lec 1: introduction Flashcards
T or F: stuttering disorders are completely psychological
false – also biological
what is a core behaviour?
the actual stuttering events
what’s the diff bw repetitions, prolongations, blocks, and interjections?
- 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
what are secondary behaviours? examples?
- extra words and behaviours
- examples: blinks, eyebrow furrowing, jaw sliding
whats the diff bw escape behaviours and avoidance behaviours?
- escape: attempt to terminate a stutter and finish the word
- avoidance: attempt to prevent stuttering
T or F: repetitions, prolongations, and blocks are secondary behaviours
false – RPB = core behaviours
whats the diff bw incidence and prevalence? what is each statistic for stuttering?
- 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%
T or F: some cultures have lower incidence rates than others
true – competitive cultures tend to have higher than non-competitive cultures
what is the average age of stuttering onset?
2-3.5 years
do spontaneous recoveries from stuttering happen often in children?
yes ~85%
what is the average time of recovery for stuttering?
18-24 months from onset
why does the sex ratio of stutterers change over time? i.e., 4:1 males for females but 1:1.2 at onset
bc females start to stutter earlier, recover earlier and recover more often
what are the big 6 predictors of stuttering persistence?
- family history
- male
- onset later than 3.5 years
- duration over a year (= worse prognosis)
- other speech/lang/motor/cognitive delays
- pattern of stuttering over time
what is the best predictor of recovery?
recovery within 12 months of onset
if a parent brings a 4 year old stuttering child to an SLP, should they wait and monitor or begin therapy? why?
- begin therapy
- treatment most effective during preschool years bc brain plasticity
name 5 fluency enhancing conditions
- delayed auditory feedback
- masking noise
- choral speech
- rhythmic speech
- reinforcements
T or F: stuttering is a neurodevelopmental disorder
true
does stuttering have a strong genetic component? which gene is responsible?
- yes (but not purely genetic)
- polygenetic
T or F: if someone has the stuttering gene(s), that means they will definitely stutter
false – genetics = predisposition NOT determination (think light switch)
T or F: your environment can cause stuttering
false – can only trigger predisposition (ie need the gene in the first place)
what are some congenital factors that are associated with stuttering onset? (3)
- infectious diseases
- head injuries
- anoxia
which 3 areas of the inferior frontal gyrus are involved in the formation of an articulatory plan? (brodmann # + name)
- BA 44, 45, 47 (broca’s area)
- BA 4 (primary motor cortex)
- BA 6 (premotor area)
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
a) interfaces between planning + execution
b) supplementary motor area (tells you “go!”)
c) speech execution
the ___ and ___-___ systems are in constant communication with the cortical areas via connective ___ ___ ___ of the cortico-striatal loops and the internal capsule.
- cerebellar
- basal-ganglia
- white matter fibres
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?
- reduced in density
- connect sensory, planning, and motor areas for speech
what does it mean if “the left premotor cortex is hypo-perfused” in someone who stutters?
that the premotor cortex is not recruited enough for speech planning and production
differences in perfusion for left vs right hemisphere of someone who stutters?
- left: often hypoperfusion
- right: more likely hyperperfusion, compensating
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
true
T or F: people who stutter have trouble getting their ideas together
false – it’s an issue of timing motor programs
how might temperament influence stuttering?
someone with a laid back temperament may handle the emotional impacts of stuttering more effectively
main points of environmental theories: parents/environmental stressors? (3)
- parent characteristics = stuttering (eg low SES, anxious, demanding)
- life events = stuttering (eg divorce, moving)
- studies show this is FALSE
main points of environmental theories: diagnosogenic? (3)
- early speech disfluencies are not stuttering
- stuttering develops after it has been diagnosed by parent
- led to reduced early intervention
main points of environmental theories: anticipatory struggle? (3)
- frequent communicative failure (eg delayed language),
- heavy communicative pressure (eg parent standards), and
- high vulnerability to communicative pressures (eg child weakness) = stuttering
main points of environmental theories: capacities and demands? (3)
- child’s capacity = bucket
- internal and environmental demands (eg temperament, interactions) = water
- overflow = disfluency
main points of cerebral dominance theory? (3)
- 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
main points of DIVA model? (4)
- 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.
DIVA model: implications of relying on the feedback pathway? (2)
- requires lots of cognitive resources
- unrealistic for children to self-monitor
which 3 theories are most useful?
- capacities and demands
- DIVA model
- two stage model
main points of two-stage model? (2)
- 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).
