what causes people to stutter?
-influences
-constitutional
-environmental
-langiage ability
-genetic
-child's personality
-motoric ability
can stuttering be cured?
kinds, spontaneous recovery happens, and early intervention is hopeful
fluency is defined in terms of:
frequency of dislfuent/fluent moments and smoothness of speech
Stuttering is characterized by:
an abnormally high frequency or duration of stoppages in the forward flow of speech
is stuttering normal hesitations in children who are developing speech and laniuggae?
no
is stuttering brief hesitations, revisions, pauses that are heard when individuals are in a hurry or uncertain?
no
is stuttering those behaviors observed in cerebral damage or disease or disfluency resulting from psychological trauma and cluttering?
no
stuttering is the real great speech ____________
neurosis
a spastic coordination whose basic cause is an inherited tendency toward the disease (basis for the disorder)
neurosis
T/F: Stuttering is a psychoneurosis caused by the persistence into later life of early stages of oral fixation
true
core behaviors of stuttering
-repetitions
-prolongations
-blocks
T/F: repetitions are most frequent among children who are just beginning to stutter
true
sound or airflow continues but movement of the articulators is stopped
prolongations
when the person inappropriately stops the flow of air or voice, and often the articulators as well
blocks
A sound, syllable or single-syllable word repeated several times
repetition (has to be repetition more than twice)
two classes of secondary behaviors
escape and avoidance
a speaker anticipates stuttering and tries to avoid it or push back its occurrence
avoidance
attempts to terminate the stutter
escape
stuttering usually begins:
from 18 months to puberty; usually between 2-5 years of age
Prevalence:
-Kindergarten: ___%
-School-age: ____%
-Adults: ____%
-extent to which a disorder occurs in a population
-2.4%
-1%
-1%
Incidence:
-up to ____% of brief periods of stuttering
-___% of stuttering lasted 6 months or more
-how many people have stuttered at some time in their lives
-15%
-5%
sex ratio of stuttering:
3 males to 1 female
3 factors of variability and predictability of stuttering
-anticipation
-consistency
-adaptation
given a reading passage most stutterers can fairly accurately predict which words they will stutter on
anticipation
if a stutterer reads a passage several times they will stutter on the same words
consistency
if a stutterer reads a passage several times, stuttering decreases
adaptation
adults and school age children who stutter do so more often on:
-consonants
-sounds in word-initial position
-contextual speech vs. isolated words
-nouns, verbs, adjectives, adverbs
-longer words
-words at beginning of sentences
-stressed syllables
preschool children stutter more on:
-pronouns
-conjunctions
-repetitions of whole words in initial position
conditions that decrease stuttering
speaking when...
-alone
-relaxed
-to an animal/infant
-while writing
-singing
-swearing
-slowly/prolonged manner
-under loud noises
-using DAF
conditions that increase stuttering:
-speaking on phone
-saying own name
-jokes
-repeating misunderstood message
-waiting to speak
-speaking to authority figures
-speaking to large audience
T/F: reactions of those in the speaker's environment play an important role in stuttering
true
who said stuttering is like an iceberg?
joe sheehan
10% of the real problem is __________; 90% below the waterline is ___________
-stuttering
-emotional baggage
iceberg analogy in a nutshell:
you cant just cure the stuttering of an individual, you also have to work on the emotional baggage at the same time to be fully effective and to not relapse; you must use psychology!
very cooperative client, very willing to listen and try new things
soft ice clients
a "typical" adult client, somewhat wary, but willing to listen and learn. These guys require significant effort but can be very rewarding when things work for them.
in-between ice clients
the very reluctant clients, unwilling to change because only THEY know what to do -- or think they do.
hard ice clients
these stutters don't stutter, but their emotional baggage is enormous and they need a lot of psychological help
covert stutters (heavy density)
is stuttering inherited or environmental?
both
T/F: children who recover from stuttering have had family members who have also recovered from stuttering
true
T/F: children who stutter have an early onset of stuttering
true
occurrence of the same clinical condition in both members of a twin pair
concordance
T/F: suttering occurs more often in monozygotic (identical) twins than in dizygotic (fraternal) twins
true
T/F: individuals who stutter tend to have decreased activity in right hemisphere especially during stuttering
false, increased activity
this study shows increased right brain activity and less left hemisphere dominance for language processing, motor speech, and motor initiation
rCBF
PET studies show:
-decreased activity in Broca's and Wernicke's areas
right hemisphere over-activation studies shows:
over activity in:
-broca's area
under activity in:
-wenicke's area
T/F: are structures smaller and less dense in the brain's of people who stutter?
yes
is the right brain wired for speech?
yes
T/F: people who stutter may have a more difficult time central auditory processing
true
T/F: people who stutter have NO delays in processing incoming and outgoing signals
false, they do have trouble processing
T/F: stutters have slower time staring and stopping a sound
true
T/F: stutterers have a faster reaction with respiratory and articulatory movements
false, they have a slower time
T/F: stutterers demonstrate that their achievement score are slightly lower
true
T/F: are other speech and language difficulties more common among children who stutter as opposed to those who do not?
yes
are stutterers more anxious than non stutterers?
no
do stutterers have an especially extensive temperament?
yes
which hemisphere is usually dominant in those who stutter?
both hemispheres are equally dominant, they mirror each other
when a stutterer is fluent, what does their speech look like?
-Lower vowel durations
-Slower transitions between vowels and consonants
-Delayed onset of voicing after voiceless consonants
disorder of cerebral localization theory says that:
Stuttering is associated with an interference by one hemisphere with the speech performance of the other; left hemisphere may not be dominant
New cerebral dominance theory says that:
Right hemisphere develops first
Signals for speech and language development arent toally drifting over to the left hemisphere- these unique cells drift over to the right hemisphere where they shouldn't be going, this leads to inefficient networks for proc
this theory is based on the premise that faulty laryngeal functioning was the cause of stuttering
Stuttering as a Disorder of Laryngeal Dynamics
with stuttering as a Disorder of Laryngeal Dynamics theory, VIT and SIT:
show relative difference between stutters and nonstutters
Stuttering as a Disorder of Timing says that:
-left hemisphere is not developed fully
-caused by emotion
how the brain stores up speech sounds and then inverts those sensory targets into motor commands necessary to produce them
Stuttering as Reduced Capacity for Internal Modeling (neilson and neilson)
refers to the increase in sensitivity within the motor system to action potentials
biasing (tuning)
why is baising/tuning important?
so we dont have to remember and store hundreds of various motor commands; it allows for rapid sequence
stuttering as a language production deficit relates to the influence of __________ factors on stuttering
linguistic
T/F: stuttering typically begins during phase of immense language growth
true
neilson =
kolk and postma =
motor speech
language
problem with the planning and assembly of language units that occur before speech production relates to what theory?
stuttering as a language production deficit
Stuttering and normal disfluencies are a result of an internal monitoring process that we use to check what we are about to articulate is exactly what we want to say
covert repair hypothesis
according to the covert repair hypothesis, we're always __________, and out brain is always ___________ what we're going to say
monitoring
fact checking
T/F: stutters are less prone to phonological errors
false, more prone
stuttering as a multi-factorial dynamic disorder says that stuttering is
dynamic
stuttering events are constantly constantly changing due to what kind of factors?
-motor speech instability
increased linguistic load
-psycho-social stressors
should you look for which factors interact in stuttering and to determine how they interact?
yes
what are the 4 developmental and environmental influences on stuttering?
-physical
-cognitive
-social/emotional
-speech/language development
-Between 1-6 years of age there is a large amount of growth physically and neurologically
-Competition of motor tasks - walking and talking
-New language concepts may temporarily postpone mastery of speech motor skills
Speech motor skills may need to catc
Physical development
The development of the processes of perceiving, reasoning, imagining, and problem solving
cognitive development
T/F: people with cognitive deficits demonstrate a high incidence of stuttering
true
-Interference between the limbic system (involved in emotion) and structures and pathways used for speech
-Emotion may interfere with speech and
language
-First stuttering incident may be related to heightened emotion
-Stuttering more prevalent in emotion
social and emotional development
T/F: threats to feelings of security may create emotional stress and disrupt the speech of children who are disposed to stuttering (birth of a sibling, resentment of having to share mother's attention)
true (social and emotional development)
-Rapid growth of structures and synchronize his speech to rates and rhythms of environment (rapid growth of lexicon)
-Movement from a lexically to a grammatically based production system
-From 2-3 years of age vocabulary jumps from 50 words to over 500 wo
speech and language development
according to speech and language development, there are delays in phonology, semantics, and syntax, but not usually:
pragmatics
Demands on one level of language functioning (morphosyntax, for example) may deplete other areas (phonology, prosody) resulting in breakdown; focuses on language domains
crystal interactive view
If demands exceed capacities then performance in other areas may suffer (there will be situations that have high demands for speech and language skills and sitaitons that don't deamnd it)
Interaction between cognitive, motor, linguistic, social/emotional
stark weather's demands and capacities model
should you look at the speech rate of the child's caregivers or parents?
yes, the child may be trying to keep up with their fast rate which causes them to stutter
T/F: neural development and neural disorganizations predispose a person to stutter
true
T/F:Speech and language processing in stutterers is vulnerable to interference from competing processes
true
who deals with temrpament and laryngeal muscle tension in stressful situations?
kagan
kisbourne and gray think stuttering is ___________ based
biologically
gray's behavioral inhibition system has three forms:
-freeze
-fight
-flight
kisbourne's lateralization of emotions include inhibiting ongoing motor behavior by means of:
-arrest
-withdrawl
-avoidance
whose theory was classical conditioning?
pavlov
The negative emotion, which underlies repetitions and prolongations are due to which conditioning?
classical
skinner's operant conditioning dealt with ___________, __________, and ______________ conditioning
positive reinforcement
shaping
escape
3 importnat factors of operant conditioning
-strength of reward or punishment
-timing
-frequency of rewards (frequent to less frequent)
escape behavior is used before stuttering occurs
avoidance conditioning
-All children may have started with normal disfluencies - repetitions - but some overreacted to these -> stuttering
-Environmental factors cause stuttering - blame was placed entirely on negative reactions of parents
wendell johnson's diagnosogenic theory
diagnosogenic theory's 3 points of modified view: stuttering is an interaction between.....
1. extent of child's disfluencies
2. listeners sensitivity to the disfluency
3. child's sensitivity to his/her own disfluency
diagsosogenic theory has an impact on:
-view of stuttering
-parents tole in creating stuttering
-therapy for stuttering
-Stuttering develops from normal disfluency that becomes tense and fragmented as the child experiences frustration and failure in attempts to talk - child's belief that speech is a difficult task
-Many factors may play a role: speech/ language delay, crit
bloodstain's communicative Failure and Anticipatory Struggle theory
2 points of stuttering as a communication failure resulting from "anticipatory struggle
-A response to stimuli representative of past speech failure
-People who stutter have acquired a belief in the difficulty of speech, struggle against an imagined obstacle in the process of articulation
emphasized belief that a PWS' hesitations and repetitions indicate a conflict between a desire to approach speaking situations and an equally strong desire to avoid them
-social tool conflict- more pragmatic use of language through speech
sheehan's stuttering as approach avoidance
-Speech fluency is a multidimensional variable composed of continuity, rate, and effort
-Child's capacities for fluent speech and demands for fluent speech imposed on the child by listeners increase
-When demand outdistances capacities - stuttering occurs
stark weather's capacities and demands theory
Capacities for fluency fall into 4 categories:
1. Speech motor control (rate and coordination)
2. Language formulation
3. Social-emotional maturity
4. Cognitive skill (general intelligence and metalinguistic skill
ranks of fluency:
-normal disfluency
-borderline
-beginning
-intermediate
-advanced
Approximate age: 1.5 to 6 years old (usually 2-5 years of age)
May swing back and forth between stages
normal disfluency
core behaviors of normal disfluency
Part-word repetitions - ma ma ma mommy
Single-syllable word repetitions - she she she didn't give it to me
Multisyllabic word repetitions - daddy daddy daddy just came home
Phrase repetitions - he said he said no
Interjections - uh, aww, oh
Revisions - in
normal disfluency has no more than ____ disfluencies per 100 words
10
most common disfluencies of normal disfluency:
-interjections
-revisions
-word repetitions
range for normal disfluency:
1-2 disfliencues per 100 words- up to 25 disfluencies per 100 words
does normal disfluency have secondary behaviors or emotional attitudes?
no
Has all the characteristics of normal stuttering but more disfluencies
Between 1.5 and 6 years of age
borderlien stuttering
core behaviors of borderline stuttering
Frequency of disfluencies - MORE than 10 per 100 words
Proportion of certain types of stuttering: within words disfluencies and broken words
More sound and syllable repetitions, word repetitions, phrase repetitions, broken words, and prolonged sounds
NO d
Child is stuttering more often and is less tolerant of it
Tension increases, struggle more evident
Between 2 to 8 years of age
beginning stuttering
core behaviors of beginning stuttering
Repetitions sound rapid and irregular
Vowel may be cut off, insertion of schwa vowel
Irregular rhythm of repetitions
Increased tension - may result in rise in vocal pitch
Prolongations
Blocks begin - stopping the flow of air sometimes accompanied by visua
secondary behaviors of beginning stuttering
-escape behaviors
-nod head
-eye squint
feelings and attitudes of beginning stutterers:
-awareness
-frequently frustrated
-no strong negative feelings about self as speaker
T/F: beginning stutterers have increased muscle tension and tempo
true
-Between the ages of 6 and 13
-Starts to fear stuttering
-Reacts to stuttering by avoiding it
intermediate stuttering
core behaviors of intermediate stutterers
Blocks become the most noticeable core behavior
Stops airflow, voice, and movement
Blocks are frequently accompanied by excessive laryngeal tension but may squeeze his lips together, put his tongue tight against the hard palate
secondary behaviors of intermediate stutterers
Stutterer is frustrated and listener is surprised and uncomfortable
Escape behaviors far more frequent and more complex
Word and situation fears/avoidances
Substitutions, circumlocutions, postponements, anti-expectancy devices
feelings and attitudes of intermediate stutterers
-fear
-embarrassment
-shame
Characterized more by age than by differences in stuttering patterns
Age 14 and above
Now there is a long history of stuttering
advanced stuttering
core behaviors of advanced stutterers
Blocks - longer, more struggle, tremors of lips, tongue, or jaw
May be able to disguise blocks
Repetitions - may still be present, are tense, rapid, irregular tempo
secondary behaviors of advanced stutterers
Avoidances may be more extensive
Try to control environment
Complex patterns of avoidance and escape behaviors
feelings and attitudes of advanced stutterers
Feels that stuttering is out of control
Is very aware of listener's reactions
Emotions of fear, embarrassment, and shame are very strong.
Stutterer has negative feelings about himself
suicide rates are higher
aware of other people's reactions
T/F: in advanced stuttering, stuttering is now automatic
true
what causes people to stutter?
-influences
-constitutional
-environmental
-langiage ability
-genetic
-child's personality
-motoric ability
can stuttering be cured?
kinds, spontaneous recovery happens, and early intervention is hopeful
fluency is defined in terms of:
frequency of dislfuent/fluent moments and smoothness of speech
Stuttering is characterized by:
an abnormally high frequency or duration of stoppages in the forward flow of speech
is stuttering normal hesitations in children who are developing speech and laniuggae?
no
is stuttering brief hesitations, revisions, pauses that are heard when individuals are in a hurry or uncertain?
no
is stuttering those behaviors observed in cerebral damage or disease or disfluency resulting from psychological trauma and cluttering?
no
stuttering is the real great speech ____________
neurosis
a spastic coordination whose basic cause is an inherited tendency toward the disease (basis for the disorder)
neurosis
T/F: Stuttering is a psychoneurosis caused by the persistence into later life of early stages of oral fixation
TRUE
core behaviors of stuttering
#NAME?
T/F: repetitions are most frequent among children who are just beginning to stutter
TRUE
sound or airflow continues but movement of the articulators is stopped
prolongations
when the person inappropriately stops the flow of air or voice, and often the articulators as well
blocks
A sound, syllable or single-syllable word repeated several times
repetition (has to be repetition more than twice)
two classes of secondary behaviors
escape and avoidance
a speaker anticipates stuttering and tries to avoid it or push back its occurrence
avoidance
attempts to terminate the stutter
escape
stuttering usually begins:
from 18 months to puberty; usually between 2-5 years of age
Prevalence:
-Kindergarten: ___%
-School-age: ____%
-Adults: ____%
#NAME?
Incidence:
-up to ____% of brief periods of stuttering
-___% of stuttering lasted 6 months or more
#NAME?
sex ratio of stuttering:
3 males to 1 female
3 factors of variability and predictability of stuttering
#NAME?
given a reading passage most stutterers can fairly accurately predict which words they will stutter on
anticipation
if a stutterer reads a passage several times they will stutter on the same words
consistency
if a stutterer reads a passage several times, stuttering decreases
adaptation
adults and school age children who stutter do so more often on:
#NAME?
preschool children stutter more on:
#NAME?
conditions that decrease stuttering
speaking when...
-alone
-relaxed
-to an animal/infant
-while writing
-singing
-swearing
-slowly/prolonged manner
-under loud noises
-using DAF
conditions that increase stuttering:
#NAME?
T/F: reactions of those in the speaker's environment play an important role in stuttering
TRUE
who said stuttering is like an iceberg?
joe sheehan
10% of the real problem is __________; 90% below the waterline is ___________
#NAME?
iceberg analogy in a nutshell:
you cant just cure the stuttering of an individual, you also have to work on the emotional baggage at the same time to be fully effective and to not relapse; you must use psychology!
very cooperative client, very willing to listen and try new things
soft ice clients
a "typical" adult client, somewhat wary, but willing to listen and learn. These guys require significant effort but can be very rewarding when things work for them.
in-between ice clients
the very reluctant clients, unwilling to change because only THEY know what to do -- or think they do.
hard ice clients
these stutters don't stutter, but their emotional baggage is enormous and they need a lot of psychological help
covert stutters (heavy density)
is stuttering inherited or environmental?
both
T/F: children who recover from stuttering have had family members who have also recovered from stuttering
TRUE
T/F: children who stutter have an early onset of stuttering
TRUE
occurrence of the same clinical condition in both members of a twin pair
concordance
T/F: suttering occurs more often in monozygotic (identical) twins than in dizygotic (fraternal) twins
TRUE
T/F: individuals who stutter tend to have decreased activity in right hemisphere especially during stuttering
false, increased activity
this study shows increased right brain activity and less left hemisphere dominance for language processing, motor speech, and motor initiation
rCBF
PET studies show:
-decreased activity in Broca's and Wernicke's areas
right hemisphere over-activation studies shows:
over activity in:
-broca's area
under activity in:
-wenicke's area
T/F: are structures smaller and less dense in the brain's of people who stutter?
yes
is the right brain wired for speech?
yes
T/F: people who stutter may have a more difficult time central auditory processing
TRUE
T/F: people who stutter have NO delays in processing incoming and outgoing signals
false, they do have trouble processing
T/F: stutters have slower time staring and stopping a sound
TRUE
T/F: stutterers have a faster reaction with respiratory and articulatory movements
false, they have a slower time
T/F: stutterers demonstrate that their achievement score are slightly lower
TRUE
T/F: are other speech and language difficulties more common among children who stutter as opposed to those who do not?
yes
are stutterers more anxious than non stutterers?
no
do stutterers have an especially extensive temperament?
yes
which hemisphere is usually dominant in those who stutter?
both hemispheres are equally dominant, they mirror each other
when a stutterer is fluent, what does their speech look like?
#NAME?
disorder of cerebral localization theory says that:
Stuttering is associated with an interference by one hemisphere with the speech performance of the other; left hemisphere may not be dominant
New cerebral dominance theory says that:
Right hemisphere develops first
Signals for speech and language development arent toally drifting over to the left hemisphere- these unique cells drift over to the right hemisphere where they shouldn't be going, this leads to inefficient networks for proc
this theory is based on the premise that faulty laryngeal functioning was the cause of stuttering
Stuttering as a Disorder of Laryngeal Dynamics
with stuttering as a Disorder of Laryngeal Dynamics theory, VIT and SIT:
show relative difference between stutters and nonstutters
Stuttering as a Disorder of Timing says that:
#NAME?
how the brain stores up speech sounds and then inverts those sensory targets into motor commands necessary to produce them
Stuttering as Reduced Capacity for Internal Modeling (neilson and neilson)
refers to the increase in sensitivity within the motor system to action potentials
biasing (tuning)
why is baising/tuning important?
so we dont have to remember and store hundreds of various motor commands; it allows for rapid sequence
stuttering as a language production deficit relates to the influence of __________ factors on stuttering
linguistic
T/F: stuttering typically begins during phase of immense language growth
TRUE
neilson =
kolk and postma =
motor speech
language
problem with the planning and assembly of language units that occur before speech production relates to what theory?
stuttering as a language production deficit
Stuttering and normal disfluencies are a result of an internal monitoring process that we use to check what we are about to articulate is exactly what we want to say
covert repair hypothesis
according to the covert repair hypothesis, we're always __________, and out brain is always ___________ what we're going to say
monitoring
fact checking
T/F: stutters are less prone to phonological errors
false, more prone
stuttering as a multi-factorial dynamic disorder says that stuttering is
dynamic
stuttering events are constantly constantly changing due to what kind of factors?
#NAME?
should you look for which factors interact in stuttering and to determine how they interact?
yes
what are the 4 developmental and environmental influences on stuttering?
#NAME?
-Between 1-6 years of age there is a large amount of growth physically and neurologically
-Competition of motor tasks - walking and talking
-New language concepts may temporarily postpone mastery of speech motor skills
Speech motor skills may need to catc
Physical development
The development of the processes of perceiving, reasoning, imagining, and problem solving
cognitive development
T/F: people with cognitive deficits demonstrate a high incidence of stuttering
TRUE
#NAME?
social and emotional development
T/F: threats to feelings of security may create emotional stress and disrupt the speech of children who are disposed to stuttering (birth of a sibling, resentment of having to share mother's attention)
true (social and emotional development)
-Rapid growth of structures and synchronize his speech to rates and rhythms of environment (rapid growth of lexicon)
-Movement from a lexically to a grammatically based production system
-From 2-3 years of age vocabulary jumps from 50 words to over 500 wo
speech and language development
according to speech and language development, there are delays in phonology, semantics, and syntax, but not usually:
pragmatics
Demands on one level of language functioning (morphosyntax, for example) may deplete other areas (phonology, prosody) resulting in breakdown; focuses on language domains
crystal interactive view
If demands exceed capacities then performance in other areas may suffer (there will be situations that have high demands for speech and language skills and sitaitons that don't deamnd it)
Interaction between cognitive, motor, linguistic, social/emotional
stark weather's demands and capacities model
should you look at the speech rate of the child's caregivers or parents?
yes, the child may be trying to keep up with their fast rate which causes them to stutter
T/F: neural development and neural disorganizations predispose a person to stutter
TRUE
T/F:Speech and language processing in stutterers is vulnerable to interference from competing processes
TRUE
who deals with temrpament and laryngeal muscle tension in stressful situations?
kagan
kisbourne and gray think stuttering is ___________ based
biologically
gray's behavioral inhibition system has three forms:
#NAME?
kisbourne's lateralization of emotions include inhibiting ongoing motor behavior by means of:
#NAME?
whose theory was classical conditioning?
pavlov
The negative emotion, which underlies repetitions and prolongations are due to which conditioning?
classical
skinner's operant conditioning dealt with ___________, __________, and ______________ conditioning
positive reinforcement
shaping
escape
3 importnat factors of operant conditioning
#NAME?
escape behavior is used before stuttering occurs
avoidance conditioning
-All children may have started with normal disfluencies - repetitions - but some overreacted to these -> stuttering
-Environmental factors cause stuttering - blame was placed entirely on negative reactions of parents
wendell johnson's diagnosogenic theory
diagnosogenic theory's 3 points of modified view: stuttering is an interaction between.....
1. extent of child's disfluencies
2. listeners sensitivity to the disfluency
3. child's sensitivity to his/her own disfluency
diagsosogenic theory has an impact on:
#NAME?
-Stuttering develops from normal disfluency that becomes tense and fragmented as the child experiences frustration and failure in attempts to talk - child's belief that speech is a difficult task
-Many factors may play a role: speech/ language delay, crit
bloodstain's communicative Failure and Anticipatory Struggle theory
2 points of stuttering as a communication failure resulting from "anticipatory struggle
#NAME?
emphasized belief that a PWS' hesitations and repetitions indicate a conflict between a desire to approach speaking situations and an equally strong desire to avoid them
-social tool conflict- more pragmatic use of language through speech
sheehan's stuttering as approach avoidance
-Speech fluency is a multidimensional variable composed of continuity, rate, and effort
-Child's capacities for fluent speech and demands for fluent speech imposed on the child by listeners increase
-When demand outdistances capacities - stuttering occurs
stark weather's capacities and demands theory
Capacities for fluency fall into 4 categories:
1. Speech motor control (rate and coordination)
2. Language formulation
3. Social-emotional maturity
4. Cognitive skill (general intelligence and metalinguistic skill
ranks of fluency:
#NAME?
Approximate age: 1.5 to 6 years old (usually 2-5 years of age)
May swing back and forth between stages
normal disfluency
core behaviors of normal disfluency
Part-word repetitions - ma ma ma mommy
Single-syllable word repetitions - she she she didn't give it to me
Multisyllabic word repetitions - daddy daddy daddy just came home
Phrase repetitions - he said he said no
Interjections - uh, aww, oh
Revisions - in
normal disfluency has no more than ____ disfluencies per 100 words
10
most common disfluencies of normal disfluency:
#NAME?
range for normal disfluency:
1-2 disfliencues per 100 words- up to 25 disfluencies per 100 words
does normal disfluency have secondary behaviors or emotional attitudes?
no
Has all the characteristics of normal stuttering but more disfluencies
Between 1.5 and 6 years of age
borderlien stuttering
core behaviors of borderline stuttering
Frequency of disfluencies - MORE than 10 per 100 words
Proportion of certain types of stuttering: within words disfluencies and broken words
More sound and syllable repetitions, word repetitions, phrase repetitions, broken words, and prolonged sounds
NO d
Child is stuttering more often and is less tolerant of it
Tension increases, struggle more evident
Between 2 to 8 years of age
beginning stuttering
core behaviors of beginning stuttering
Repetitions sound rapid and irregular
Vowel may be cut off, insertion of schwa vowel
Irregular rhythm of repetitions
Increased tension - may result in rise in vocal pitch
Prolongations
Blocks begin - stopping the flow of air sometimes accompanied by visua
secondary behaviors of beginning stuttering
#NAME?
feelings and attitudes of beginning stutterers:
#NAME?
T/F: beginning stutterers have increased muscle tension and tempo
TRUE
-Between the ages of 6 and 13
-Starts to fear stuttering
-Reacts to stuttering by avoiding it
intermediate stuttering
core behaviors of intermediate stutterers
Blocks become the most noticeable core behavior
Stops airflow, voice, and movement
Blocks are frequently accompanied by excessive laryngeal tension but may squeeze his lips together, put his tongue tight against the hard palate
secondary behaviors of intermediate stutterers
Stutterer is frustrated and listener is surprised and uncomfortable
Escape behaviors far more frequent and more complex
Word and situation fears/avoidances
Substitutions, circumlocutions, postponements, anti-expectancy devices
feelings and attitudes of intermediate stutterers
#NAME?
Characterized more by age than by differences in stuttering patterns
Age 14 and above
Now there is a long history of stuttering
advanced stuttering
core behaviors of advanced stutterers
Blocks - longer, more struggle, tremors of lips, tongue, or jaw
May be able to disguise blocks
Repetitions - may still be present, are tense, rapid, irregular tempo
secondary behaviors of advanced stutterers
Avoidances may be more extensive
Try to control environment
Complex patterns of avoidance and escape behaviors
feelings and attitudes of advanced stutterers
Feels that stuttering is out of control
Is very aware of listener's reactions
Emotions of fear, embarrassment, and shame are very strong.
Stutterer has negative feelings about himself
suicide rates are higher
aware of other people's reactions
T/F: in advanced stuttering, stuttering is now automatic
TRUE