Fluency Final Flashcards
Speech fluency is made up of…
Continuity
Rate
Effort
Rhythm
Fluency
the aspect of speech production that refers to the continuity, rate, effort, and rhythm with which phonological, lexical, morphological, and syntactical language units are spoken.
Disfluency
the “normal” disruptions in fluency
Dysfluency
the atypical type, referring to stuttering
Wingate’s definition of stuttering
disruption in fluency of verbal expression which is characterized by involuntary audible or silent repetitions or prolongations in sounds, syllable, and monosyllabic words. Accompanied by negative emotions (often not correlated with severity of stutter) and sometimes accompanied by accessory characteristics.
List of disfluencies (* =characteristic of stuttering, a.k.a. dysfluency)
1) interjections
2) phrase repetitions
3) revisions
4) incomplete phrases
5) part-word repetitions *
6) word repetitions (* …only monosyllabic, and it still depends)
7) prolongations *
8) broken words *
List of dysfluencies
o Part-word repetitions Sound Syllable o Monosyllabic word repetitions o Sound prolongations Audible Inaudible o Broken words
5 aspects that measure stuttering
frequency
duration
frequency by type
speech rate
Frequency
o Old method – stuttering moments/unit of time … but if you had one huge, difficult prolongation, your frequency would be lower than if you had two really easy ones, which is misleading
o Current – percent of words OR syllables stuttered (usually use syllables because if we use words, we can’t count multiple stutters within a single word)
o Recent suggestion – time interval judgments
o Note that interjections are not counted as stuttering moments, but if they stutter on the interjection itself, you can count that
Duration
o Stopwatch, computerized scoring (holding down key for stutter, clicking for syllables), acoustic measures (most accurate, i.e. for research)
o In SSI, we count only the 3 longest moments
Frequency-by-type
o Proportional distribution of dysfluency types, out of 100% dysfluent moments
For initial analysis/Dx, you may want to include all disfluencies
For someone who you already know stutters, just use dysfluencies
o Useful for analyzing whether client has progressed into less severe, difficult types of stuttering (i.e. simple monosyllabic word rep’s rather than inaudible prolongations)
Speech rate
o Different than articulation rate (syllables/min during fluent speech)
o The idea is that lower speech rate means you are stuttering more and couldn’t get through as many words
o Provides limited and questionable information, can be thrown off by individual variation
Stuttering severity
o Old: subjective ratings (i.e. Iowa scale)
o Never used much: sound prolongation index (frequency-by-type analysis, the more prolongations you have, the more severe)
o Used now: Instruments (indexes) that combine multiple measures (Stuttering Severity Index, SSI)
Based on 3 scores of overt characteristics:
• Frequency (in % stuttered syllable)
• Average duration of 3 longest moments
• Evaluation and scaling of accessory characteristics
Covert Characteristics
attitudes and emotions
Assess covert characteristics
o C.A.T. test showed that stuttering kids have negative attitudes about their speech even at 3-4 years old (KiddyC.A.T. test), although negative attitudes get worse with age. ..More proof that Wendell was wrong, kids are already aware they talk differently, we don’t need to keep it a secret`
Accessory characteristics
o Are learned (operant conditioned) behavior, NOT a part of the motor programming dysfunction. They are not tics. May be learned because the person feels like it helps them get a sound out, i.e. jerking head, or it helps them avoid anxiety, i.e. closing eyes)
Two classifications of Accessory Characteristics
1) By assumed purpose (escape, struggling, etc.) – But we shouldn’t assume
2) By type (this is how we categorize them in SSI)
• Facial grimaces
• Distracting sounds
• Head movements
• Movement of extremities
Acquired “neurogenic” stuttering
o Can occur from lesion to pretty much any part of cortex or subcortical structures
o TBI, CVA, degenerative disease, etc.
o Almost always combined with aphasia or some other language disorder
May be hard to distinguish from apraxia of speech, but apraxic symptoms would be repeated sounds groping at different articulatory positions, while stuttering would be repeating sounds at same articulatory position
o Unlike developmental stuttering, neurogenic stuttering does NOT improve with
Adaptation effect (reading something 5x)
Altered auditory feedback
o There is little research on neurogenic stuttering, and for now people kind of just adapt normal stuttering Tx and use it with them
Acquired “psychogenic” stuttering
Term used when no organic cause is found…controversial
Cluttering
o Fast spurts of speech, imprecise articulation, rephrasing, confused grammar, collapsed words, inability to monitor own speech and to respond to listener cues
o Actually a language disorder, not speech
o Comorbid with stuttering, articulation disorders, ADHD, learning disabilities
Spasmodic dysphonia
o A voice disorder
o Spasms of adductor and sometimes abductor muscles of VFs, can cause people to get stuck in a way like stuttering
o Most common in middle aged women
Stuttering age of onset
• Age of onset = about 2-4 y/o
o Problematic because of
Gradual onset
Based on parent recollections
Based on when parents noticed it as a problem, not necessarily when it just began
o Yairi study (bring your kid in the moment you suspect any stuttering) found that
65% of stutterers stuttered by age 3;0
85% of stutterers stuttered by age 3;6
o Classic idea is that stuttering has a gradual increase from relaxed word & syllable repetitions to more tense repetitions and prolongations, and finally accessory characteristics… although Yairi found that in 1/3 of cases, severe symptoms appeared pretty suddenly from the outset
