Typical disfluencies

Phrase repetitions
Multisyllabic word repetitions
Phrase revisions
Non grammatical interjections (ummm)

Atypical disfluencies

More commonly seen in individuals who stutter:
Sound, syllable, word repetitions
Prolongations
Block

Core stuttering behaviors

Atypical difficulties are called what in people who stutter?

Secondary behaviors

Attempts to control the core stuttering mvmts
Can either be escape or avoidance behaviors

Escape behaviors

Eye blinks
Head nods
Motor adjustment made to "get out" of the moment of stuttering

Avoidance behaviors

When an individual fears that they will stutter on a sound or word, they may choose to substitute a different sound or word (learned behavior)

Common feelings that individuals who stutter report include...

Shame, guilt, embarrassment ( in reaction to their stuttering)

Negative attitudes and beliefs

What two things are formed over time and is more evident in older children and adults

Different types of stuttering

Development stuttering
Neurogenic stuttering
Cluttering
Psychogenic stuttering

development stuttering

Most common type of stuttering
Emerges between 2 and 5 years
80% spontaneous recovery rate
Prolongations, repetitions, blocks, and secondary behaviors are present

Neurogenic stuttering

Acquired (seen most commonly in adults with brain injuries or neurologic diseases)
Few or no secondary behaviors

Cluttering

Low-incidence
Abnormally rapid and irregular rate of speech
Reduced self-awareness

Psychogenic stuttering

Emerges after a prolonged period of stress or emotional trauma

Direct treatment

Skills in teaching the child how to respond to disfluencies, developing the ability to demonstrate fluency skills and/or using operant methods or other feedback to reinforce fluent productions
-Parent focused
-Model natural, relaxed speech
-Provide adequa

School-age children who stutter (intermediate stuttering)

By the time children who stutter are enrolled in elementary school, they are blocking, repetitions, and prolongations and also experiencing some of the negative attitudes and feelings

Treatment for school-aged children

Treatment focused on developing fluent speech, modifying stuttering and equipping the child for success in a variety of social and academic situations

Approaches to tension reduction

*Learning to describe what is happening during stuttering
*Relaxing speech muscles and differentiating degrees of muscular effort/tension

Speech modification approaches

Cancellation and voluntary stuttering

Cancellation of stuttering

involves repeating a stuttered word in a more fluent way

Voluntary stuttering

Involves practicing one's stuttering as a method to decrease fear

Fluency shaping

Goal is to replace stuttered speech with fluent speech
-Rate modification (especially at the initiation of speech)
-Easy onset of phonation as a method of reducing hard glottal
-Light contact of articulators
-Continuous phonation

Adolescents and adults who stutter (advanced stuttering)

The same approaches as in intermediate stuttering are available for older clients
-Clients typically have previous therapy/treatment experiences
-Building a trusting relationship is very important

Intermediate vs. advanced stuttering treatment

The major difference is the necessity to approach the more mature individual as an adult, allowing for open discussion and reflection and developing an expectation for independent use of treatment skills outside of therapy