Language and Stuttering Flashcards
Motherese
Infant directed speech
Shorter phrases
Sing-song voice
Enthusiasm
Contextually redundant phrases
Concrete vocabulary
Late Talker
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
reflexive vocalizations
0-2 months
Body’s automatic responses
Cooing/gooing
2-4 months
Back vowels and consonants
Vocal play/expansion
4-6 months
Raspberries, trills, growls, squeaks → some cv
canonical/reduplicated babbling
6-8 months
CVCV chains
variegated/non-reduplicated babbling
8 months-1 year
CV sequences with variety of C’s and V’s
perlocutionary stage
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
illocutionary stage
aka intentional stage
8-12 months
Development of intentionality (using behaviors like pointing to communicate meaning), joint attention, and protowords (phonetically consistent forms)
locutionary stage
emergence of words
12+ months
First words appear, words and gestures have a symbolic meaning
No longer dependent on gestures
Experimenting with words
Nativist/Natural Theory
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
Behaviorist Theory
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
Cognitive theory
lang grows as kid thinks and understands more through stages of learning
Piaget
Stages of cognitive development
Object permanence
Social Interaction Theory:
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
Selective Mutism
Rare
significant social/academic impairment
consistent failure to speak in specific settings
Runs in families
Associated with behavioral inhibition
Comorbidities: anxiety and neurodevelopmental disorders
Tx of Selective Mutism
First steps: psychoeducation and behavioral management
Gradual exposure and reward contingency
Strategy: use exposure-based practice
Factors that improve the prognosis for a child who is not speaking
Younger age
Presenting with selective mutism
Early identification
Types of fluency disorders
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)
Contributing Factors to fluency disorders
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.
stuttering - dx measures
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).
stuttering - Primary Behaviors:
related to the the actual SLD
Sound/word repetitions (e.g., “ba-ba-ball”).
Prolongations, blocks.
stuttering - secondary Behaviors:
Escape behaviors (e.g., eye blinks, head nods).
Avoidance behaviors (e.g., word substitutions, circumlocution).
stuttering assessment types
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.
fluency shaping
Goal: Establish 100% fluent speech by modifying speaking patterns.
Techniques: Slow speech rate, gentle onsets, continuous phonation.
Stuttering modification
Goal: Reduce tension and struggle during stuttering moments - make stutter less abnormal
Techniques: Cancellations, pull-outs, preparatory sets.
stuttering - counseling for parents
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.
Adaptation Effect:
Stuttering decreases with repeated readings.
Delayed Auditory Feedback (DAF)
fluency inducing (temporarily) using choral effect
Risk factors for persistent stutter
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.
Loci of Stuttering:
Common/predictable locations of stutter: initial sounds, stressed syllables.
Consistency Effect
Tendency to stutter on the same words in repeated passages.
Cluttering
Excessive nonSLDs
Low concern/awareness
NO secondary behaviors
Significant (reading/writing issues)
Onset in later childhood (7+)
CAS
Incidence: Around 1-2 children per 1,000 are diagnosed with CAS.
Characteristics:
Difficulty coordinating speech movements
Inconsistent speech errors
Poor/lack of prosody
CAS treatment
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
Clinician-directed models
modeling, drills/drill-play
Child-led models
child leads the session, and the clinician follows the child’s interests while embedding language or speech targets naturally
Facilitative Play
Child-led
The clinician provides indirect modeling by commenting, expanding, or recasting the child’s language.
Self-Talk, Parallel Talk, Expansions
Hybrid Models
Milieu Teaching
Mand model
Script Therapy
Milieu Teaching
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
Mand Model
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.
Self Talk
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.”
Parallel Talk
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.”
expansion
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”
Phonological Awareness
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
Phonological Awareness skills
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/).
Print Awareness
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.
Print Awareness skills
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.
Minimal Pairs
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
A mother is concerned child is only using 20 words at 18 months. What would you tell the mother?
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
What should an SLP tell parents about bilingualism and therapy?
Bilingualism doesn’t cause a language disorder
Developmental Order
Cooing.
Babbling.
Echolalia.
Developing plurals.
Order These by Skill
Recognizing words.
Understanding graphemes/morphemes.
Listening to a story.
Independently orienting/reading a story.
macrostructure
The overarching organization of a narrative (e.g., plot, characters, etc.).
Examples:
Story has a beginning, middle, and end.
microstructure
Smaller linguistic units (e.g., syntax, vocabulary, cohesion).
ex: Uses varied sentence structures, correct grammar.
