Fluency Disorders

Question 1

what is fluency?

Answer 1

the consistent ability to move the speech production mechanism in an effortless, smooth, and rapid manner resulting in a continuous uninterrupted flow of speech

Question 2

examples of some disorders that interrupt fluency

Answer 2

• apraxia
• dysarthria
• aphasia
• stuttering
• cluttering

Question 3

sound repetitions are most frequently associated with….

Answer 3

severe stuttering

Question 4

example of sound repetition

Answer 4

b-b-boy

Question 5

example of syllable repetition

Answer 5

be-be-before

Question 6

word repetition example

Answer 6

the-the-the boy

Question 7

where do sound repetitions usually occur?

Answer 7

in the initial position of a word

Question 8

phrase repetitions

Answer 8

the boy, the boy

Question 9

prolongations

Answer 9

• more severe than repetitions

- mostly occur on vowels and semi vowels

Question 10

example of prolongation

Answer 10

thhhhhhaaaaaaaaa booooooy

Question 11

blocks

Answer 11

the_____________boy

*most severe manifestations of stuttering

Question 12

revisions

Answer 12

the boy, the guy

Question 13

what is the normal age range for kids to stutter?

Answer 13

3 Y O

+/- 6 months

Question 14

why do kids stutter?

Answer 14

speech and language skills are catching up to cognitive skills

Question 15

developmental stuttering

Answer 15

occurs in the course of speech language development without any known trauma or neurological event

Question 16

neurogenic stuttering

Answer 16

occurs after some form of trauma to the nervous system such as accident or disease

Question 17

bloodstein’s stages

Answer 17

• 4 stages of stuttering
• begins between 2-6 years
• final stage is around 8 years
• after 8, there may be another factor causing ther stuttering NOT developmental

Question 18

what is avoidance?

Answer 18

the consequence of stuttering

-people avoid situations in which stuttering is likely to occur

Question 19

secondary features

Answer 19

behaviors that accompany stuttering although they don’t directly relate to speech
-dont have a positive affect on fluency

Question 20

common secondary features

Answer 20

• avoiding eye contact
• hand/foot tapping
• twitches

Question 21

organic theory of stuttering

Answer 21

• says there is a PHYSICAL cause within the person’s CNS

- brain imaging lends SOME support

Question 22

behavioral theory

Answer 22

• stuttering is a learned response the conditions external to the individual
• a result of parents trying to increase a child’s fluency
• not strongly supported

Question 23

psychological theory

Answer 23

• stuttering is a neurotic symptom
• fear of expressing oneself, conflicts with others
• not strongly supported

Question 24

linguistic theory

Answer 24

• demands of a more complex language create fluency problems
• beatrice stocker (queens college)
• -for some people communicating complex novel info increases disfluency
• related to the more current demands and capacities model

Question 25

covert repair hypothesis

Answer 25

• errors in speech production are quickly caught by the speaker who attempts to repair them
• phonological encoding is the root problem

Question 26

indirect therapy

Answer 26

• involves modifying the environment, reducing pressure around speaking
• work with parents, teachers, siblings

Question 27

direct therapy

Answer 27

-explicitly work on reducing disfluencies

Question 28

direct therapy strategies

Answer 28

prolonged rate of speech-reduces number of disfluencies

-delayed auditory feedback- delayed presentation of the person’s speech via headphones increases fluencies

Question 29

reduced rate of speech

Answer 29

reduces pressure

Question 30

reducing muscular tension by

Answer 30

speaking slower

-the faster you speak, the more tension

Question 31

easy onset voicing

Answer 31

don’t start talking with a lot of tension

-dysfluencies usually occur at the onset of voicing

Question 32

charles van riper’s approach

Answer 32

includes cancellations, pull outs, and preparatory techniques (sequence)

-how do we gain control over stuttering?

Question 33

cancellations

Answer 33

following the stuttered word, the client waits 3 seconds then repeats the word in slow motion
b-b-boy 1 2 3 boooooy

Question 34

what do cancellations teach?

Answer 34

teaches how to produce the word fluently and cencels the disfluency with fluent output

Question 35

pull-out

Answer 35

client realizes they are stuttering on a word and begins to slow down and produce the word fluently without stopping (speeds up cancellation process)

b-b-b-b bbbboooooooyyyy

Question 36

preparatory sets

Answer 36

the slowing down of speech occurs prior to the actual stuttering, when the person is aware that they may stutter
-works well because people often know which words will cause them to stutter

Question 37

prep sets require

Answer 37

• a lot of word from patient
• carryover
• person to think about how they are producing speech