Lecture 5

Question 1

List 5 types of disfluencies

Answer 1

1) audible/ silent sound and 2) syllable repetitions
3) sound prolongations
4) dysrhythmic phonations
blocks
5) intra-syllabic fragmentation

Question 2

What are some Stuttering Contingent Behaviours that may be observed at the respiratory, phonatory or articulatory levels of the speech mechanisms

Answer 2

disordered breathing
glottal fry
lip pursing
eye blinks
facial grimacing
head jerks
abnormal body movements

Question 3

Describe avoidance behaviours

Answer 3

scanning to predict stuttering, avoidance strategies (word substitution, phrase revision, circumlocution)
situational avoidance

Question 4

What are the 4 levels in the The World Health Organization’s Consequences of Disease or Disorder

Answer 4

Disorder > Impairment

> Disability > Quality of Life (Handicap)

Question 5

Any loss or abnormality of psychological, physiological, or anatomical structure or function is termed an ____________

Answer 5

Impairment

Question 6

How can you quantify the degree of impairment in stuttering?

Answer 6

> Frequency of stuttering behaviour
Duration of instances of disruption
Severity
Secondary behaviour

Question 7

Any restriction or lack of ability (resulting from an impairment) to perform a normal human activity is termed a ___________

Answer 7

Disability

Question 8

A disability is the _______________ of an impairment.

Answer 8

functional consequence

Question 9

Would the Inability to say specific words/sounds or Difficulty communicating in specific situations be considered impairment or disability?

Answer 9

Disability - the consequence of the impairment

Question 10

The social consequence of an impairment or disability defined by the attitude and responses of others. Thus, the state of being handicapped is relative to other people is termed _____________________

Answer 10

Quality of Life (Handicap)

Question 11

A child’s ___________ is effected when they experience Classroom discrimination
Teasing and bullying
Social, leisure and recreational limitations
Issues of self confidence, self esteem

Answer 11

Overall Quality of life

Question 12

The WHO’s 2001 classification of functioning breaks down into what two categories?

Answer 12

1) Body Function and Structure: describes the major physiological and psychological functions of the body
2) Activities and Participation: describes the major areas of person’s daily lives

Question 13

In stuttering, the link between impairment and the resulting negative consequences is largely mediated by the speaker’s _______ to stuttering. Which include… (3 aspects)

Answer 13

Reactions

1) Affective: Feelings, attitudes, emotions
2) Behavioral: Actions (Avoidance, tension, struggle)
3) Cognitive: Thought processes, self-evaluation

Question 14

According to the WHO’s Model for representing the entirety of the stuttering disorder. Disfluency begins with impairment in function (I.e. observable stuttering behaviours) which then interact with what two factors?

Answer 14

1) personal factors/reactions (Affect, behaviour, cognition) and 2) environmental factors

Question 15

Reactions and environmental factors lead to limitation in what to areas (WHO’s model)

Answer 15

!) activity limitation

2) participation restriction

Question 16

Riley’s ______ is the most common measure used in the field of stuttering.

Answer 16

Stuttering Severity Instrument

Question 17

Which intrument for evaluating stuttering is based directly on the WHO’s ICF model such that it addresses the entirety of the stuttering disorder?

Answer 17

Overall Assessment of the Speaker’s Experience of Stuttering (OASES)

Question 18

How many sections does the OASES and what are they?

Answer 18

100 items in 4 sections, each on a 5 point scale
Section 1: General information about stuttering
Section 2: Speaker’s affective behavioural and cognitive reactions
Section 3: Communication in Daily Situations
Section 4: Impact of stuttering on Quality of Life

Question 19

According to CASLPO What are the 5 goals of assessment in stuttering?

Answer 19

1) Background information
2) Speech Samples
3) Quantitative and qualitative descriptions of the patient’s/client’s fluent and stuttering speech behaviours
4) Obtain information that influences fluency level
5) Convey results to the client and family

Question 20

How can one obtain Quantitative and qualitative descriptions of the patient’s/client’s fluent and stuttering speech behaviours

Answer 20

> frequency of primary (core) and secondary stuttering behaviours
distinguishing normal non-fluencies from stuttering.
Computing percentage of syllables or words stuttered.
Measuring speech and articulatory rates

Question 21

WHat are the characteristics of normal disfluency

Answer 21

Easy, with no tension, No change in pitch or loudness

Occur often in preschoolers

Question 22

Give 5 examples of normal disfluencies

Answer 22

1) Multi-syllabic word repetition e.g., “because because”
2) Easy repetitions of a word or syllable e.g., “co-cold”
( If they occur less often than every 10 sentences and don’t consistently exceed 3 units.)
4) Interjections e.g., “I want the umm…umm…bicycle”
Phrase revisions e.g., “You know who…you know what I saw today?”
5) Phrase repetitions e.g, “Can I..Can I..Can I have some juice?”

Question 23

Stuttering like behaviours exhibit increased ______ and ________

Answer 23

Fragmentation and Tension

Question 24

True or false a stuttering like behaviour is any type of disfluency withincreased tension or struggle
rise in pitch or loudness
tension in jaw or face
Avoidance, fear about talking
Increased consistency

Answer 24

TRUE

Question 25

What are some crossover behaviours?

Answer 25

Crossover Behaviors:
	Rapid whole-	word repetitions
	Part-word repetitions
	No tension/struggle
	2-3 iterations

Question 26

What are the 2 main types of secondary behaviours and how are they different?

Answer 26

> Escape behaviours
Speaker is trying to terminate the disfluency and finish the word.
Avoidance behaviours
To avoid stuttering and the negative experience that accompanies it

Question 27

What are the2 main types of Analysis of stuttering and how are they different?

Answer 27

1) Global (molar) analysis
Looks at how much stuttering there is
%SS
2) Molecular analysis
Looks at the kind of stuttering 
Types of stuttering, secondary behaviours, avoidance behaviours

Question 28

List risks for persistence of stuttering (6)

Answer 28

1) Family history of persistent stuttering
2) Gender
3) Age at onset
4) Stuttering-Like Disfluency Trends (SLD)
5) Time since onset
Disfluency length and tempo
6) Precocious language
Other speech sound disorders

Question 29

During assessment What things should you be looking in the speech sample?

Answer 29

> Types of stuttering,
frequency and severity
Number of repetitions, >length of disfluency
Struggle
Secondary behaviours/Avoidance behaviours
Percent Syllables Stuttered (%SS)
Parent interaction

Question 30

True or false natural recovery is less likely in school age children who stutter?

Answer 30

True :(

Question 31

True or false School age CWS may exhibit weaker feelings and attitudes about their stuttering

Answer 31

False - they will exhibit strong feelings

Question 32

List 6 areas to consider during intake information collection for school age children

Answer 32

>progression
>Reaction/Awareness
>Family History
>Previous treatment
>Developmental History
>Social History

Question 33

How can physical development impact stuttering?

Answer 33

A child with speech motor delays may benefit from learning how to coordinate respiration, phonation & articulation

Question 34

How can cognitive development impact stuttering?

Answer 34

A child with learning disabilities may need modifications to a treatment program

Question 35

How can Social-emotional development impact stuttering?

Answer 35

A child may need help in relating more easily in social situations

Question 36

How can academic adjustment impact stuttering?

Answer 36

> Influence of stuttering on academic performance

>Influence of academic demands on stuttering

Question 37

What should you cover when relaying results of assessment to parents and child?

Answer 37

> Nature of disfluencies/stuttering
>Treatment options
>What can be done at home
>What is expected of them /family involvement
>Manage their expectations

Question 38

What are some speech observations to obtain during Assessment of stuttering in Adolescents and adults?

Answer 38

Reading
Single words
Sentences with increasing length
Paragraph reading
Monologue and conversation (approximately 200 words)
Difference between reading and conversation?
Automatic speech
Counting, days of the week, months of the year, singing

Question 39

What is used to measure Stuttering frequency and severity in adolescents?

Answer 39

SSI-4 (Glyndon, 2009)

Question 40

What is used to measure Attitudes and self-perceptions in adolescents?

Answer 40

> OASES (Yaruss & Quesal in collaboration with Coleman, 2010)
PSI (Woolf, 1967)
S-24 Modified Erickson Scale of Communication Attitude (Andrews & Cutler, 1974)
Locus of Control of Behaviour Scale (Craig, Franklin, & Andrews, 1984)

Question 41

The S-24 (Erickson) Measures interpersonal communication attitudes about stuttering. What is the average score for a person who stutters vs. a fluent speaker?

Answer 41

Average Score for Person Who Stutters = 19 (range 9-24)

Average Score for Normally-Fluent Speakers = 9 (range 1-21)

Question 42

What is meant by locus of control

Answer 42

Degree to which an individual feels they have control over what happens to them (Internal) vs. how much the environment controls (external)