Fluency Disorders Flashcards
what is fluency?
the consistent ability to move the speech production mechanism in an effortless, smooth, and rapid manner resulting in a continuous uninterrupted flow of speech
examples of some disorders that interrupt fluency
- apraxia
- dysarthria
- aphasia
- stuttering
- cluttering
sound repetitions are most frequently associated with….
severe stuttering
example of sound repetition
b-b-boy
example of syllable repetition
be-be-before
word repetition example
the-the-the boy
where do sound repetitions usually occur?
in the initial position of a word
phrase repetitions
the boy, the boy
prolongations
- more severe than repetitions
- mostly occur on vowels and semi vowels
example of prolongation
thhhhhhaaaaaaaaa booooooy
blocks
the_____________boy
*most severe manifestations of stuttering
revisions
the boy, the guy
what is the normal age range for kids to stutter?
3 Y O
+/- 6 months
why do kids stutter?
speech and language skills are catching up to cognitive skills
developmental stuttering
occurs in the course of speech language development without any known trauma or neurological event
neurogenic stuttering
occurs after some form of trauma to the nervous system such as accident or disease
bloodstein’s stages
- 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
what is avoidance?
the consequence of stuttering
-people avoid situations in which stuttering is likely to occur
secondary features
behaviors that accompany stuttering although they don’t directly relate to speech
-dont have a positive affect on fluency
common secondary features
- avoiding eye contact
- hand/foot tapping
- twitches
organic theory of stuttering
- says there is a PHYSICAL cause within the person’s CNS
- brain imaging lends SOME support
behavioral theory
- 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
psychological theory
- stuttering is a neurotic symptom
- fear of expressing oneself, conflicts with others
- not strongly supported
linguistic theory
- 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
covert repair hypothesis
- errors in speech production are quickly caught by the speaker who attempts to repair them
- phonological encoding is the root problem
indirect therapy
- involves modifying the environment, reducing pressure around speaking
- work with parents, teachers, siblings
direct therapy
-explicitly work on reducing disfluencies
direct therapy strategies
prolonged rate of speech-reduces number of disfluencies
-delayed auditory feedback- delayed presentation of the person’s speech via headphones increases fluencies
reduced rate of speech
reduces pressure
reducing muscular tension by
speaking slower
-the faster you speak, the more tension
easy onset voicing
don’t start talking with a lot of tension
-dysfluencies usually occur at the onset of voicing
charles van riper’s approach
includes cancellations, pull outs, and preparatory techniques (sequence)
-how do we gain control over stuttering?
cancellations
following the stuttered word, the client waits 3 seconds then repeats the word in slow motion
b-b-boy 1 2 3 boooooy
what do cancellations teach?
teaches how to produce the word fluently and cencels the disfluency with fluent output
pull-out
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
preparatory sets
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
prep sets require
- a lot of word from patient
- carryover
- person to think about how they are producing speech
