Other fluency Disorders Flashcards
What is psychogenic stuttering?
Late onset, stereotyped pattern of stuttering normally beings after stress or traumatic event.
What is neurogenic stuttering
Stuttering appeared to be caused or exacerbated by neurological disease or damage.
Acquired after childhood as the result of CVA, head trauma, Parkinson’s, drug toxicity.
According to the WHO:
When the stuttering behaviour first occurs after acquired neurological damage it is diagnosed as SAAND (stuttering after acquired neurological damage)
We must consider adult onset of stuttering as a potentially positive neurological sign - shows that something might be wrong neurologically.
What is SAAND?
Neuropathology: distinct from primary dysarthria, apraxia, aphasia.
CVA, CHI, tumours, surgery, progressive degenerative disorders, metabolic disturbances.
Left and right side lesions.
All lobes except occipital lobe.
Cortical and subcortical (particularly basal ganglia) affected.
What are the speech behaviours for developmental stuttering?
Stuttering more frequent on content words.
Primarily on initial syllables.
Usually escape and avoidance behaviours which can be severe.
Decrease in stuttering with successive readings.
Noticeable reductions in stuttering with DAF, masking noise, speaking to rhythm.
Have already developed fears and anxiety about stuttering and speaking.
What are the speech behaviours of neurogenic stuttering?
Stuttering on function and content words - equally affected
Not restricted to initial syllables in words
Rarely are there secondary nonverbal behaviours - if so, mild
No adaptation effect occurs with repeated readings
Less responsive to fluency-enhancing conditions - smooth speech, DAF
Individuals may appear annoyed but not anxious (not sure about this!)
What is cluttering?
Disorder affecting intelligibility.
Often thought of an stuttering with a language disorder.
Characterised by: unawareness of the disorder, short attention span, disturbances in perception, articulation and formulation of speech processes.
Verbal manifestation of central language imbalance.
Affects all channels of communication and behaviour in general.
Lots of speaking in short bursts with no information.
What are the signs of cluttering?
Consists of: Word and phrase repetitions (dominant) Revisions Hesitations All usually without tension. Speaking rate is not consistent. Sudden bursts of speech with many mistakes. Usually unaware of problem! Disorganised thoughts and verbal clarity. Secondary behaviours are rare. Learning problems often. Pure cluttering is rare. Cluttering-stuttering is more common. 1/3 of people who show at clinic for stuttering show signs of cluttering.
What is the repressed needs theory?
Stuttering is a covert expression of hostile or aggressive impulses.
The person fears to openly express these impulses that have arisen from early child-parent interaction.
Influenced by psychoanalysis.
Psychodynamic and non-behavioural.
What is the anticipatory struggle theory?
Individuals who stutter have learned to believe that speech is somehow problematic.
Belief has arisen from pressure in the early developmental years.
Primary stuttering theory - Child learns to anticipate, fear or avoid speech situations because of the reactions of others.
Diagnosogenic theory - Stuttering is caused by the diagnosis. It’s in the ear of the parents not the mouth of the child.
Communication failure theory - response to tension caused by failures in communication.
What is the learned theory?
Approach-avoidance theory.
Stuttering results from conflict between desire to speak and desire to avoid speaking.
What is psychological conversion theory?
Stuttering is a manifestation of internal emotional conflict, stress and distress.
Can be sudden onset or present from childhood.
What is psychogenic stuttering?
Sudden onset typically related to some event.
Repetitions of initial words and sounds common.
May have stutters on every syllable.
Fluency enhancing effects don’t help.
Absence of neurological factors.
Improvement with trial therapy.
Increasing severity under fluency inducing conditions.
Bizarre struggle behaviours.
According to breakdown theories what is the aetiology of stuttering?
Stuttering represents a momentary failure at an organic level in the complex coordinators that are required for speech.
What is the organic breakdown theory?
Momentary failure in complex coordinators involved in speech.
Therefore physiological, organic causality.
What are some of the organic breakdown theories?
Orton-Travis: unestablished cerebral dominance.
West: Biochemical imbalance. Increased levels of dopamine related to basal ganglia.
Fairbanks: Feedback theory - what we intend to say we can adjust by what we hear.
Kidd: Hereditary model - 3x more likely with family history.
