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SLP 3 > Stammering > Flashcards

Stammering Flashcards

1
Q

Difference between dysfluency and disfluency

A

Dis- normal non fluency

Dys- disorder

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2
Q

Male to female ratio of stammering

A

4:1

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3
Q

What model is often used to look at the personal factors, activity limitation, participation and environmental factors of stammering

A

Yaruss and Queasal 2006

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4
Q

Name 3 forms stammering can take

A

Repetitions
Prolongations
Blocks

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5
Q

What is a block?

A

Stoppage of air/voice or articulators

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6
Q

Name some behaviours that are not considered to be stammering

A

Repetition of multisyllabic word eg “mummy mummy mummy”
Pauses
Revisions

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7
Q

Name some escape and avoidance behaviours

A

Fillers eg- well actually
Eye blinks
Head jerks
Avoidance of sounds/ words/ situations

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8
Q

Who’s model is the ice burg

A

Sheehan 1970

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9
Q

Describe the overt and covert parts of the iceberg

A

Overt- what we can hear and see
Stammered speech
Some secondary behaviours

Covert- thoughts about stammering and self
Feelings
Some secondary behaviours eg avoiding words

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10
Q

Describe the macro and micro environmental factors

A

Macro- support and relationships
Professionals eg teachers
Attitude of society
Micro- specific speaking situations eg phone calls

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11
Q

With reference to literature describe participation restriction in schools

A

Daniels et al 2012- more likely to be rejected by peers

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12
Q

What is the conflict theory?

A

Sheehan 1970

Conflict between identifying as a fluent speaker and identifying as a person who stammers

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13
Q

Describe the genetic theory of stammering with literature

A

Runs in families
Males more at risk
Yairi 1992- 66.3% participants had positive history

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14
Q

Describe the brain structure and function theory of stammering

A

Some changes in brain imaging
Impairment of left hemisphere
Some children have the ability to switch speech to right side of brain

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15
Q

Describe the basal ganglia theory of stammering

A

Basal ganglia is processing unit
Causes movement of speech to be triggered
Disorder- motor initiation problem
BG sends pulse to cortex to release mvmt if the pulse is weak- stammer?
Noisy background - cluttering?

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16
Q

Describe sensorimotor deficits theory of stammering

A

PWS impaired on speech and non speech motor tasks
Articulatory discoordination during fluent speech- eg more slowly
Affected by syntactic complexity - more complex task puts more demand on individual

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17
Q

Describe Levelts monitoring loops

A

Internal loop- before preverbal plan generated
After phonetic plan
External loop- after speech articulated

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18
Q

Describe the vicious circle hypotheses

A

Vasic and Wijnen 2005

PWS do so because they are trying to avoid it

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19
Q

What environmental factors could affect stammering?

A

rapid speech rate
Competition for speaking
Frequent interruptions
Complex syntax

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20
Q

What are the linguistic and physiological aspects of Palins multifactorial model

A 
Linguistic- syntactic complexity 
- language and phonology skills 
Physiological- genetics 
- basal ganglia 
- gender
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21
Q

Describe the demands and capacities model

A

Starkweather (1987)
Capacities- what the system can offer
Demands- what tasks the system needs to perform
Stammering occurs when demands exceed capacities

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22
Q

With reference to literature describe the features of normal dysfluency, borderline stammering and beginning stammering

A 
Guitar 1998,2006
Normal- <10/100 words stammered
Borderline - 10/100
Beginning - rapid/ irregular blocks 
Some secondary behaviours 
Aware
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23
Q

Describe intermediate and advanced stammering

A 
Intermediate- blocks in which sound and airflow are cut off
Escape and avoidance behaviours 
Fear/ frustration 
Advanced- long tense block 
Escape and avoidance
Negative self concept
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24
Q

What are some risk factors for persistent stammering

A 
Being male 
12> since onset 
Relative who stammers
Anxious temperament 
Phonological problems
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25
Q

Name some assessment tools in children

A

Case history
Observation
Pre appointment questionnaire
Audio/ video recording

26
Q

Describe single syllable whole word repetitions

A

And-and- and

27
Q

How would you draw a sound prolongation

A

M:ummy

28
Q

How would you draw a block

A

(B)all

29
Q

What is the calculation for percentage syllables stammered

A

Total number of syllables stammered / total number of syllables x 100

30
Q

What should you ask in a case history for a child

A 
Age of onset 
>12 months?
Awareness 
How does it present 
Temperament 
Life events 
Parents concerns
S&amp;L milestones
31
Q

Name some indirect and direct interventions

A 
Indirect- change environment 
- demands and capacities 
PCI
Direct- lidcombe <6
- fluency shaping 
- gradually increase length of childs utterance
32
Q

What advice could you give to parents?

A

Modelling pauses
1:1 quality time
Avoid interrupting and asking lots of questions
Encourage them to observe fluency environments

33
Q

Name some potential fluency disrupters

A 
Direct questions 
Complex speech 
Competitive speaking environments 
Rushed speaking 
Negative comments
34
Q

Describe PCI

A

Take video
Follow childs lead in play using commenting
Special time- 5 mins 1:1 undevided attention with child picked activity
1 hour sessions- 6 weeks

35
Q

Describe lidcombe

A 
Based on operant conditioning 
Aims to make speech fluent 
Praise and acknowledge ‘smooth’ speech - ‘was that smooth?’ Only when fluent
Acknowledge ‘I heard a bump’ 
Comment more on smooth speech
36
Q

What else would you need to gather in a case history for adults

A 
Whether they had any previous SLT input 
Developmental stammering?
Has there been a change in the stammer 
Tension behaviours in speech 
Feelings? Self concept?
37
Q

Name 4 tools for assessment

A

WASSP- looks at covert features of stammering
OASES- yaruss 2006- likely scale, agree or disagree with statement 7+
ACES- similar to OASES but for children
CAT- children’s attitude test

38
Q

What would you look for when assessing PWS speech

A 
Frequency of stammer 
Type 
Duration 
Secondary behaviours
Rate 
Pitch
39
Q

What are the 5 principles of ‘stammer more fluently’

A 
Variation
Identification 
Desensitisation 
Avoidance reduction
Voluntary stammering
40
Q

What is variation

A

Change around speech/ non speech items
Broaden self construct
Stammer in different way?

41
Q

What is identification

A

What happens when they stammer?
Map out stammer on to iceberg
Thoughts/ feeling

42
Q

What is desensitisation

A

Van riper
View it in less scary way
Broaden construct of what stammering is
Confronting disorder

43
Q

What is avoidance reduction

A

Sheehan

Reducing avoiding words/situations/feelings/ relationships

44
Q

What is voluntary stammering

A

Stammering modification

Gaining control

45
Q

Theory behind stammering modification

A

Van riper 1973
Fear of stammering- increased stammering
Replace stammer with less difficult stammer - reduce fear and avoidance

46
Q

Name the three stages of block modification

A

Post block modification -ask client to stammer, think about stammer, do it again but easier
In block modification- do something in the moment
Pre block modification- know you may stammer so make it easier beforehand

47
Q

Describe soft contacts

A

Hearing difference between hard and soft contrasts

Experiment with softness

48
Q

What is easy onset

A

Taught in context of breathing

Exhale first - gradual onset of phonation

49
Q

What is the camper down programme

A

Used for older children
Aim- not stammering
Very slow exaggerated talking

50
Q

What packs can be used with children to represent slowing etc

A

Swindon fluency packs

51
Q

What is cluttering

A 
Uncontrolled speed of utterance 
Rapid, dysrhythmic 
Speech sounds jumbled 
Handwriting affected?
Difficulty planning sentences 
Word finding difficulties
52
Q

Discuss attention and disinhibition in cluttering

A

Insufficient attention to listener
Poor self monitoring of speech
Impulsive/ impatient/ excess talking

53
Q

What would you look for in assessment of cluttering

A

Dysfluency types
Rate
Festinating (speeding up)
Grammatical error

54
Q

Describe the scores for cluttering/not cluttering on the predictive cluttering inventory

A

> 120 cluttering

<80 not cluttering

55
Q

Intervention for cluttering

A

Increased monitoring (recording themselves?)
Modify rate
Improve attention span
Over articulation

56
Q

Name the 5 types of acquired stammering

A 
Neurogenic 
Psychogenic 
Drug induced 
Aggravated developmental 
Idiopathic
57
Q

Describe neurogenic stammering

A

Following neurogenic disease/event eg stroke/ TBI (75%) disease (16-18%)
Not related to function words
Speaker annoyed not anxious
Absence of secondary behaviours

58
Q

Describe psychogenic stammering

A

As a result of emotional trauma or stressful event
History of mental health problems?
Presence of primary and secondary gain
(Primary- benefit eg more attention, time off work)
(Secondary- changes to interactions?)
Can be intermittent

59
Q

What is aggravated developmental stammering

A

Late onset- developmental but reoccurring?

60
Q

What is drug induced stammering

A

Can be side effect of some medications

61
Q

What is idiopathic stammering?

A

No history
No neuropathology
No medication
No trauma

SLP 3 (3 decks)

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