Fluency Disorders

Question 1

Fluency

Answer 1

Fluent Speech is the consistent ability to move the speech production apparatus in an effortless, smooth and rapid manner resulting in a continuous , uninterrupted forward flow of speech

Question 2

Stuttering

Answer 2

Stuttering is the most common fluency disorder
Greatest medical mystery with no known cause or no known cure
Many people have studied stuttering to find a cause or cure, but neither has been discovered
Stuttering affects the ability to produce fluent speech
A disturbance in the normal fluency and timing patterns of speech that is inappropriate or the person’s age
Stuttered speech is characterized by involuntary repetitions, prolongations and broken words.
Repetitions
buh-buh-buh-buh-ball
Prolongations
mmmmmm-mommy
Broken words (blocks)
b-oy

Question 3

Secondary Features (behaviors)of Stuttering

Answer 3

Behaviors which accompany stuttering
Result from excessive mental and physical efforts to promote fluent speech
Common secondary features
Eye blinking
Facial grimacing
Facial tension
Head jerks
Pauses
Word changes
Filler words e.g. um, uh
Another secondary feature is a negative attitude toward speaking
Worry about speaking
Believe other people don’t like the way they speak

These behavior become habitual and can remain permanently associated with a person’s stuttering

Question 4

Charles VanRiper

Answer 4

Distinguished professor of speech pathology at Western Michigan University
Pioneer in the treatment of stuttering – many of his treatment techniques are still used today
Was a stutterer himself
Spent most of his life looking for a cure

“To the ancient birch tree to whom, when I was a youth and it was a sapling, I swore an oath to find the cause and cure of stuttering that afflicted me and so many others. Though I have failed and we have both grown old I did my utmost and am content. Others will take up my quest”

Question 5

Famous Stutterers

Answer 5

Famous people who stuttered
Sir Isaac Newton
Winston Churchill
Carly Simon
Marilyn Monroe
Bruce Willis
Ann Glen

Question 6

Incidence of Stuttering

Answer 6

5% of adults report stuttering at some point in their life
65-75% of children who stutter will recover within the first 2 years after it’s onset
85% will recover within the next few years
1% of those reported stuttering will remain throughout adulthood
High familial incidence – 50%
Affects males 3:1 ratio

Question 7

How does stuttering affect a person’s life?

Answer 7

Affects school, work, daily life and social interactions
Children may withdraw and refuse to communicate in school
Adults may choose careers where they don’t have to speak
May avoid social contact due to their fear of speaking

Question 8

Theories of Stuttering

Answer 8

MANY THEORIES - NONE PROVEN
Fall into three categories
Organic
Behavioral
Psychological

Question 9

Organic Theories

Answer 9

Believe there is an actual physical cause

Earliest – Aristotle felt there was a disconnect between mind and body

Question 10

Behavioral Theories

Answer 10

Believe stuttering is a learned behavior

Question 11

Psychological Theories

Answer 11

Believe that stuttering is a neurotic symptom with ties to unconscious needs and interanl conflicts and treated appropriately with psychotherapy

Question 12

Developmental Dysfluencies

Answer 12

Children normally exhibit many hesitations, revisions and interruptions in their utterances
Children at around 25 months of age are more fluent than they will be at 37 months
No secondary symptoms
Fluency improves following the third birthday
Normal dysfluencies
2 years – typically whole word repetitions – I want, I want milk
Interjections – can we go um now?
Revisions – He can’t – He won’t play baseball

Question 13

Onset of Stuttering

Answer 13

Typically occurs between 2 and 5 years of age
Stuttering is gradual for most children
Stuttering severity increases as the child grows older

Question 14

Bloodstein’s Phases of Developmental Stuttering

phase I

Answer 14

Phase I
Corresponds to the pre-school years, roughly between 2 and 6 years of age
Tends to be episodic; periods of stuttering followed by periods of relative fluency
Sounds and syllable repetitions are the dominant feature
Most children are unaware of the interruptions in their speech
Child will usually stutter when excited or upset about something
Usually occurs at the beginning of words or phrases
Occurs on both content words (nouns/verbs) and function words (articles/prepositions)

Question 15

Phase II

Answer 15

Represents a progression of the disorder
Associated with children of elementary school age
Essentially chronic, or habitual, with few intervals of fluent speech
Has developed a concept of himself as a person who stutters – will refer to himself as a stutterer, but typically does not express concern about stuttering
Occurs primarily on content words
Stuttering more widely dispersed throughout the child’s utterances
Occurs primarily on content words

Question 16

Phase III

Answer 16

Age 8 to young adulthood
In response to specific speaking situations, such as telephone, speaking in groups, strangers
Certain words become regarded as more difficult and will avoid feared words or substitute with a similar word

Question 17

Phase IV

Answer 17

The “apex” of stuttering
Stuttering at it’s most advanced form
Vivid and fearful anticipation of stuttering
Certain words, sounds, or situations are feared and avoided
Evidence of embarrassment
Very advanced secondary symptoms