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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
Created by: rcraun



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