Fluency Disorders and Treatment

Question 1

How many people in the US stutter?

Answer 1

About 3 million

Question 2

Is stuttering more common in boys or girls?

Answer 2

Boys. Male to female ratio is 4:1

Question 3

Can children outgrow stuttering?

Answer 3

Yes

Question 4

Can stuttering have a onset later in childhood (after other language development?)

Answer 4

Yes

Question 5

What causes stuttering?

Answer 5

Nobody knows exact ideology.

Question 6

T/F Stuttering can be cured.

Answer 6

False. There is no cure for stuttering. Just treatment approaches and strategies to help people who stutter control their speech.

Question 7

What does speech fluency involve?

Answer 7

Rate
Continuity
Rhythm
Effort

Question 8

Stuttering is an abnormally high _____________ and or ________________ of _______________ in the forward flow of speech.

Answer 8

frequency; duration; stoppages

Question 9

What are the core behaviors with stuttering? (4)

Answer 9

Repetitions (sounds, syllables & words)
Prolongations
Blocks
Dysfluencies primarily on 1st sound/syllable

Question 10

What are secondary behaviors with stuttering? (2)

Answer 10

Escape behavior (head nods, eye blinks, tremors)
Avoidance behavior (substitutions, tension, pauses)

Question 11

What factors within the child should be considered when diagnosing stuttering? (4)

Answer 11

Family History
Sensitive Temperament
Male
Presence of Other Speech/Lang Disorder

Question 12

What factors within the environment should be considered when diagnosing stuttering? (4)

Answer 12

Rapid-fire, high pressure comm patterns in home
Impatience or anxiety about child’s stuttering
Traumatic Events in Child’s Life
High Expectations

Question 13

What sort of nonfluencies are considered normal in children?

Answer 13

Phase repetitions
Interjections (umm)
Revisions

(experienced by many children between 2-8 yrs.)

Question 14

When should we view disfluencies as Disordered rather than part of a normal developmental stage?

Answer 14

When disfluencies are:
Frequent (more than 10% of syllables)
Occur in several situations
Occur over longer periods of time

Question 15

What 4 stuttering treatment components would be used with a preschooler?

Answer 15

Distinguish between normal dysfluencies and stuttering
Address parental concern
Teach parents and caregivers what to do
Direct Intervention (speech therapy)

Question 16

What things can a parent or caregiver do to help promote fluency in a young child?

Answer 16

Give child time to talk (pause 1 sec)
Talk more slowly
Use shorter, simpler sentences; limit questions
Don’t correct or tell the child to slow down (don’t add pressure)

Question 17

T/F: With older children and adults, you need to focus on whether or not the person is stuttering.

Answer 17

False. Focus on what they do when they are disfluent and how the SLP can help them be more fluent.

Question 18

What are the 4 components to stuttering treatment for older children and adults?

Answer 18

Use fluency shaping techniques
Stuttering modification techniques
Generalize skills to spontaneous speech
Help client carry over skills to natural environment

Question 19

What things are measured when assessing and diagnosing a person who stutters? (5)

Answer 19

Frequency and Type of Disfluency
Average length of Most Severe Stuttering Moments
Types of Disfluencies (how many repetitions? how many prolongations? how many blocks?)
Attitudes and Emotions Measure
Situational Assessment

Question 20

What are the three main approaches to treatment of disfluent speech?

Answer 20

Fluency Shaping (teach to produce fluent sound)
Stuttering Modification (teach to stutter more easily)
Combination of Both of these

Question 21

What are the Fluency Shaping/Fluency Enhancing Techniques?

Answer 21

Easy Onsets
Decrease Speaking Rate 
Light Articulation Contacts 
Continuous Phonation 
Change Overall Speech Pattern (not just stuttering moment) 
Delayed Auditory Feedback

Question 22

What are the Stuttering Modification Techniques?

Answer 22

Cancellations
Pull Outs
Preparatory Sets

Question 23

What are the 3 Areas of Focus when “Treating the Entire Disorder” ?

Answer 23

Addressing Impairment: Improving Fluency (Timing, Rate, Tension)
Addressing the Impairment in Body Function (Speech Machine, Physical Tension)
Addressing the Rest of the Disorder (ABC Reactions)

Question 24

What are the “ABC Reactions” that a child might have?

Answer 24

Affective (shame, embarrassment, isolation, anxiety)
Behavioral (physical tension, avoids being social)
Cognitive (evaluates himself negatively as a communicator)

Question 25

What techniques can be used to address the timing and tension in a person who stutters?

Answer 25

Change timing through pacing
Change tension through light contact
Change timing and tension through easy starts

Question 26

What techniques can be used to address the impairment in body function?

Answer 26

Learn about “speech machine”
Staying “the the block” to explore what is happening during the stuttering moment
Pseudostuttering to reduce tension

Question 27

What are the General Treatment Guidelines for stuttering?

Answer 27

Systematically Increase Difficulty Level
Work Towards Naturalness of Task
Move Client Towards Self-Monitoring
Refer/Provide Support Group

Question 28

What 3 techniques can be used to minimize a client’s reaction to loss of speech control?

Answer 28

Self-Analysis (increase client’s awareness)
Relaxation (reduce the client’s anxiety and tension)
Desensitization (reduce negative emotions associated with stuttering-can be done through voluntary stuttering)

Question 29

How does assessment and treatment for adults who stutter differ from preschoolers with disfluencies?

Answer 29

With adults, the focus is not on whether or not the person is stuttering. With young children, it is important to determine what is disordered and what might be a developmental disfluency.