Lecture 3

Question 1

Diagnosogenic theory
(Wendell Johnson

Answer 1

Parental mislabeling of normal disfluency: Stuttering is “not in the child’s mouth but in the parent’s ear.”
Child worries about the label and tries not to stutter.
Stuttering becomes what the child does not to stutter.
Child reacts with anxiety and avoidance, setting up a cycle of fluency failure, anxiety, and more fluency failure.

“The Monster Study”
The stutterer, if I may speak for him as a type, does not want pity any more than he wants contempt, but he does want the understanding
which the normal respect of one human being for another makes possible. He is a human being, trying to make a stutterer’s
adaptation to a world of glib speakers.

Question 2

Stuttering as learned behavior

Answer 2

Many of the models in this category can be termed “anticipatory struggle” hypotheses.
 The first professional speech-language pathologists suggested some of these theories (The “Iowa” school).

Question 3

Approach-
avoidance

Answer 3

Speech
a) Approach – Achieve goal of communication
b) Avoidance – Shame and guilt

Silence
a) Approach – Eliminates threat of speaking and
stuttering
b) Avoidance – Abandon communication

Question 4

Two-Factor model

Answer 4

Brutten & Shoemaker (1967) two-factor model:
Stuttering is the involuntary disruption of speech resulting
from:
Negative emotional responses that are classically conditioned.
Secondary behaviors are instrumentally conditioned

Question 5

The Continuity Hypothesis
Oliver Bloodstein

Answer 5

 Stuttering emerges from normal disfluency, and the child’s responses that lead to tension and
fragmentation.
 These responses are self-generated and are not caused by parental reactions.

Question 6

Psychological Theories
What it is and who came up with it ?

Answer 6

 Freudian – stuttering as a symptom of psychosexual fixation
 Parent must allow the child’s impulse for pleasure
 Fixation occurs if the child is not allowed to experience pleasure without guilt. Persists into
later life.
 Parental mishandling, perfectionist demands, or inconsistent nurturing

Question 7

Psychological Model

Answer 7

Still a popular lay account, especially in other cultures
Stuttering was classified as a neurosis in the past
Ex: repressed need hypothesis: stuttering is the result of a repressed neurotic conflict
 Psycho-sexual (Glauber, Freud) or
 Inadequate interpersonal relationships (Barbara, Wyatt)
No evidence to support the theory (e.g., Yairi, 1997)
DSM-V Nov 18, 2019
Childhood-onset fluency disorder (stuttering) is now considered a communication
disorder
in the chapter on neurodevelopmental disorders.

Question 8

Multi-factorial models

Answer 8

Multi-factorial models attempt to integrate physiology, learning and the environment in the
etiology and development of stuttering.
 Starkweather’s Demands and Capacities Model
1) When demands for speech exceed a client’s capacity to produce speech, stuttering occurs.
2) Fluency occurs when capacities exceed demands.

Question 9

Demands and Capacities (DCM)

Answer 9

 Model popularized by Starkweather, Gottwald & Halfond, 1990.
 Genetic weaknesses in systems that result in fluency
problems (language, motor, emotional, cognitive, etc.)
 Interact with environmental factors (external and internal demands) to
precipitate and maintain fluency failure

Question 10

Demands and Capacities Model
External vs internal

Answer 10

External
Environment (rapid parental speech rate, rapid turn-taking)
Linguistic (increased syntactic, semantic, and pragmatic demands)
Internal
Child own tendency to hurry and struggle
Stress

Question 11

Demands and Capacities Model
Capacities

Answer 11

Capacities
a) Speech-motor control
b) Language
c) Cognitive skills
d) Social-emotional skills

Question 12

Co-Occurrence of Anxiety and Stuttering
Statistics

Answer 12

 Social anxiety/Social phobia
Present in ~20 to 40% of adults who stutter
16 to 34x greater risk than typical speakers
 General anxiety disorders
6 to 7x greater risk than typical speakers
 Mood disorders (e.g., depression)
2x greater risk than typical speakers (Logan, 2021)

Question 13

Listener Behavior

Answer 13

 Helpfulness, supportiveness, acceptance
 Verbal reactions to stuttered speech
 Non-verbal reactions to stuttered speech
 Inclusiveness during conversation
(Logan, 2021)

Question 14

Listener Behaviors and Evaluations

Answer 14

 Assorted stereotypes
Occupational stereotypes
Competence stereotypes

 Inaccurate information
Causes of stuttering
How to help people who stutter
How people who stutter can help themselves
 E.g., “Think about what you want to say.”
(Logan, 2021)

Question 15

Listener Behaviors and Evaluations
Children who stutter in class settings:

Answer 15

 Children who stutter in class settings:
More likely to be excluded/rejected than non-stuttering children
Less likely to be viewed as popular, as leaders
More likely to be characterized as targets of bullying

Question 16

Listener Behaviors and Evaluations

Answer 16

 Studies of bullying experiences
People who stutter are 3 to 5 times more likely to have been bullied than people who do not stutter
Between 50 to 90% of people who stutter report having been bullied during school years
Effects of bullying persist into adulthood, in form of poorer self-ratings on measures of psychosocial
functioning
Logan, 2021