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SPH511 > Fluency (stuttering) > Flashcards

Fluency (stuttering) Flashcards

1
Q

No agreed and failsafe definition of stuttering. True or false?

A

True

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2
Q

Wingate’s (1964) symptomatic definition of stuttering

A

(a) disruption in the fluency of verbal expression, which (b) is characterised by involuntary, audible or silent, repetitions or prolongations in the utterance of short speech elements, namely: sound, syllables and words of one syllable. The disruptions (c) usually occur frquently or are marked in character and (d) are not readily controllable (p. 488)

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3
Q

Ambrose and Yairi (1999) symptomatic definition of stuttering:

A

More than 3 stutter-like disfluencies (SLDs) per 100 syllables.

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4
Q

Perkins (1984) internal definition of stuttering

A

…temporary overt or covert loss of control of the ability to move forward fluently in the execution of linguistically formulated speech (p. 431)

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5
Q

Bloodstein (1987) consensus or perceptual definition of stuttering:

A

…whatever is percieved as stuttering by a reliable observer who has relatively good agreement with others (p. 9)

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6
Q

In Lidcombe Behavioural Data Language (LBDL), why is syllable rather than word used as the frame of reference?

A

Because the syllable is the metric of speech production, while the word is a unit of meaning –> reflects view that stuttering is a speech disorder.

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7
Q

Does the Lidcombe Behavioural Data Language (LBDL) describe stuttering as observable behaviour?

A

yes

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8
Q

Which 3 broad categories does the Lidcombe Behavioural Data Language (LBDL) place stuttering behaviours into?

A
  • Repeated movements
  • Fixed postures
  • Superfluous behaviours
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9
Q

List the Lidcombe Behavioural Data Language REPEATED MOVEMENTS (3)

A
  • syllable repetition
  • incomplete syllable repetition
  • multisyllable repetition
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10
Q

List the Lidcombe Behavioural Data Language FIXED POSTURES (2)

A
  • with audible airflow (prolongation)

* without audible airflow (block)

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11
Q

List the Lidcombe Behavioural Data Language SUPERFLUOUS BEHAVIOURS (2)

A
  • verbal

* nonverbal

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12
Q

Which taxonomy of stuttering uses seven descriptors under three broad categories to describe stuttering behaviour?

A

The Lidcombe Behavioural Data Language (LBDL)

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13
Q

To describe a single occurrence of stuttering, as many of the descriptors for stuttering behaviour as necessary can be used. True or false?

A

True

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14
Q

Which unit of speech is the focus of repeated speech movements?

A

the syllable

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15
Q

Is pa-pa-pa-sing an example of syllable repetition or incomplete syllable repetition?

A

syllable repetition. In spoken English syllables often produced in CV form, so this word is broken up pa/sing

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16
Q

Incomplete syllable repetition looks like…(2)

A

i) Vowel or dipthong is incomplete. Either too short, or doesn’t reach target shape.
ii) Consonant or Consonant cluster without vowel is repeated.

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17
Q

Multisyllable repetition is when more than one syllable is repeated as a unit. Some examples:

A
  • Multisyllabic words “over-over-over the top..”
  • Cluster of words -> “in the- in the- in the end…”
  • Syllables that form part of a word “…photo- photo- photogenic.”
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18
Q

What are fixed postures as described by LBDL?

A

The structures of the vocal tract are stationary during attempts to speak.

a) with audible airflow (+/-v)
b) without audible airflow

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19
Q

Are superfluous behaviours as described by LBDL, part of the intended utterance?

A

No. But can be spoken ie “I went- oh well - oh well, I- well…”

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20
Q

Provide examples of some nonverbal superfluous behaviours in stuttering according to LBDL:

A
  • Visible or audible behavours such as facial, head and torso movements (nonverbal)
  • speaking on inpiratory air.
  • grunts and other inappropriate noises.
  • abberrant fluctualtions in pitch and loudness.
  • ->typically idiosyncratic.
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21
Q

On repeated reading of a passage, stuttering moments tend to recurr on the same words (consistancy). What happens if those words are removed?

A

*The stuttering moment will occur close to where the removed word had been located (adjacency).

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22
Q

Where do stuttering moments tend to occur?

A
  • First sounds of words
  • First words of utterances or clauses
  • Consonants rather than vowels
  • Longer words rather than shorter words.
  • Content words rather than function words (maybe opposite for children)
23
Q

True or false (3 questions)

  1. People who stutter may find some speech sounds more difficult than others?
  2. Longer utterances tend to mean increased stuttering?
  3. Stuttering moments tend to cluster?
A

All true.

24
Q

3 types of auditory feedback/blocking that usually reduce stuttering?

A

i) Delayed auditory feedback (DAF)
ii) Frequency altered feedback (FAF)
BUT –> poor transferability if not using device
ii) masking (white noise in ear - can’t hear own voice)

25
Q

3 ways a person can change their speech, that usually reduced stuttering:

A
  • changing speech (loudness, accent)
  • reduced speech rate
  • Rhythmic speech (ie with metronome. Effective, but sounds abnormal).
26
Q

3 [reading] methods that can reduced stuttering (while doing this):

A
  • repeated readings
  • chorus reading
  • shadowing (repeating what someone has just said)
  • -> BUT poor transferability
27
Q

What is response contingent stimulation?

A

Operant conditioning. It’s at the core of the Lidicombe program. Reward is given for good behaviour (no punishments).
For adults they are punished with a 3 second time-out from speaking for every stuttering moment.

28
Q

What is epidemiology?

A

The study of rates of diseases in populations and the variables that can influence those rates.

29
Q

Why is knowing the epidemiology of a disorder useful in clinical practice?

A
  • provides clues about the nature and cause of the disorder.
  • facilitates planning healthcare for the disorder.
  • Provides knowledge about the untreated course of a disorder.
  • Knowledge about this disorder in relation to other disorders.
30
Q

Cumulative incidence of stuttering in Australia:

A
  • about 10%

* *BUT the PREVALENCE of stuttering is 1.5% in all populations.

31
Q

What is the sex ration (approx)?

A

More adult males stutter than adult females. BUT similar number of small boys to girls stuttering.

32
Q

Early stuttering is a less severe population than advanced stuttering, and overall there are more mild cases than severe ones.

A

–>? Mild cases more likely to spontaneously recover, while severity increases in those who didn’t spontaneiously recover…?

33
Q

Onset of stuttering is sudden (1-3 days) in how many cases?

A

About 50%

34
Q

When is the most common age of onset for stuttering?

A

between 2-4 years.

35
Q

True or false (2 questions)

1) Onset appears to be associated with rapid language development?
2) stuttering can be severe at onset?

A

1) true

2) true -> repeated movements prominent

36
Q

True or false. 2 questions:

1) Even within preschool years, stuttering can develop into a chronic condition?
2) Early stuttering is very variable across time and situations?

A

Both true.

37
Q

4 predictors of natural recovery:

A

1) Gender (female more likely)
2) Age
3) Family history of natural recovery
4) phonological skills

38
Q

Best practice treatment for early stuttering? Treatment time?

A

Lidcombe program

~11 hours. Very high success rate

39
Q

Best practice treatment for advanced stuttering? Treatment time?

A

Programmed speech restructuring treatments

~105-130 hours. Lower success rate than Lidicombe for early stuttering.

40
Q

Treatment outcome differences early vs advanced stuttering become evident how early?

A

As early as school-age years.

41
Q

Some issues with treatment outcomes after treating advanced stuttering:

A
  • Higher levels of residual stuttering
  • quality of life issues
  • speech naturalness issues
  • prone to relapse
42
Q

Why is it critically important to intervene early with preschool children who stutter?

A
  • efficacy (degree and quality of outcome reduced for advanced stuttering - evident in school aged children)
  • efficiency (therefore, cost of care: 11hrs vs 130 hours!)
43
Q

Why is it critically important to intervene early with preschool children who stutter?

A
  • efficacy (degree and quality of outcome reduced for advanced stuttering - evident in school aged children)
  • efficiency (therefore, cost of care: 11hrs vs 130 hours!)
  • bullying, negative peer reactions –> begins in preschool! –> low self-esteem, mental health…
44
Q

Potential sequelae of chronic stuttering:

A

*Occupational attainment hindered.
*QoL compromised.
*Higher prevalence of mental-health disorders (GAD - 4 x more, social phobia 6-7x more, panic disorder 6x more)
*

45
Q

Early intervention for stuttering crucial. Why?

A
  1. efficacy (degree/quality of outcome)
  2. efficiency (11hrs vs ~130hrs - costs)
  3. Negative peer reactions.
  4. –> poor job outcomes
  5. –> bad mental health
  6. —-> reduced Quality of Life (QoL).
46
Q

Superfluous behaviours often occur just before/with other stuttering behaviours., and they are not under volitional control (not normal facial expressions of frustration etc). True or false?

A

True

47
Q

How big a speech sample is needed as a minimum to adequately analyse stuttering behavours?

A

500 syllables (approx. 3-5 minutes)

48
Q

Stuttering onset typically coincides with a period of rapid language development? True or false?

A

True.

49
Q

Within how many months of the onset of stuttering is natural recovery usually experienced? How many children recover naturally?

A

Usually within 12 months of stuttering onset, if it’s going to happen.
80-90% of preschoolers recover naturally.

50
Q

Why is there a high relapse rate for adults learning prolonged speech patterns?

A

Clients need to do daily practice and try to maintain all speech in the new way they’ve learnt. Like being taught another accent and having to always speak that way –> high cognitive load. They’re forced to focus on how they’re speaking, rather than what they are saying.

51
Q

Preferred terminology for

  1. ) when somebody has an instance of stuttering
  2. ) when they are speaking without stuttering
A
  1. ) stuttering moment.

2. ) stutter-free speech. No stuttering.

52
Q

Comparison between early and advanced stuttering:

A

EARLY: *Less severe *Natural recovery possible *Variability across time and situations (can disappear and return for days) *More responsive to treatment.

ADVANCED: *More severe, not variable *Longer treatment time (speech restructuring treatments). *treatment outcomes: residual stuttering, speech naturalness issues, QoL issues, prone to relapse.

53
Q

Chandra: 16, in yr 10. Parents concerned stuttering will reduce job prospects. Stuttering severity fluctuates across situations -> worse in front of audience.
Bhutanese refugee, bilingual (Dzongkha). Many Bhutanese families nearby.
–>
For each MoP develop list of relevant factors to consider for assessment planning. Include rationales.

A

CRP - Bilingual. Lang. abilities of parents. Translation of reports. Standardised Ax won’t be standardised for him. Research attitudes to stuttering/SP in Bhutanese culture to target education and facilitate family support. Practice techniques in both languages to support his parents in understanding what you are doing and help them feel involved.
EBP - treatment suitable for age. Speech sample to categorise and count stuttering behaviours. Check literature on bilingualism and stuttering to plan next steps for CRP.
IPP - Interpreter. cross-cultural worker (so family can understand and engage in treatement. So I can better undersand environmental barriers/facilitators). Teachers to support at school. Councillor as his stuttering recently worse and he’s a refugee - may be psychological component.
FCP - Parent goals to get good job, go to uni. What are Chandra’s goals?

54
Q

Chandra’s parents ask what will happen next:

A
  1. Analyse info.
  2. Sit down with family to develop goals.
  3. Intervention planning - EBP.
  4. Implement intervention with ongoing evaluation.

SPH511 (10 decks)

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