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Fluency Disorders T3
Fluency Disorders for Test 3
| Question | Answer |
|---|---|
| Fluency | Smooth, uninterrupted forward flow of speech. |
| The smooth, uninterrupted forward flow of speech | fluency |
| Dysfluency | Any disruption on the flow forward flow of speech |
| Dysfluency is any ________ in the smooth, forward flow of speech. | disruption |
| Fluency does not just include... | Stuttering (but it is most common) |
| T/F: most people speak fluently | FALSE - there are normal disfluencies |
| 10 Basic Features of Stuttering -Begins as some forms of dysfluency _______ | Increases |
| 10 Basic Features of Stuttering -Begins in ______ childhood - | early |
| 10 Basic Features of Stuttering -_______ or _______, the Frequency of dysfluencies increases | suddenly or gradually |
| 10 Basic Features of Stuttering -Usually, there is nothing unusual about the _____ of _______ | time of onset |
| 10 Basic Features of Stuttering - T/F: Typically, NOT due to language deficit | TRUE |
| 10 Basic Features of Stuttering - Varies across ______, _______ and ________ | time, situations, & listeners |
| 10 Basic Features of Stuttering - T/F: Most people who stutter can sing with little or no dysfluency | TRUE |
| 10 Basic Features of Stuttering - T/F: does not run in families | FALSE |
| 10 Basic Features of Stuttering - More ______ than ______ stutter | males than females |
| 10 Basic Features of Stuttering - Most people who stutter (can/cannot)______ benefit from treatment | can |
| Stuttering occurs ________ between the ages of ____ | naturally; 4-5 years old - because the brain is working faster than the words can come out of the child's mouth |
| How parents _____ can determine if they grow out of the stuttering stage | react |
| If stuttering is still occurring around age _____ then it is a disorder | 7 |
| T/F: A traumatic event can trigger stuttering | FALSE - there is no specific timeline |
| Stuttering varies depending on... | situation, certain words, etc. |
| It is important to ____ when stuttering occurs the most. | target |
| melodic therapy | involves rhythm & music. Generally stuttering subsides when there is a rhythm to a person's speech |
| Genetics plays a role in stuttering. ______ are more likely to study than ______ | males; females |
| Wingate's Definition of Stuttering | FREQUENT DISRUPTIONS IN THE FLUENCY OF VERBAL EXPRESSION SOMETIMES ACCOMPANIED BY ACCESSORY STRUGGLE AND TENSION IN THE PRESENCE OF EMOTIONAL STATES AND EXCITEMENT THAT MAY OR MAY NOT RELATE TO TALKING. |
| _______ DISRUPTIONS IN THE FLUENCY OF VERBAL EXPRESSION SOMETIMES ACCOMPANIED BY ACCESSORY STRUGGLE AND TENSION IN THE PRESENCE OF EMOTIONAL STATES AND EXCITEMENT THAT MAY OR MAY NOT RELATE TO TALKING. | Frequent |
| Wingate's Definition | Techniques developed to help with stuttering & breaking the techniques to get over it |
| Types of Disfluencies | Whole word repetitions - part word repetitions - phrase repetitions - prolongations - interjections of sounds, syllables, words & phrases - |
| T/F: stuttering is universal | TRUE |
| ____% of the general population in the U.S. & ____% of children stutter | 1%; 4% |
| ____ stutter more than ______ | males; females; 4:1 |
| Normal Dysfluency | Interjections - Pauses - Part word Repetitions - Sound Prolongations - |
| Normal dysfluency - common in children who are still developing language skills | Pauses |
| Normal Dysfluency - frequency of repetitions determines if it is an abnormal dysfluency | Part Word Repetitions |
| Normal Dysfluency - should not occur longer than 1 second | Sound Prolongations |
| Loci of Stuttering - Dysfluencies (are/are not)______ randomly distributed throughout the utterance | are not |
| Loci of Stuttering - Stuttering is more likely to occur... | - on the first syllable of the first word in a phrase or sentence - With consonants - on longer words - with less frequently used words |
| 3 Bases to distinguish a person who stutters | - The frequency of all dysfluencies combined - The presence of certain types of dysfluencies - The duration of dysfluencies |
| it is beneficial to ______ sessions with clients | record |
| Use the criterion of ____% or more dysfluencies to distinguish stuttering from normal speech | 5% |
| ____ types of dysfluencies are counted | ALL |
| Frequency of all dysfluencies combined. Based on _______ _______ studies | listener judgment |
| Not necessarily of often they occur...usually based on.... | their presence |
| T/F: Some types of dysfluencies are not common in normal speakers | TRUE |
| ___-____repitions & _____-______prolongations (frequency is not counted) | part-word; speech-sound |
| Associated with ______tension & struggle | muscle |
| considered excessive if the duration last longer than _______ | 1 second |
| Certain motor behaviors & _____ behaviors may be parts of the stuttering problem | avoidance |
| Motor behaviors include... | eye-blinking - foot tap - breathing abnormalities (inhaling, holding breath, etc) |
| Behaviors are ________ by being seen as "helping" the stutterer get the words out | reinforced - they have to be addressed as well in therapy. Not a healthy habit. |
| Stuttering can create a variety of negative ______ & _______ of words & speaking situations | emotions & avoidance |
| People who tend to stutter avoid... | strangers - formal audiences - service counters - telephones - restaurants - introductions |
| Dealing with _____ is part of an SLP's job | avoidance |
| Circumlocation | a strategy that people who stutter use - saying anything other than that word that makes them stutter - beating around the bush - avoidance behavior - frustration occurs |
| Negative emotions associated with stuttering.... | frustration - anxiety - depression - isolation - apprehension |
| 3 Theories of Stuttering | Organic Theories - Behavioral Theories - Psychological Theories |
| Organic Theories involve... | the tongue - the larynx (tense laryngeal muscles) - Cerebral Dominance (one side of the brain is stronger than another) - Defective Auditory system (Delay in the speech process. Delayed auditory feedback technique) |
| Behavioral Theories involve Wendall Johnson's Diagnosogenic Theory. - Stuttering is not in the mouth of the child but in the _____ of the listener | ear |
| Behavioral Theories involve Wendall Johnson's Diagnosogenic Theory. - The child tries to avoid the patterns that the parents think is a problem (normal Dysfluencies) = | Stuttering |
| Psychological Theories (Freudian Psychoanalysis) - Stuttering as a ______ symptom | Neurotic - Mild mental or psychological disorder |
| Psychological Theories (Freudian Psychoanalysis) - _____ & ______ fixations | oral & anal |
| Psychological Theories (Freudian Psychoanalysis) - PSYCHOTHERAPY (Has/Has not)_______ BEEN DEMONSTRATED TO BE AN EFFECTIVE METHOD OF TREATMENT. | HAS NOT |
| Warning Signs | Multiple Part Word Repetitions - Prolongations - Schwa Vowel - Struggle & Tension - Pitch & Loudness Rise - Tremors (Lips/Tongue) - Avoidance & Fear - Difficulty in Initiation of Voice. |
| Case History Information Includes (Stuttering) | Info on the onset & development of stuttering - Family History - Developmental, educational, social, & occupational history of the client - Prior Assessment & Treatment |
| Assessment of Stuttering | Observe Types & Frequencies of dysfluencies - Associated Motor Behaviors - Avoidance - Emotional Reactions |
| Assessment of Stuttering Includes | Determine Frequency of stuttering (verbal & oral readings) - Determine Types - Environmental Factors - Client Perception - Case History - Treatment Plan/Prognosis - Counseling |
| Stuttering Modification Therapy developed by... | Charles Van Riper |
| Charles Van Riper | A Pioneering & influential SLP - Severe Stutterer - Normal Fluency is not the goal |
| Goal of stuttering Modification Therapy | Reduced severity of stuttering & learning to live with it. |
| This technique is classified as ________ _________ because the goal for the person who stutters is to unlearn maladaptive behaviors, such as struggling, & learning new adequate behaviors, such as speaking with ease. | Stuttering Modification |
| The new way of stuttering is considered... | "easy stuttering" or "fluent stuttering" |
| Stuttering Modification Therapy - Style of Presentation | 1 hr of individual therapy & 1 hr of group therapy 3 days a week over a period of 3 months. Following up with 1 or 2 times a week for another three to four months for stabilization |
| 4 Phases of Stuttering Modification Therapy | Identification - Desensitization - Modification - Stabilization |
| Identification Phase | Teaches client to recongnize core behaviors & secondary behaviors, & feelings & attitudes associated with his/her individual nature of stuttering |
| Identification Phase - Therapy Strategies to identify behaviors are... | oral reading, discussion, modeling stuttered behaviors, & self observation |
| Desensitization Phase | Person who stutters learns strategies to reduce negative feelings and anxiety associated with stuttering. |
| Desensitization Phase - Therapy Strategies... | confront the disorder and desensitize the individual to stutter behaviors and listener reactions. |
| Modification Phase | Clients learn how to use Van Riper's modification techniques. Which include Cancellations, Pull-Outs, Preparatory Set Techniques. |
| Modification Phase - Cancellations | after stuttering, there is a pause and the word is said a second time using an “easy” stutter. |
| Modification Phase - Pull-Outs | when a person begins to stutter, they are to say the rest of the word with ease. |
| Modification Phase - Preparatory Set Techniques | when the person anticipates a word to be difficult, they are encouraged to work through all sounds of the word slowly and calmly. |
| Stabilization Phase | The person who stutters becomes self-aware and confident in monitoring his/her own stutter behaviors. |
| Clinician provides support for the client as independence is developed and therapy is gradually reduced. | Stabilization Phase |
| Generalization and maintenance are addressed during the __________ phase. | Stabilization Phase |
| Therapy is considered __________ when the client changes from a person who stutters to a person who is in control and speaks fluently with occasional moments of mild stuttering. | successful |
| Strengths of Stuttering Modification Therapy - Program is _____________ and feelings and attitudes associated with stuttering are considered. | individualized |
| Strengths of Stuttering Modification Therapy - ______ and _________counseling are included in therapy. | Family & Individual |
| Strengths of Stuttering Modification Therapy -The client develops a sense of internal _______ of ________ | Locus of Control |
| Strengths of Stuttering Modification Therapy - Client becomes aware that ____________ are common among all speakers. - | disfrequencies |
| Weakness of Stuttering Modification Therapy - Program requires... | excessive amount of time and effort to ensure strategy effectiveness. |
| Weakness of Stuttering Modification Therapy - There is a ______ of _____ to support the approach. | lack of evidence |
| Weakness of Stuttering Modification Therapy - Only appropriate for... | advanced stutterers (recommended) |
| _________ strategies are recommended for the beginning stutterer. | Prevention |
| Teaching Fluent Speech (for treatment) | Modified Airflow - Gentle Initiation of Sound - Slower Rate of Speech - Soft Contact of Articulators |
| Use of Electronic Devices (for treatment) | Delayed auditory Feedback |
| Begin treatment with... | one word or two word phrases |
| Treatment Options -Pause to talk | A brief duration of silence immediately following a stutter |
| Treatment Options -Response Cost | Client earns a token for fluent productions and loses one for each stuttering |
| Transfer/Maintenance | HOME ASSIGNMENTS ROLE PLAYING SITUATIONS FAMILY/PEER INVOLVEMENT CLIENT SELF-RATING SCALES COUNSELING |
| Relapse - Possible Factors | LACK OF INTEREST MINIMAL CARRYOVER POST THERAPY MONITORING COVERT ISSUES NOT ADDRESSED |
| Relapse is a return to ________ state | prethereapy |
| Cluttering may be confused with _____ | stuttering |
| T/F: Cluttering can coexist with stuttering | True |
| Characteristics of Cluttering | Impaired fluency Excessive dysfluencies Rapid but disordered articulation Possibly disorganized thought and language production Jerky or stumbling rhythm Compressed or deleted words or syllables |
| Cluttering is a ______ disorder & a _____ disorder | fluency; rate |
| Medical term for Cluttering | tachyphemia - rapid speech |
| Diagnosed since ____ | 1700s |
| Cluttering is Excessive x4 | speech/language disfluencies, speech rate, arrhythmia/irregularity, and co-articulation/syllabification |
| Treatment of Cluttering - Reducing rate of ______ is usually helpful | speech |
| Treatment of Cluttering - Problem | Treatment effects are not generalized or maintained |
| Perhaps people who _____ are less invested in therapy, due to lack of self-awareness, or for other reasons. | clutter |
| People who clutter do not tend to be ______-_______ | self-referring |
| T/F: Our obligation to show and tell them about potential therapy benefits | TRUE |
| Signs of a (subtle) language disorder co-occurring with possible diagnosis of cluttering: | Fewer self-corrections Fewer complete utterances More revisions or “mazes” (Loban, 1976) (semantics/syntax), Difficulty taking listeners’ perspectives into account (pragmatics |
| Behavioral disorders: | Attention-Deficit Hyperactivity Disorder Learning disabilities Comorbidity of ADHD + LD is found in about 3.5% of 6- to 11-yr-old children (Center for Disease |
| Syndromes: | Down Syndrome (80%) Asperger’s Syndrome |
| Speech/lang. disorders: | Articulation (2/3); even apraxia Stuttering (14 - 32% of stutterers show “cluttering” symptoms) Language disorders? |
Created by:
jevelti1