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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
Name some assessment tools in children
Case history Observation Pre appointment questionnaire Audio/ video recording
26
Describe single syllable whole word repetitions
And-and- and
27
How would you draw a sound prolongation
M:ummy
28
How would you draw a block
(B)all
29
What is the calculation for percentage syllables stammered
Total number of syllables stammered / total number of syllables x 100
30
What should you ask in a case history for a child
``` Age of onset >12 months? Awareness How does it present Temperament Life events Parents concerns S&L milestones ```
31
Name some indirect and direct interventions
``` Indirect- change environment - demands and capacities PCI Direct- lidcombe <6 - fluency shaping - gradually increase length of childs utterance ```
32
What advice could you give to parents?
Modelling pauses 1:1 quality time Avoid interrupting and asking lots of questions Encourage them to observe fluency environments
33
Name some potential fluency disrupters
``` Direct questions Complex speech Competitive speaking environments Rushed speaking Negative comments ```
34
Describe PCI
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
Describe lidcombe
``` 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
What else would you need to gather in a case history for adults
``` 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
Name 4 tools for assessment
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
What would you look for when assessing PWS speech
``` Frequency of stammer Type Duration Secondary behaviours Rate Pitch ```
39
What are the 5 principles of ‘stammer more fluently’
``` Variation Identification Desensitisation Avoidance reduction Voluntary stammering ```
40
What is variation
Change around speech/ non speech items Broaden self construct Stammer in different way?
41
What is identification
What happens when they stammer? Map out stammer on to iceberg Thoughts/ feeling
42
What is desensitisation
Van riper View it in less scary way Broaden construct of what stammering is Confronting disorder
43
What is avoidance reduction
Sheehan | Reducing avoiding words/situations/feelings/ relationships
44
What is voluntary stammering
Stammering modification | Gaining control
45
Theory behind stammering modification
Van riper 1973 Fear of stammering- increased stammering Replace stammer with less difficult stammer - reduce fear and avoidance
46
Name the three stages of block modification
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
Describe soft contacts
Hearing difference between hard and soft contrasts | Experiment with softness
48
What is easy onset
Taught in context of breathing | Exhale first - gradual onset of phonation
49
What is the camper down programme
Used for older children Aim- not stammering Very slow exaggerated talking
50
What packs can be used with children to represent slowing etc
Swindon fluency packs
51
What is cluttering
``` Uncontrolled speed of utterance Rapid, dysrhythmic Speech sounds jumbled Handwriting affected? Difficulty planning sentences Word finding difficulties ```
52
Discuss attention and disinhibition in cluttering
Insufficient attention to listener Poor self monitoring of speech Impulsive/ impatient/ excess talking
53
What would you look for in assessment of cluttering
Dysfluency types Rate Festinating (speeding up) Grammatical error
54
Describe the scores for cluttering/not cluttering on the predictive cluttering inventory
>120 cluttering | <80 not cluttering
55
Intervention for cluttering
Increased monitoring (recording themselves?) Modify rate Improve attention span Over articulation
56
Name the 5 types of acquired stammering
``` Neurogenic Psychogenic Drug induced Aggravated developmental Idiopathic ```
57
Describe neurogenic stammering
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
Describe psychogenic stammering
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
What is aggravated developmental stammering
Late onset- developmental but reoccurring?
60
What is drug induced stammering
Can be side effect of some medications
61
What is idiopathic stammering?
No history No neuropathology No medication No trauma

SLP 3 (3 decks)

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