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FLUENCYYYFINAL
Question | Answer |
---|---|
fluency is said to include | rate, effort and continuity |
a fluency disorder characterized by a rate of speech that interferes with intelligibility | cluttering |
what is not a core feature of stuttering? | avoidances |
what is helpful in the differential dx of developmental stuttering and neurogenic stuttering in adults? | disfluencies occur on grammatical words as frequently as substantial, stutters occur in all positions, 2ndaries ususually dont occur, stuttering is inconsistent across speech tasks |
Disruptions of fluency include: | PWR, WWR, prolongations, blocks |
Secondary symtoms may include: | escape, physical concomitants, tension, tremor, breathing irregularities, anticipatory behaviors, timing devices, circumlocution |
cluttering is different from stuttering in that: | cluttering is more often associated with other problems. |
tendency to stutter on many of the same words on repeated readings of the same passage | consistency effect |
eye blinks, head nods | escape behaviors |
Percentage of spontaneous recovery vary from: | 30-85% |
Theories of stuttering which cite results of brain imaging studies as supportive evidence are: | interference theories |
a theory that implicates the listener's response as a cause of stuttering: | diagnosogenic theory |
when teaching soft starts in tx, what is an appropriate linguistic level at which to begin? | single word level |
to complete articulation rate in SPM, you would divide all stuttered and non-stuttered words by 60 | FALSE - only non stuttered |
what are the three aspects that SSI assesses? | stuttering frequency, stuttering duration, concomitant behaviors. |
Dx instrument to assess stuttering applicable only to children: | SPI |
Changing "blank" was not mentoined in the DVD: | Pitch |
Pullout should be used when... | The client has already learned to hold and tolerate the moment of stuttering |
Disclosure is important becasue: | client openly acknowledges stuttering to listenere, allows client to take control of situation, promotes openness, helps listeners |
which of the following goals/procedures would most likely be used by clinicians who engage in "fluency shaping" for an adult client who is in the advanced stages of stuttering? | reduce the frequency of stuttering to less than 1% of suttered WPM |
contingent response management referes to: | approaches using operant conditioning |
a well researched contingent response management approach for preschoolers is: | Lidcombe Program |
Tx approach that focuses on modyfing speech motor patters and parent counseling: | speech rate tx for preschoolers who stutter |
a commonly used cut off point in determining if a child is stuttering is 3% of stuttered words or syllables; a similar criteria suggested by Yairi is at lease SLDs per 100 syllables. | 3 |
parents communication style can cause stuttering | false |
indirect tx involves: | changing parents' communication patterns |
a percentage of children who spontaenously recover from stuttering is: | 75% |
the GILCU program includes: | stop.. speak fluently |
which of the following approaches begins with an exploration of stuttering and then teaches flexible rate, gentle onsets, light contacts, and proprioception? | Guitar's integrated approach |
According to the CALMS model, a multidimensional focus addressing the assessment of stuttering would include: | cognitive, affective, linguistic, motor, social |
desensitization may be an important part of the child's stuttering tx because: | she/he demonstrated avoidance of specific speaking situations |
progress in school-based tx is measured by: | decrease in adverse effects on academic, nonacademic, and extracurricular activities |
learning the "facts" about stuttering from self-help organizatio helps the child: | build locus of contorl skills |
an important step in obtaining generalizatin of fluency skills is: | IDing the everyday environmental cues that should trigger appropriate management strategies |
The regulated breathing program is similar to smooth speech in what ways? | attention to appropriate breathing for speech |
stuttering mod and regulated breathing have the following components in common: | ID phase |
oASES was designed to assess: | speakers reaction to stuttering, functional communication, quality of life |
pharmacological tx for stuttering: | has not produced uncomplicated positive results |
SpeechEasy: | choral effect using combined DAF and AAF |
the principle that the power of a stimulus to evoke anxiety and stuttering is weakened when the stimulus is experienced in a relaxed state: | desensitization |
the camperdown program: | uses PS w/o DAF |
using pausing immediately upon the occurrence of stuttering as the primary means by which the person who stutters increases his/her fluent speech: | self-initiated time out |
an example of an EBP program for adults who stutter: | Camperdown, SITO, comprehensive suttering program |
tx for cluttering does NOT include | an emphasis on stuttering modification |
The result of consuluting EBP for tx is(3): | research-based, client-centered, outcomes-focused approach to practice |
goal of best clinician practice addresses the following 3 things: | Research, clinician expertise, client preference |
only studies that met criteria for 4/5 methodological critera for preshool were the "blank" type of tx: | response-contingent |
Best developed and most extensively researched tx for preschool: | Lidcombe |
An operant program that involves parent administered positive contingencies for fluent responses and corrective contingencies for stuttered responses | Lidcombe program |
intervention should increase the child's capacities for fluency and guide families in reducing demands that stress the child's fluency | demands and capacities |
systematic application of operant conditioning procedures ( + and - contingencies) can increase desired behaviors and decrease undesired behaviors | GILCU |
increase levels of airflow before and during speech, stabilize muscle dysfunction, regulate breathing by pausing, increase feelings of control by increasing self esteem | smooth speech |
stuttering is a central processing disorder of the brain which is often associated with irregularities in breathing and results in speech muscle dysfunction - need to learn to control which can be taught by behavioral principles | smooth speech |
increase a person's awareness of when an undesirable behavior occurs and carryout an incompatible behavior whenever the undesirable behavior occurs | parent-assisted regulated breathing |
stop talking immediately when a stutter occurs, exhale reamining air, inhale, exhale slightly prior to initiating speech again | parent-assited regulated breathing |
decrease or elimitate stuttering and maintain decreased stuttering in typical speaking situations | camperdown |
reduce or eliminate stuttering in clinic and everyday speaking situatiosn - maintain levels achieved at the end of program - operant conditioning | SITO |
an integrated approach that involves fluency shaping, stuttering mod, and other procedures | comprehensive stuttering program |
Higher levels of normal disfluencies occur in: | 50% of children |
Peak of child disfluency: | 2.6-4 years |
comm disorder related to speech fluency that generally begins during childhood and often continues into adulthood | developmental stuttering |
most common type of fluency disorder | developmental stuttering |
reductions in stuttering symptoms that usually occur with repeated readings of the same passage | adaptaton effect |
the tendency for stuttering to occur on the same words over repeated readings | consistency effect |
conditions associated with decreased stuttering | DAF, slowed speech, shadowing, singing, rhythmic speech, choral reading, lipped speech, whispering |
accessory behaviors include: | escape behaviors, physical concomitants, tensio and tremor, breathing irregularities, anticipatory behaviors, timing devices, circumlocutions |
Stuttering ABCs | Affective, Behavioral, Cognitive |
Affective components of stuttering | feelings, emotions, attitudes |
Behavioral components of stuttering | speech - disfluencies, naturalness, secondaries |
Cogntive components of stuttering | personal strategies, beliefs, interpretations |
Disorder of stuttering includes: | presumed etiology, impairment in body function, ABC, environment, limitations in communication activities and restrictions |
stuttering, often transient, that began with- or is maintained as a result of - a specific, identifiable neurological lesion or insult | neurogenic stuttering |
stuttering that is clearly related to psychopathology | psychogenic stuttering |
rapid and dramatic response to behavioral management, stuttering worsens on easier tasks, is intermittent or unpredictable, vary with situation, person, time of day, secondaries usually do not occur | psychogenic stuttering |
fluency disorder characterized by a rate that is perceived to be abnormally rapid, irregular, or both for a speaker | cluttering |
percentage of children who stutter who have a coexisting phonological and/or language disorder | 33-44% |
incidence of stuttering: | 4% |
Prevalence of stuttering: | 1% |
median age of stuttering onset: | 2-5 years- new research: 30-38mos |
Highest prevalence of stuttering: | 2.5% in preschool age |
boys are times more likely to stutter | 3-4x |
first degree relatives are times more likely to stutter | 3x |
concordance rate between twins: | 77% - monozygotic; 32% dizygotic; non-twin siblings: 15% |
achievement of improved fluency or normalcy with or without intervention | recovery from stuttering |
achievement of or return to normalcy without the intervention of outside agents | spontaneous recovery |
spontaneous recovery rage: | 30-85% - 75% is frequently stated |
Most people will recover with in years of onset. Best window is years. | 3. 2. |
Differences in brain structure and function of PWS: | larger and more symmetrical L and R planum temporale, more activity in R hemisphere during speaking than in L hemisphere, more L hemisphere activity during speech after tx. |
Differences in sensory processing of PWS: | poorer central auditory processing for temporal information; longer latencies and lower amplitudes of auditory evoked potentials for linguisically complex auditory stimuli; less R ear/L hemisphere advantage on dichotic listening tasks |
Differences in speech motor control of PWS: | slower reaction times; speech motor systems are more variable, slower fluent speech, slower less accruate and less L hemisphereic dominance |
stuttering or a predisposition is inherited | physciological perspective: genetic theory |
in normal speech/language production, a dominant hemisphere takes primary responsibility for linguistic functions - PWS dominance fails to occur causing competing commands | cerebral dominance theory |
normal L hemisphere lateralizatoin, normal R hemisphere function, interference with L hemisphere coming from the R hemisphere through a "slop over" | interhemisphereic interference theory |
normal hemispheric specialization for speech, L hemisphere system for speech but has "pores", lack of L hemisphere activation bias | two factor inference theory |
PWS have a temporal impairment in phonological encoding - adapted to by covert repairs, restarts and postponements. stuttering is a byproduct of self repairs | covert repair hypothesis |
disfluencies occur d/t a disruption in timing among various linguistic formulation and motoric execution demands - stuttering is a loss of control, speaker cannot proceed but does not know why | neuropsycholinguistic model |
deficit in the person's ability to make and use inverse internal models of the speech prod system - PWS has a weakness between what he wants to say & the motor movevement required - sensory to motor transformation | inverse modeling deficit |
the result of one or more factors related to PWS interaction with the environment | environmental theories |
parents react poorly to normal disfluencies in children; this reaction is perceived and responsed to with anxiety and avoidance by the children | diagnosogenic theory |
stuttering evolves from normal disfluency and the child's reponses that lead to tension and fragmentation; responses are self generated | continuity hypothesis - OR anticipatory struggle hypothesis |
child learns to associate speaking witha n emotional response | classical conditioning |
fluency failures are shaped by the responses they elicit | operant conditioning |
stuttering is the involuntary disruption of speech resulting from negative emotional responses that are classically conditioned, while secondary behaviors are operantly conditioned | two-factor model |
integrate physiology, learning and the environment in the etiology and development of stuttering | multi-factorial model |
conditioned weakenss in systems that support fluency interact with environmental factors to precipitate and maintain fluency failure - imbalance between child's current capacities and the demands placed on the child | demands and capacities model. |
peak of stuttering is mos post onset | 2-3 mos |
decline in frequency adn severity of stuttering is mos after onset | 6 mos |
3 aspects of fluency assessment: | data collection, analysis and interpretation, info and counseling |
normal disfluencies: | interjections, revisions, incomplete phrases, phrase repetition, pause |
number of stuttered words that occur in the recorded amount of talking timeq | stuttering rate |
total difluencies divided by the total words, changed to a percentage = | total disfluency index |
expressed in WMP or SPM | speech rate |
stuttered and nonstuttered words are conted in computing total words | overall rate |
only fluent words/syllables are counted in WMP | articulatory rate |
SPI: | stuttering prediction instrument |
3 goals that be attained from tx: | spontaneous fluency, controlled fluency, acceptable stuttering |
child's speech and related behaviors are not consistent with a dx of stuttering | therapy is not indicated |
child is stuttering but shows fewer rather than more risk factors for dev chronic stuttering | tx may be indicated |
parents are concerned and/or the weight of evidence suggests the child is at risk of continuing to stutter | tx is indicated |