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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 |