Theories of Stuttering:
...
Disorganized brain models:
left hemisphere activated for speech
PWS analogous areas of the right are activated
PWS have too much activation in the right hemisphere
--draws sources away from left leads to speech break down
-person doesn't have to be disordered- just lack of resources to complete more difficult taskspresent in some people who stutter
...
Disordered Timing Model:
many __________ have to occur at the same time to produce speech
if movement is delayed signal can't be completely organized as it is produced
any ___________ of a single component can cause a breakdown in fluent production of spe
factors/ delay
right frontal lobe damage --can't inhibit thoughts
code that comes into play fro language say things our parents say (those around us)
...
Reduced Capacity Model: hypothesized that speech requires ...
PWS do well with constant vigilance
distracted when situations increase in difficulty
this lack of resources under stress- can result in stuttering
constant movement and activation of neural resources
Language Production Models:
for language to move forward pieces must be lined up in correct order and with correct timing
when an error is sensed internally, the person is still trying to go forward, but internally is trying to correct the error
(internal correction results in stuttering)
Physiological Tremors:
of the speech mechanism shown by some researchers, not true for all
...
Past Theories:
Cerebral Dominance
Unspeakable Feelings About Stuttering
Diagnostic Theory of Wendell Johnson
Operant Conditioning
Past Theories:
Cerebral dominance Theory:
brains of PWS w/o asymmetry necessary producing speech in the bilateral representation for speech one hemisphere interfere with speech performance of the other
...
Travis "Unspeakable Feelings About Stuttering" reaction to deep psychological illness- Freudian- psycho-sexual struggle
...
emotions do have an impact on stuttering
...
Diagnostic Theory of Wendell Johnson:
child will have 'normal' disfluencies these are labeled
child is considered to be a stutter- child tries not to stutter
struggle causes the stutter
...
Operant conditioning: people learn to stutter
Stuttering is a behavior; therefore can be changed O.C. models of Goldiamond and Azrih
...
Stuttering Severity Index 4th Edition: (mainly overt behavior)
4 areas of speech behavior:
frequency
duration
physical concomitants
naturalness of individual's speech
Duration: how long?
based on clinic and beyond __________ __________
Computerized Scoring of Stuttering
software- calculations frequency and duration
speaking sample
Naturalness of individual's speech based on_______________________________________________________ 1(natural)-9(unnatural)
degree speakers of the same age, gender, dialect, scale
Physical Concomitants:
video/ live observations
secondary behaviors example: ____________________________
0-5
distracting sounds, facial grimaces, head movements
SSI ____-_____ syllables
2 different enviornments one being _______________
3rd grade reading level; _________ and ___________
nonreading 2 communication samples
150-500
clinic
reading/ communication
OASES:
-General Info about stuttering
-Speaker's Affective Behavioral Cognitive Reaction
-Communication in _________ _________
-Impact of Stuttering on ______________________
student:
Ages: ____________________
daily situations
Quality of Life
7-12
13-17
18+
Reader vs. Nonreaders
gather a __________ ______________
Why read? conversational speech vs. speech reading
sample of conversation
video record natural conversation
Adults have to chose between having _______________ or ______________.
Communication sample
natural or have disfluencies
adults choice
What is the purpose of the OASES?
Purpose overall impact of stuttering in a person's life. Mild (more comfortable) to Severe (avoid communication)
--Gives us goals based on how person feels-- avoidance step by step
Types of Fluency Disorders: 5
Neurogenic
Psychogenic
Cluttering
Malingering
and lang. disorders that mimic stuttering but are really disfluencies
Neurogenic stuttering:
lang.--____________, _____________
motor-- ____________
...Aphasia, Dysarthria
Tourette's Syndrome
Psychogenic Stuttering:
severe traumatic event; may develop later in life
Cluttering:
lots of nonfluencies, non-stuttering in nature
malingering:
faking it
Based on what we have learned so far what we want to know about CWS and PWS:
Do they stutter?
How do we determine this?
Will they recover?
How will you determine this?
...
Kids who stutter: _________ __________
other speech, lang., learning, and other disorders
genetic link
Logan talks about other things to ask about:
______________, _____________, academic functioning
limitations
personal factors
__________ ___________ ___________ _____________
____________________________________
social life, work, environmental factors
participation restriction
impairment disabilities
Terminology IFC: ____________________________________________________
: provides excellent starting point to guide assessment.
WHO International Classification of Functioning, Disability and Health
1st thing: impairment is the _____________________ or _______________condition (what is different about the body)
disability performance of individual how act in environment
activity limitation/ participation restriction: known as disability
anatomical or physiological
Term disability covers what a person __________________________________________________________.
can/ does not do something.
Functioning how person performs on ADL based on anatomical and psychological differences
...
Describe person's fluency functioning across: 4
_________________________________________
Based on what a person can and can't do.
Stuttering varies across settings
settings
conditions
tasks
listeners etc.
Goal 1-4:
1 Describe how the person currently functions
Fluency and other com dis
2 Describe clients current areas of disability
in and out of clinic
3 How context affects performance
Max performance testing
Stim Test
4 Interpret Data; make recommendation
...
Impairment:
-can't speak stutter free in large groups functioning- with control can answer telephones with minimal stuttering
physiological can't produce speech fluent speech
Assess: Functionality (verbal speaking tasks)
high/ low levels of performance
levels of disability outside of therapy tasks (as natural as possible)
context
environment
...
Goal:
describe how the person currently functions
A. Fluency
B. other commun. domains
...
Goal 2: describe clients current areas of disability
How they function in and out of clinical setting
...
3 Determine how context affects performance
...
4 interpret data to make recommendation
If they begin therapy what kind
Specific therapy goals
...
Getting a representative sample for kids
convo with _______________
______________ measures
various levels of complexity beyond clinic
at home
parents
standardized
In clinic Adults:
oral reading conversation with clinician
monologues with clinicians/ alone
The Rainbow Passage and The Grandfather Passage: _____________________, ____________________________
standardized, phonetically balanced
Types of data collection: clinician-designed tasks
published standardized and norm-referenced material
...
Interviews: Checklists/ Structured
Ethnographic/ Semi-structured
...
What are the conditions or settings that we could assess a person suspected of stuttering?
...
Remember the purpose of an assessment is to getas complete of a picture as possible of the person's skills, performance and attitudes about communication.
This requires careful consideration of significant pieces of data.
...
� Key to Abbreviations Used with the Profile
� %SS = percentage of "stuttering-like" disfluencies
� %nonfl = percentage of all types of nonfluencies
� %P-A = percentage of postponement and avoidance behaviors
� type = type of disfluencies exhibited (a des
...
� Things to see in this assessment
� Length
� Complexity
� Condition
� Rate
� Fluency Induction
� Self-report
� QOL
� Anxiety
� Self-concept
...
� Types of data collection
� Clinician-designed tasks
� Published standardized and norm-referenced materials
� Interviews
� Checklists/Structured
� Ethnographic/Semi-structured
� Speech samples
...