills; repetitions and prolongations at a rate of 15 per 100 words; two revisions; and one incomplete phrase. Of the following courses of treatment for a preschooler diagnosed with mild stuttering, which is appropriate at this time?
a. Do nothing at this time; these speech fluency characteristics are within normal limits
b. Enroll the child in a prevention and early intervention program to address parental concerns and the child’s speech fluency
c. Use an indirect treatment approach
d. Wait and discuss information with the parents at later date and then retest the child to determine the extent of the speech fluency behaviors
e. Enroll the child in a direct treatment program

Answer 53

b. Enroll the child in a prevention and early intervention program to address parental concerns and the child’s speech fluency

Question 54

Many researchers have examined the conversational rates of parents of children who stutter. They have concluded that although the results are inconsistent, there is no information to support the claim that mothers’ communication behaviors contribute to the causes of stuttering. There is, however, information that supports the notion that parental communication behaviors can be manipulated to promote positive outcomes for chil. dren who stutter.
These behaviors are reflected in
speaking rate, as well as:
a. Length and complexity of utterances, interruptions, and turn-switching pauses
b. Length and complexity of utterances, interruptions, and turn-taking
c. Length and complexity of utterances, turn-switching pauses, and turn-taking
d. Length and complexity of utterances, interruptions, and silence
e. Interruptions and turn-taking strategies

Answer 54

a. Length and complexity of utterances, interruptions, and turn-switching pauses

Question 55

Many authorities have discussed the role of temperament and personality in the development and course of childhood stuttering. According to Conture and Curlee (2007), temperament is rooted in basic psychological processes. From a neurological standpoint, these psychological processes are believed to be tied to the combined influences of all the following except:
a. The degree of reactivity
b. The number and degree of self-regulatory processes that the child exhibits
c. The weakness of emotional responses
d. The level of physical activity and regularity of biological cycles
e. The ability to facilitate or inhibit reactive and emotional responses

Answer 55

c. The weakness of emotional responses

Question 56

During the stuttering evaluation process, the SLP tries to elicit speech in a variety of speaking situations. An SLP collects several speech samples. In this task, the clinician asks the patient to describe how the SLP does his or her job. In addition, the patient is asked to discuss a movie he or she had just seen. This clinical interaction is an example of what type of communicative interaction?
a. Conversation
b. Monologue
c. Reading
d. Narrative discourse
e. Description

Answer 56

d. Narrative discourse

Question 57

A preschool child is enrolled in stuttering treatment, and the SLP is using a direct treatment approach. The approach focuses on the child’s speech, the parenting style, and the child’s temperament. The SLP is focusing on teaching the parents how to conduct treatment, monitor progress, and measure stuttering in everyday settings. The program that the SLP is using is
a. The Lidcombe Program Onslow et al (2003)
b. The Gregory early intervention program Gregory
(2003)
c. A stuttering prevention program
d. The indirect treatment approach to early intervention
e. The indirect treatment approach for early intervention and childhood stuttering

Answer 57

a. The Lidcombe Program Onslow et al (2003)

Question 58

There is evidence to support the notion that with above-average mean length of utterance (MLU), preschool children who stutter display stuttering-like behaviors and children who do not stutter display nonstuttering-like dysfluent behaviors. When the children’s MLUs are in the average range, dysfluent behavior is less evident.
These findings lend support to the hypothesis that:
a. Utterance length and complexity are directly linked to stuttering
b. Utterance length and complexity indicate that language issues are the underlying factor associated with stuttering
c. Utterance length and complexity may change speech-language planning and production and may support the maintenance of speech fluency
d. Utterance length and complexity are the causes of stuttering
e. Utterance length and complexity have no direct relations to stuttering

Answer 58

c. Utterance length and complexity may change speech-language planning and production and may support the maintenance of speech fluency

Question 59

A parent training group includes eight mothers, each with a preschooler who stutters or who is at risk for stuttering. All the parents are from middle-income backgrounds and are highly educated, stay-at-home mothers. The parents are eager to learn as much information as possible about stuttering. The appropriate treatment for the group of parents would be to:
a. Have the parents purchase information from the Stuttering Foundation of America, have the highly educated parents meet together, and find out whether they have questions
b. Have the parents meet together, have them share stories about their children, and guide them on the best possible way for dealing with the stuttering
c. Teach the parents to use normally slower talking and shorter utterances, to minimize questions, to use pauses during conversations, and to avoid corrections; parents are also encouraged to discuss issues that affect stuttering
d. Teach parents how to videotape speech at home, monitor behaviors, and avoid situations that cause stuttering, and discuss issues that affect stuttering
e. None of the above

Answer 59

c. Teach the parents to use normally slower talking and shorter utterances, to minimize questions, to use pauses during conversations, and to avoid corrections; parents are also encouraged to discuss issues that affect stuttering

Question 60

A stuttering treatment program is designed for children in preschool and early elementary school who stut-ter. The program focuses on universal rules, primary rules when airflow and laryngeal difficulties are pres-ent, and secondary rules when concomitant behaviors are present. This program is described in which of the following publications?
a. Clinical Management of Childhood Stuttering (Wall and Myers, 1995)
b. Symmetric Fluency Training for Young Children (Shine, 1988)
c. “An Indirect Treatment Approach for Early Intervention for Childhood Stuttering” (Richels & Conture, 2007)
d. “The Fluency Rules Program for School-Age Children Who Stutter” (Runyan & Runyan, 2005)
e. Working With People Who Stutter: A Lifespan Approach (Bennett, 2006)

Answer 60

d. “The Fluency Rules Program for School-Age Children Who Stutter” (Runyan & Runyan, 2005)

Question 61

Counseling is a very important part of providing speech therapy to individuals who stutter. Counseling is a dynamic process that is everchanging. The role of the SLP is to help the patient or client manage change. Although many approaches have been used in managing stuttering, the current approach made popular by DiLollo, Manning, and Neimeyer 2005) focuses on the belief that humans create their own reality and construct personal meanings with the development of nar-ratives. This broad area of counseling is known as:
a. Narrative therapy
b. Constructivist counseling
c. Psychotherapy
d. Self-actualization
e. Self-help

Answer 61

a. Narrative therapy

Question 62

A school-based clinician uses a stuttering program that is an integrated treatment approach. It addresses overt stuttering and attitudinal-emotional consequences of stuttering and provides strategies for managing teasing and bullying. The program is ideal for patients aged 7 to 12 years; it is delivered in a 4-week intensive period. The basic treatment goals and components include speech-related, attitudinal-emotional, self-management, and environmental concerns. This program is described in:
a. “The Comprehensive Stuttering Program for School-Age Children with Strategies for Managing Teasing and Bullying” (Langevin et al, 2005)
b. “The Fluency Rules Program for School-Age Children Who Stutter” (Runyan & Runyan, 2005)
c. Working With People Who Stutter: A Lifespan Approach (Bennett, 2006)
d. Assessment of Fluency in School-Age Children (Thompson, 1983)
e. Cooper Personalized Fluency Control Therapy-Revised (Cooper & Cooper, 1985)

Answer 62

a. “The Comprehensive Stuttering Program for School-Age Children with Strategies for Managing Teasing and Bullying” (Langevin et al, 2005)

Question 63

Byrd and associates (2005) indicated that one third of the children who exhibit fluency disorders also have a concomitant phonological impairment. Although data on treatment outcomes are limited, Wolk (1998) outlined six clinical principles that are based on which approach?
a. Modification of phonological errors but a direct approach for the modification of dysfluency
b. The concurrent application of phonology and fluency intervention strategies
c. Direct modification of dysfluency with allowing phonological errors to naturally correct themselves
d. Modification of the phonological errors and use of this approach to address the dysfluency
e. None of the above

Answer 63

a. Modification of phonological errors but a direct approach for the modification of dysfluency

Question 64

There are many similarities and differences between adolescents and adults who stutter. It is well established that motoric, behavioral, emotional, and cognitive aspects of stuttering are important components. One aspect that is very important to the treatment process is attitudinal-emotional. From the following list, which secondary goal is directed to the attitudinal-emotional area of treatment?
a. Positive attitudes toward communication
b. Openness about stuttering and fluency-enhancing techniques
c. Reduced avoidance behaviors
d. Increased family understanding of the causes and development of stuttering
e. Improved communication and social skills

Answer 64

d. Increased family understanding of the causes and development of stuttering

Question 65

An SLP developed goals for a 20-year-old college student with a history of stuttering. His stuttering was considered moderate in nature.
The SLP’s goals focused on self-monitoring, self-evaluation, problem-solving, manipulating the environment, and sequencing practice activities. Of the following categories, which best describes the goals that the SLP is working on?
a. Speech-related goals
b. Attitudinal-emotional goals
c. Self-management goals
d. Environmental goals
e. Self-study

Answer 65

c. Self-management goals

Question 66

Working on cognitive-behavioral skills has long been thought to contribute to the maintenance of improved fluency in adolescents and adults. Ivey and colleagues (1987) identified some cognitive-behavioral tasks of therapy. Of the following tasks, which is not cognitive-behavioral?
a. Examining transfer of skills
b. Examining how one thinks and, if necessary, changing thinking and cognition
c. Ensuring that patients act on those cognitions through behavior in their daily lives
d. Engaging in decision making to determine how to act
e. None of the above

Answer 66

a. Examining transfer of skills

Question 67

A patient exhibits subtle but salient features of stuttering. These include syllable repetitions, prolongations, and secondary mannerisms. Her speaking difficulties affect her socially, emotionally, educationally, and vocationally. The likely diagnosis for this patient will be:
a. Overt stuttering
b. Covert stuttering
c. Social stuttering
d. Psychological stuttering
e. Neurogenic stuttering

Answer 67

b. Covert stuttering

Question 68

A patient exhibits subtle but salient features of stutter. ing. These include syllable repetitions, prolongations, and secondary mannerisms. Her speaking difficulties affect her socially, emotionally, educationally, and vocationally. Because the diagnosis is covert stuttering. the course of treatment for this patient would probably include:
a. A counseling approach in conjunction with a techniques approach
b. Techniques and strategies alone
c. Counseling alone
d. Fluency shaping
e. All the above

Answer 68

a. A counseling approach in conjunction with a techniques approach

Question 69

An adolescent with learning disabilities is having difficulties with dysfluent behaviors. He is often dysfluent when trying to retrieve a word during conversation, when storytelling, and when he is trying to organize what he wants to say. He exhibits primarily word and phrase repetitions, as well as hesitations. Also noted are articulatory gropings and interjections. His diagnosis is:
a. Dysarthric stuttering
b. Apraxic stuttering
c. Dysnomic stuttering
d. Language stuttering
e. Psychogenic stuttering

Answer 69

c. Dysnomic stuttering

Question 70

Transfer of skills is the biggest challenge that clinicians face when working with individuals who stutter. Of the following definitions, which is accurate for the main goal of transfer?
a. To generalize clinic-established behavior to representative everyday speaking situations
b. To promote sequential modification to promote fluency in progressively more difficult situations
c. To modify the antecedents or stimuli that trigger stuttering in situations beyond the clinic
d. To self-evaluate speech in all speaking situations
e. To self-educate so that one is ready to speak in all situations

Answer 70

a. To generalize clinic-established behavior to representative everyday speaking situations

Question 71

An SLP completed a diagnostic protocol that included case history (medical, social, occupational, and personal information; onset and development of stuttering); testing of general functions (language [vocabulary, reading, naming] speech [motor speech examination], and cognition); speech fluency assessment (reading, spontaneous speech, automated speech, trial therapy and techniques, speaking situations, and stuttering severity); and self-assessment. This protocol is probably for:
a. acquired stuttering
b. Apraxic stuttering
c. Dysarthric stuttering
d. Dysnomic stuttering
e. All the above

Answer 71

e. All the above