lec 1

Question 1

T or F: stuttering disorders are completely psychological

Answer 1

false – also biological

Question 2

what is a core behaviour?

Answer 2

the actual stuttering events

Question 3

what’s the diff bw repetitions, prolongations, blocks, and interjections?

Answer 3

• repetitions: repetition of sounds or syllable(s)
• prolongations: airflow continues but articulators stop moving
• blocks: stoppage of airflow and articulators
• interjections: adding extra words/sounds such as um, uh, like etc

Question 4

what are secondary behaviours? examples?

Answer 4

• extra words and behaviours
• examples: blinks, eyebrow furrowing, jaw sliding

Question 5

whats the diff bw escape behaviours and avoidance behaviours?

Answer 5

• escape: attempt to terminate a stutter and finish the word
• avoidance: attempt to prevent stuttering

Question 6

T or F: repetitions, prolongations, and blocks are secondary behaviours

Answer 6

false – RPB = core behaviours

Question 7

whats the diff bw incidence and prevalence? what is each statistic for stuttering?

Answer 7

• incidence: how many people have stuttered at some point in their lives? 5-8%
• prevalence: how many people are stuttering at one point in time? <1%

Question 8

T or F: some cultures have lower incidence rates than others

Answer 8

true – competitive cultures tend to have higher than non-competitive cultures

Question 9

what is the average age of stuttering onset?

Answer 9

2-3.5 years

Question 10

do spontaneous recoveries from stuttering happen often in children?

Answer 10

yes ~85%

Question 11

what is the average time of recovery for stuttering?

Answer 11

18-24 months from onset

Question 12

why does the sex ratio of stutterers change over time? i.e., 4:1 males for females but 1:1.2 at onset

Answer 12

bc females start to stutter earlier, recover earlier and recover more often

Question 13

what are the big 6 predictors of stuttering persistence?

Answer 13

1. family history
2. male
3. onset later than 3.5 years
4. duration over a year (= worse prognosis)
5. other speech/lang/motor/cognitive delays
6. pattern of stuttering over time

Question 14

what is the best predictor of recovery?

Answer 14

recovery within 12 months of onset

Question 15

if a parent brings a 4 year old stuttering child to an SLP, should they wait and monitor or begin therapy? why?

Answer 15

• begin therapy
• treatment most effective during preschool years bc brain plasticity

Question 16

name 5 fluency enhancing conditions

Answer 16

1. delayed auditory feedback
2. masking noise
3. choral speech
4. rhythmic speech
5. reinforcements

Question 17

T or F: stuttering is a neurodevelopmental disorder

Answer 17

true

Question 18

does stuttering have a strong genetic component? which gene is responsible?

Answer 18

• yes (but not purely genetic)
• polygenetic

Question 19

T or F: if someone has the stuttering gene(s), that means they will definitely stutter

Answer 19

false – genetics = predisposition NOT determination (think light switch)

Question 20

T or F: your environment can cause stuttering

Answer 20

false – can only trigger predisposition (ie need the gene in the first place)

Question 21

what are some congenital factors that are associated with stuttering onset? (3)

Answer 21

• infectious diseases
• head injuries
• anoxia

Question 22

which 3 areas of the inferior frontal gyrus are involved in the formation of an articulatory plan? (brodmann # + name)

Answer 22

• BA 44, 45, 47 (broca’s area)
• BA 4 (primary motor cortex)
• BA 6 (premotor area)

Question 23

what do each of the following parts of the brain do regarding speech production:
a) premotor area – ventral part
b) premotor area – dorsal part
c) primary motor cortex

Answer 23

a) interfaces between planning + execution
b) supplementary motor area (tells you “go!”)
c) speech execution

Question 24

the ___ and ___-___ systems are in constant communication with the cortical areas via connective ___ ___ ___ of the cortico-striatal loops and the internal capsule.

Answer 24

• cerebellar
• basal-ganglia
• white matter fibres

Question 25

what would the white matter connections in someone who stutters look like relative to someone who does not stutter? what purpose do these connections serve?

Answer 25

• reduced in density
• connect sensory, planning, and motor areas for speech

Question 26

what does it mean if “the left premotor cortex is hypo-perfused” in someone who stutters?

Answer 26

that the premotor cortex is not recruited enough for speech planning and production

Question 27

differences in perfusion for left vs right hemisphere of someone who stutters?

Answer 27

• left: often hypoperfusion
• right: more likely hyperperfusion, compensating

Question 28

T or F: after treatment, compensation by the left hemisphere speech regions,rather than by the right, may be more effective in bypassing the structural anomalies and improving the efficiency of signal transmission

Answer 28

true

Question 29

T or F: people who stutter have trouble getting their ideas together

Answer 29

false – it’s an issue of timing motor programs

Question 30

how might temperament influence stuttering?

Answer 30

someone with a laid back temperament may handle the emotional impacts of stuttering more effectively

Question 31

main points of environmental theories: parents/environmental stressors? (3)

Answer 31

• parent characteristics = stuttering (eg low SES, anxious, demanding)
• life events = stuttering (eg divorce, moving)
• studies show this is FALSE

Question 32

main points of environmental theories: diagnosogenic? (3)

Answer 32

• early speech disfluencies are not stuttering
• stuttering develops after it has been diagnosed by parent
• led to reduced early intervention

Question 33

main points of environmental theories: anticipatory struggle? (3)

Answer 33

• 1) frequent communicative failure (eg delayed language), 2) heavy communicative pressure (eg parent standards), and 3) high vulnerability to communicative pressures (eg child weakness) = stuttering

Question 34

main points of environmental theories: capacities and demands? (3)

Answer 34

• child’s capacity = bucket
• internal and environmental demands (eg temperament, interactions) = water
• overflow = disfluency

Question 35

main points of cerebral dominance theory? (3)

Answer 35

• left hemisphere should be dominant for speech
• for stuttering, the hemispheres are competing = asynchronous nerve impulses
• forced children to be right-handed – did not help

Question 36

main points of DIVA model? (3)

Answer 36

• feedback pathway: slow and consciously controlled + directed by the cortex and cerebellum.
• feedforward pathway: quick and automatic + directed by the basal ganglia and sensory motor area.
• stuttering = impaired feedforward pathway.
• people who stutter should use feedback pathway to achieve fluency.

Question 37

DIVA model: implications of relying on the feedback pathway? (2)

Answer 37

• requires lots of cognitive resources
• unrealistic for children to self-monitor

Question 38

which 3 theories are most useful?

Answer 38

1. capacities and demands
2. DIVA model
3. two stage model

Question 39

main points of two-stage model? (2)

Answer 39

• primary stuttering: inherited or congenital causes = structure/function issues in speech planning pathways.
• secondary stuttering: factors can promote recovery or cause stuttering to persist (eg temperament, conditioning).