Language and Stuttering

Question 1

Motherese

Answer 1

Infant directed speech
Shorter phrases
Sing-song voice
Enthusiasm
Contextually redundant phrases
Concrete vocabulary

Question 2

Late Talker

Answer 2

less than 50 words or no two-word combinations by 24 months
1-2/5 toddlers persist in their language delay beyond the preschool years
Toddlers who persist in their language delay are diagnosed as having a language disorder or a developmental language disorder

Question 3

reflexive vocalizations

Answer 3

0-2 months
Body’s automatic responses

Question 4

Cooing/gooing

Answer 4

2-4 months
Back vowels and consonants

Question 5

Vocal play/expansion

Answer 5

4-6 months
Raspberries, trills, growls, squeaks → some cv

Question 6

canonical/reduplicated babbling

Answer 6

6-8 months
CVCV chains

Question 7

variegated/non-reduplicated babbling

Answer 7

8 months-1 year
CV sequences with variety of C’s and V’s

Question 8

perlocutionary stage

Answer 8

non-intentional communication
Birth-8ish months
Actions or signals performed without specific communicative intent, often non-verbal
Adult often interprets behaviors as meaningful
Ex: baby points to a balloon in excitement

Question 9

illocutionary stage

Answer 9

aka intentional stage
8-12 months
Development of intentionality (using behaviors like pointing to communicate meaning), joint attention, and protowords (phonetically consistent forms)

Question 10

locutionary stage

Answer 10

emergence of words
12+ months
First words appear, words and gestures have a symbolic meaning
No longer dependent on gestures
Experimenting with words

Question 11

Nativist/Natural Theory

Answer 11

Chomsky
Language Acquisition Device: a natural ability to learn language by being exposed to it
Universal grammar: all humans both with basic grammar structure that helps us learn any language
suppress incorrect processes as we age

Question 12

Behaviorist Theory

Answer 12

copy others and be rewarded
BF Skinner
Operant conditioning: learning happens because of rewards/consequences
Reinforcement: when something good d happens it encourages us to do it again

Question 13

Cognitive theory

Answer 13

lang grows as kid thinks and understands more through stages of learning
Piaget
Stages of cognitive development
Object permanence

Question 14

Social Interaction Theory:

Answer 14

interact with others and learn from people that know more
Vygotsky
Zone of proximal development
Social interaction: interacting with others is KEY to learning lang

Question 15

Selective Mutism

Answer 15

Rare
significant social/academic impairment
consistent failure to speak in specific settings
Runs in families
Associated with behavioral inhibition
Comorbidities: anxiety and neurodevelopmental disorders

Question 16

Tx of Selective Mutism

Answer 16

First steps: psychoeducation and behavioral management
Gradual exposure and reward contingency
Strategy: use exposure-based practice

Question 17

Factors that improve the prognosis for a child who is not speaking

Answer 17

Younger age
Presenting with selective mutism
Early identification

Question 18

Types of fluency disorders

Answer 18

Developmental Stuttering: Common in early childhood, gradual onset.
Acquired Stuttering: Sudden onset due to neurological or psychological trauma (e.g., Neurogenic, Psychogenic).
Cluttering: Rapid/irregular speech rate, high disfluency rate (acquired later childhood, child usually unbothered)

Question 19

Contributing Factors to fluency disorders

Answer 19

Biological: Genetic predisposition (42–84% heritability), reduced gray/white matter in brain areas linked to speech.
Environmental: Stress, high demands exceeding capacities.
Temperament: High emotional reactivity, low regulation.

Question 20

stuttering - dx measures

Answer 20

Frequency (total disfluencies per words spoken).
3+ SLD per 100 words or 3% of spoken words - indicative of stuttering
5% of any disfluency during spoken words - indicative of stuttering
Severity: types of disfluency
SLDs: repetitions, prolongations, and blocks
Disfluencies lasting more than 1 second are significant
Disfluencies with visible tension, strained speech, or multiple iterations
Feelings/attitudes (embarrassment, fear).

Question 21

stuttering - Primary Behaviors:

Answer 21

related to the the actual SLD
Sound/word repetitions (e.g., “ba-ba-ball”).
Prolongations, blocks.

Question 21

stuttering - secondary Behaviors:

Answer 21

Escape behaviors (e.g., eye blinks, head nods).
Avoidance behaviors (e.g., word substitutions, circumlocution).

Question 21

stuttering assessment types

Answer 21

Speech Disfluency Analysis: Quantify type, frequency, and pattern of disfluencies.
SSI (Stuttering Severity Instrument): Evaluates severity.
Emotional Impact Assessments: Gauge attitudes, feelings, and social implications.

Question 22

fluency shaping

Answer 22

Goal: Establish 100% fluent speech by modifying speaking patterns.
Techniques: Slow speech rate, gentle onsets, continuous phonation.

Question 23

Stuttering modification

Answer 23

Goal: Reduce tension and struggle during stuttering moments - make stutter less abnormal
Techniques: Cancellations, pull-outs, preparatory sets.

Question 24

stuttering - counseling for parents

Answer 24

Education: Normal disfluencies (um, so, etc.) vs. stuttering-like disfluencies and behaviors.
Support Strategies:
Encourage slow, relaxed speech at home.
Reduce communicative pressure/demand.
Maintain positive, supportive communication environments.

Question 25

Adaptation Effect:

Answer 25

Stuttering decreases with repeated readings.

Question 26

Delayed Auditory Feedback (DAF)

Answer 26

fluency inducing (temporarily) using choral effect

Question 27

Risk factors for persistent stutter

Answer 27

Biological male, family history of stuttering/if they naturally recovered or not, stuttering duration >12 months, onset at or after 3.5 years, worsening over time.

Question 28

Loci of Stuttering:

Answer 28

Common/predictable locations of stutter: initial sounds, stressed syllables.

Question 29

Consistency Effect

Answer 29

Tendency to stutter on the same words in repeated passages.

Question 30

Cluttering

Answer 30

Excessive nonSLDs
Low concern/awareness
NO secondary behaviors
Significant (reading/writing issues)
Onset in later childhood (7+)

Question 31

CAS

Answer 31

Incidence: Around 1-2 children per 1,000 are diagnosed with CAS.
Characteristics:
Difficulty coordinating speech movements
Inconsistent speech errors
Poor/lack of prosody

Question 32

CAS treatment

Answer 32

DTTC
Knowledge of Performance → principles of motor learning
Sound Production Treatment
- Minimal contrasts: fine tune small sound differences in words
- Targeting errors: words are chosen based on speech error the client is targeting
- Flexible approach: adapts depending on clients progress
- Generalization
- Maintenance

Question 33

Clinician-directed models

Answer 33

modeling, drills/drill-play

Question 34

Child-led models

Answer 34

child leads the session, and the clinician follows the child’s interests while embedding language or speech targets naturally

Question 35

Facilitative Play

Answer 35

Child-led
The clinician provides indirect modeling by commenting, expanding, or recasting the child’s language.
Self-Talk, Parallel Talk, Expansions

Question 36

Hybrid Models

Answer 36

Milieu Teaching
Mand model
Script Therapy

Question 37

Milieu Teaching

Answer 37

Hybrid model
SLP arranges interactive activities that require social communication from the child
Teaches functional communication skills through everyday verbal interactions that arise naturally in naturalistic settings
Incidental teaching
Adult waits for child to initiate verbal response → clinician focuses on response-promoting stimulus → if child doesn’t elaborate, clinician prompts/models

Question 38

Mand Model

Answer 38

Hybrid
helps children learn to use language in appropriate contexts and know when and how to use their words
help children develop the value of communication and make social interaction more valuable
Manding: The child makes a request for what they want. For example, a therapist might ask a child who wants to play with bubbles, “What do you want?” or “Tell me, ‘bubbles’”.
Modeling: The adult demonstrates how to use the correct words. For example, if the child says “bubbles” or something similar, the therapist praises the child and gives them the bubbles.

Question 39

Self Talk

Answer 39

The clinician talks about their own actions to model language.
Matches language to context, child not required to say anything
Ex: Mommy’s washing the dishes. Here’s a cup. Wash the cup.”

Question 40

Parallel Talk

Answer 40

The clinician talks about the child’s actions.
Matches language to context, child not required to say anything
Ex: “Look at the truck. You’re making the truck go.”

Question 41

expansion

Answer 41

adult adds 1-2 more words to child’s utterance, likely making it more “adult-like” or grammatically correct
Ex: child - “bus”; adult - “yellow bus”

Question 42

Phonological Awareness

Answer 42

Understanding sound structures (e.g., rhymes, syllables)
child’s ability to detect & manipulate sounds & syllables in words (rhyming)
foundational for learning to read and spell - helps children understand how words are constructed from sounds

Question 43

Phonological Awareness skills

Answer 43

Rhyming: Identifying words that sound the same (e.g., “cat” and “hat”).
Syllable Awareness: Recognizing and manipulating syllables in words (e.g., breaking “elephant” into “el-e-phant”).
Segmenting: Breaking words down into individual sounds (e.g., “dog” into /d/, /o/, /g/).
Blending: Combining individual sounds or syllables to form a word (e.g., /k/ + /at/ = “cat”).
Isolation: Identifying individual sounds in words (e.g., the first sound in “bat” is /b/).

Question 44

Print Awareness

Answer 44

Understanding how print works (e.g., left-to-right reading direction).
child’s knowledge about functions & forms of written language (distinguishing uppercase from lowercase letters, pointing at signs)
helps children understand the connection between spoken and written language, which is essential for reading comprehension and writing skills.

Question 45

Print Awareness skills

Answer 45

Understanding that reading is done from left to right and top to bottom.
Letter Recognition: Identifying and differentiating between uppercase and lowercase letters.
Word Recognition: Recognizing that spaces between words separate individual words and that a word is a distinct unit of meaning.
Print Concepts: Understanding that print carries meaning, and that pictures and print work together in books.

Question 46

Minimal Pairs

Answer 46

2 words that differ by a single phoneme and by one feature (e.g., “bat” vs. “pat” - only differs by voicing)
Teaches that small changes effect meaning
Best for children mild-moderate, consistent phonological errors
Starts with listening and words toward producing subtle sound differences
Focus on phonological contrasts.
Minimal pairs to treat FCD? yes

Question 47

A mother is concerned child is only using 20 words at 18 months. What would you tell the mother?

Answer 47

encourage her to engage in more conversation with child to increase vocab
inform her that this is normal and as long as she gets to 2 with at least 50 words it’s fine

Question 48

What should an SLP tell parents about bilingualism and therapy?

Answer 48

Bilingualism doesn’t cause a language disorder

Question 49

Developmental Order

Answer 49

Cooing.
Babbling.
Echolalia.
Developing plurals.

Question 50

Order These by Skill

Answer 50

Recognizing words.
Understanding graphemes/morphemes.
Listening to a story.
Independently orienting/reading a story.

Question 51

macrostructure

Answer 51

The overarching organization of a narrative (e.g., plot, characters, etc.).
Examples:
Story has a beginning, middle, and end.

Question 52

microstructure

Answer 52

Smaller linguistic units (e.g., syntax, vocabulary, cohesion).
ex: Uses varied sentence structures, correct grammar.