Stuttering/Fluency Flashcards
Stuttering
- disruption in the fluency of verbal expression
-characterized by involuntary, audible, or silent repetitions, prolongations, or fixations in the utterance of speech elements (sounds, syllables, words, phrases)
Core Behaviors
characteristics of disfluent speech itself
Part Word Repetition
Repetition of a part of a word or a sound or syllable
“S-S-S-Study”
“St-St-St-Study”
Sound Prolongations
Sounds produced for a duration longer than typical
“NNNNNNNNNo more
studying
Silent Prolongations
An articulatory posture held for a duration
longer than average but with no vocalization
holding the articulatory
posture for /m/ for the word
money
Secondary Behaviors
extraneous physical behaviors associated w/ the disfluent speech
1.
Escape
physiological movements that is tacked on that they think will help.
o Eye blinks
o Head nods
Avoidance Behaviors
things they do so they don’t even get to the disfluency
o Fillers (um, uh, you know)
o Starters (“My name is…”)
o Substitutions/ circumlocutions – talking around the problem (“my father’s brother vs. uncle)
o Timing hand movements to saying a word
o Avoiding situations where they’re likely to stutter
Revisions/Incomplete phrase
(“it seemed better… it seemed more thoughtful if…)
Pauses
Silent intervals in the speech sequence at
inappropriate junctures or of unusually long duration
Broken Words
Silent intervals within words, also known as intralexical pauses
Incomplete Sentences
Often described as incomplete phrases, these are
grammatically incomplete productions
“ I really wanted … I
really wanted.. to pass”
Revisions
Changes in wording that do not change the overall
meaning of an utterance
- “Let me have a large
coffee, maybe extra large”
Sound/Syllable
Interjection
The common “um” and the schwa interjections
Whole Interjection
Interjections of like, okay, well
Phrase Interjection
Interjections of you know, I mean
Cancellations (Modification)
Cancellations involve pausing and rephrasing after
experiencing a stuttering block. This technique allows the individual who stutters to take a moment to reflect on what they were trying to say and then rearticulate the word or phrase more fluently.
- Example: If someone stutters on the word “b-b-bicycle,” they would
pause, take a breath, and then say, “I like riding my bicycle.”
Pull- Outs (Modification)
Pull-outs involve changing stuttering mid-course when a
block occurs. It’s a technique that helps the individual “pull out” of the stutter and continue speaking more fluently.
- Example: : If someone is starting to stutter on the word “s-s-sun,” they might transition into it more fluently by saying, “s…u…n.”
Preparatory Sets (modification)
Preparatory sets involve altering the manner of stuttering by
deliberately introducing a brief pause before attempting a potentially challenging word
- Example: If someone typically stutters on their name, “John,” they might use a preparatory set by saying, “My name is (pause) John.”
Van Riper Method
- primary goal is not to achieve normal fluency but to
make stuttering less severe and less visibly abnormal. - client is taught to
recognize stuttering and
associated emotional and
attitudinal issues in both clinical
and daily life situations. - Clients learn to produce
more fluent, easier, and
less visibly abnormal
stuttering. - encouraged to use
stuttering modification
techniques (cancellations, pullouts, and preparatory sets)
consistently in all speaking
situations.
Camperdown Program
structured, behavioral approach designed for managing
stuttering in adolescents and adults. The program’s primary aim is to reduce stuttering
in everyday talking through teaching a fluency technique and empowering clients with
self-management skills
Camperdown Stage I
Teaching Treatment Components
1. Goal: Introduce fundamental
treatment components, including
a key fluency technique.
2. Process: Learn and practice a
specialized fluency technique in a
clinical setting to reduce
stuttering.
3. Skills: Develop initial fluency,
apply techniques in structured
scenarios, and begin self- assessment.
Camperdown Stage II
Establishing NaturalSounding Stutter-Free Speech
1. Goal: Make stutter-free speech
sound natural while maintaining
low stuttering levels.
2. Process: Refine fluency
technique for more natural
speech rhythm and intonation.
3. Skills: Adjust speech pace to be
more natural without increasing
stuttering, building confidence
in stuttering control
Camperdown Stage III
Generalization
1. Goal: Apply stuttering control
from clinical settings to
everyday speaking situations.
2. Process: Encourage use of
fluency techniques in diverse
real-life situations.
3. Skills: Gain confidence in
controlling stuttering across
various social and occupational
settings, addressing social
anxiety.
Camperdown Stage IV
Maintaining Stuttering
Control
1. Goal: Maintain achieved stuttering
control and manage long-term
stuttering.
2. Process: Develop coping
strategies and self-management
skills for potential stuttering
increases.
3. Skills: Master self-evaluation of
speech, maintain fluency, set longterm goals, and adapt techniques
to various life scenarios.
Fluency Reinforcement Method
- Goal: Promote fluid speech by reinforcing fluency.
- Techniques: Apply positive reinforcement, modeling, and real-life materials.
- Positive Reinforcement: Praise fluent speech to reinforce it.
- Modeling: Exhibit relaxed speaking for
natural fluency. - Limitation: Risks of unnatural-sounding fluency and possible relapse.
Direct Stuttering Reduction
- Behavioral techniques to reduce stuttering, such as time-outs and response costs, suitable for
older children and adults. - Pause-and-Talk: Clients learn to pause after stuttering before continuing, fostering self-monitoring.
Fluency Shaping Method
- Goal: Establish normal fluency, not fluent stuttering.
- Techniques: Various fluency-enhancing techniques like prolonged speech, airflow management, and gentle onset of
phonation. - Camperdown Program: An abbreviated
fluency shaping method focusing on prolonged speech. - Limitation: Generates slow, deliberate, somewhat unnatural-sounding fluency,
leading to potential relapse
Fluent Stuttering Method
- Modifies Stuttering: Teaches fluent and controlled stuttering.
- Reduces Fear: Aims to lessen anxiety around stuttering.
- Key Techniques: Includes cancellations, pull-outs, and preparatory sets.
By Charles Van Riper: A widely recognized stuttering therapy approach. Also called Stutter-More-Fluently
Adaptation Effect
A decrease in stuttering
frequency during repeated
readings of the same text
Consistency Effect
The tendency for stuttering to occur on the same words in
repeated readings or speaking of the same material, or in response to the same cues or stimuli
Adjacency Effect
The tendency for stutterings to occur adjacent to previously stuttered words which have
been blotted out in successive readings of a passage
Audience Size Effect
The observation is that the frequency of stuttering increases with an increase in
audience size.
NEUROGENIC STUTTERING (NS)
- Includes repetitions of medial and final syllables, not just initial syllables.
- Strokes,traumatic brain injuries, neurodegenerative diseases (e.g., Parkinson’s, ALS), and other neurological conditions.
Neurogenic Stuttering Treatment
- Speech Rate Control
- Assistive Technologies
- Addressing Underlying Issues
Psychogenic Stuttering
- Rare condition that appears to occur almost exclusively in individuals with severe emotional trauma or who have a history of psychiatric illness.
- Characterized primarily by the rapid repetition of initial word sounds
Response Cost
a token is given for each fluent production, and one is withdrawn for each dysfluency
Distinguishing Features of Neurogenic Stuttering
- Dysfluencies on function words and in imitated speech,
- Lack of adaption
- Minimal or no effect of masking noise
Cluttering
fluency disorder where language is perceived as too fast, too irregular, or both
Cluttering Characteristics
- rapid or irregular rate
- false starts, breaks, repairs
- collapsing/distorting words
- disorganized language
- poor self monitoring/awareness
Cluttering Treatment
- slow rate - primary focus
- pausing/phrasing
- DAF
- visual biofeedback - improving self-monitoring skills
Easy Onsets
- method to initiate voicing in a gentle fashion
- mainly used on vowels in initial word position
- feel your quietest possible voice, feel smooth increase in loudness until normal speaking level
Light Contacts/ Soft Starts
- bringing articulators together with a feather light touch
- feel articulators barely touch, then pull apart
