Basic Principles And Theoretical Foundations Of Stuttering

Question 0

From the ABC theory of stuttering, define the Affective components.

Answer 0

Stuttering is a complex, intricate disorder involving cognitive processes associated with emotions elicited by communication failures. Situational anxiety is a result of stuttering.

Includes: emotions, self-concepts, grief, temperament

Question 1

Who is associated with the Affective, Behavioral, & Cognitive Components of stuttering?

Answer 1

Bennett

Question 2

Define emotion.

Answer 2

The affect aspect of consciousness, a state of feeling.

Variable based on present environmental stimuli, variable, not always conscious, an immediate evaluation of the likelihood of survival

Question 3

What is the process of emotional development?

Answer 3

Primary emotions, exposed emotions, and evaluative emotions

Question 4

Define primary emotions.

Answer 4

Develop early in childhood.

Happiness, sadness, anger, fear

Question 5

Define exposed emotions.

Answer 5

Develop along with self awareness

Embarrassment, empathy, envy

Question 6

Define evaluative emotions.

Answer 6

Develops with the acceptance of societal rules and standards

Pride, embarrassment, shame, guilt

Question 7

At what age are most of emotions in place?

Answer 7

3 years old

Question 8

What are core emotions?

Answer 8

Emotions that are experienced repeatedly and are often difficult to acknowledge.

Question 9

What may suppressed emotions lead to?

Answer 9

negative self-esteem.

Question 10

Describe the cycle of stuttering and emotions.

Answer 10

Stuttering leads to negative emotions which leads to stuttering, which leads to more intense emotions, leading to stuttering which leads to more negative emotions…

Question 11

What are two negative self-attributes that often develop with stuttering?

Answer 11

Interpersonal and interpersonal.

They often lead to more severe stuttering patterns, increased secondary behaviors, and social consequences.

Question 12

What does a healthy, balanced emotional life require?

Answer 12

Experience a feeling, recognize, accept, and express it, and then let it go.

Question 13

What are the three emotions of stuttering?

Answer 13

Anger, guilt, and shame

Question 14

Define anger.

Answer 14

A strong feeling of displeasure, considered an emotion of choice, an emotion that may block the awareness of other painful emotions.

Question 15

What are the side effects of anger?

Answer 15

Belief system becomes inflexible, feelings of helplessness, shifts responsibilities onto someone else

Question 16

How to reduce anger:

Answer 16

Not victims of own emotions, creative problem solvers, adequate view of selves and others, and develop our emotional self reliance

Question 17

Name 6 sources of guilt.

Answer 17

1. Primary guilt (precedes and leads to stuttering- it is wrong)
2. Secondary guilt (feeling of failure after stuttering- easy to fix, just slow down)
3. Audience punishment guilt (feeling that stuttering is offensive or adversities to the listener)
4. Therapy induced guilt (perception that therapy isn’t useful- not doing enough)
5. Clinician induced guilt (therapist uses acceptance of stuttering- you’re a stutterer and need to accept it)
6. Timing guilt (client asked to do something they are not ready for)

Question 18

What are the three types of guilt SLPs need to watch for in the therapy room?

Answer 18

Therapy induced, clinician induced, and timing guilt

Question 19

What can be done to help a client with his or her guilt?

Answer 19

Explore source of guilt, maintain self-esteem, learn from guilt, accept responsibility

Question 20

Define shame.

Answer 20

Evaluation of oneself, rather than one’s actions
Characterized by external (avoiding eye contact, blushing, inability to speak, shrinking into body) and internal components (wishing to vanish, shrink, and/ or disappear)

Question 21

What are two types of shame and define?

Answer 21

Healthy shame- helps maintain people’s adherence to social standards
Unhealthy shame- negative eval leading to neg self concept

Question 22

What are the four categories of shame?

Answer 22

1. Existential shame- individual suddenly sees himself as others do
2. Class shame- comes from being different
3. Narcissistic shame- pathological, pervasive negative self concept
4. Situational shame- arises from some experience having a temporary effect

Question 23

How is shame related to stuttering/ possibly caused by stuttering?

Answer 23

Family openness to discussion
Unresolved shame and a shame spiral
Resistive client who doesn’t want to relive moments of shame

Question 24

Define self-concept and how is it related to stuttering?

Answer 24

One's perception of oneself, based on info from significant others and from personal experiences. Negative emotions and experiences lead to negative self-evaluations. Impacts interpretation of his ability to be an effective communicator.

Question 25

What are the six stages of grief?

Answer 25

Denial, anger, bargaining, depression, and acceptance

Question 26

Describe temperament and stuttering.

Answer 26

Some people who stutter have a reactive temperament- react more to uncomfortable or unfamiliar events, higher degree of sensitivity to changes in routines, perfectionism, may show more resistance to treatment in therapy

Question 27

What are the components of temperament?

Answer 27

Activity(physical) Rhythmicity (adherence to daily routine or schedule) Approach (response in new situations) Adaptability Intensity (amount of energy put into responding to the environment- loud v. quiet, quick to fatigue) Mood (consistent pattern of mood- pleasant v. irritable) Persistence and attention (ability to sustain focus and complete tasks) Distractibility Threshold (sensory reaction to texture, odor, light, etc)

Question 28

What are the behavioral components of stuttering?

Answer 28

Respiration, phonation, articulation, and feedback

Question 29

What are the linguistic components of stuttering?

Answer 29

Phonetic, lexical, syntactic, pragmatic

Question 30

What are the linguistic components that increase a person's likelihood to stutter?

Answer 30

Phonetic- long >short words, initial position, stressed syllable of a multisyllabic word, and on less frequently occurring initial phonemes Lexical features- less frequent words, open category words > closed category words (ever growing v. relatively fixed number) Syntactic features- increased MLU and complexity Pragmatic features- high number of people, high demand speech act, higher social stature of person, pressure/ emotional dynamics, convos in which cultural differences are present, in requests v. responses

Question 31

Define the cognition of stuttering.

Answer 31

The act or process of knowing including awareness and judgement. Perceptions- listener and self Attitudes toward communication- negative self talk, cognitive distortions, and maladaptive responses

Question 32

What are common listener perceptions of someone who stutters?

Answer 32

Anxious, insecure, afraid, less well adjusted

Question 33

What did the physiological theories of stuttering believe?

Answer 33

Stuttering came from a physical defect- tongue too slow to keep up with thoughts/ too thick/ too short/ too swollen/ too dry

Question 34

What type of treatment was done In alignment with the physiological theories?

Answer 34

Tongues heated and surgeries performed, adenoidectomy and tonsilectomies

Question 35

Describe the psychological theories of stuttering.

Answer 35

Stem from a weakness in psyche or resulted from: phobia reaction to articulation, lack of confidence in communication, belief that speech production is difficult, conflict in psychosocial development, latent hostility and guilt from talking to others

Question 36

Describe the organic theories.

Answer 36

20-30s: suggested biochemical imbalance, interaction of predisposing factors and environment, higher incidence in families, cerebral differences Cerebral dominance

Question 37

What is the Cerebral Dominance theory?

Answer 37

An organic theory by Travis. Based on frequency of people who stutter that were naturally left handed and forced to become right handed One hemisphere dominant over the other to control the timing of speech movements Some studies show pws hacks right brain activation for speech Breakdown in synchronization of brain hemispheres leading to conflicts in speech control between hemispheres

Question 38

Who is associated with the Diagnosogenic theory?

Answer 38

Wendell Johnson

Question 39

Describe the Diagnosogenic theory.

Answer 39

Semantic theory- reaction to the meaning of stuttering. Stuttering develops when parents misdiagnose normal disfluencies as stuttering- places blame on parents by suggesting children become self- conscious and try to speak without disfluencies Stuttering caused by environmental factors Speaker expects stutter to occur, dreads it, and becomes tense anticipating and trying to avoid it Led to belief it shouldn't be talked about Pediatricians still say "ignore it, it'll go away"-- conspiracy of silence

Question 40

What are the clinical treatment implications of the Diagnosogenic theory?

Answer 40

Parents need to be counseled about develop,entail disfluencies, stuttering, and how to set up a home environment that best suits the CWS

Question 41

Who is associated with the Approach-avoidance theory?

Answer 41

Sheehan

Question 42

Describe the Approach-Avoidance Conflict theory.

Answer 42

Semantic theory- people want to talk, but want to be silent When both desires are equal stuttering occurs; avoidance is greater than approach withdraw from conversation Conflict continues, stuttering persists and secondary behaviors grow

Question 43

Describe Sheehan's iceberg.

Answer 43

Demonstrates that much of what happens with stuttering occurs below the surface or is unknown to the observer. Only see the behaviors associated with stuttering, but not the emotions.

Question 44

Describe the Anticipatory Struggle Hypothesis.

Answer 44

developmental semantic theory, stuttering emerges from child's frustration and failures when trying to talk Child struggles to be understood or is penalized for the way he talks, it leads to tension and later anticipation and of having to speak Leads to fragmented speech Children thought to have traits of perfectionism or sensitivities

Question 45

What are important clinical implications Bloodstein's Anticipatory- Struggle Hypothesis?

Answer 45

Parent and child counseling and environmental adaptations are important

Question 46

What is the Genetic Basis theory?

Answer 46

Presence of stuttering is familial, but not severity. 33-50% of PWS report having a family member who stutters Greater correlation is drawn from combining genetics with certain environmental factors

Question 47

Define the Covert Repair Hypothesis.

Answer 47

A psycholinguistic theory, deficit in phonological encoding of an utterance, explains repetitions, prolongation a, and blocks. PWS detect superfluous errors and take time attempting to correct errors that do not exist.

Question 48

Who is associated with the Covert Repair Hypothesis?

Answer 48

Postma and Kolk

Question 49

Who is associated with the Demands and Capacities Model?

Answer 49

Starkweather

Question 50

Describe the Demands and Capacities Model.

Answer 50

Disfluencies and stuttering emerge when the capacities of the child for fluency aren't equal to the demands of the environment for speech performance

Question 51

What are the treatment implications of the Capacities and Demands Theory?

Answer 51

The child's environmental demands related to his or her capacities need to be assessed. Treatment would focus on increasing capacities for fluent speech and decreasing demands until CWS catches up.

Question 52

What are two types of environmental demands?

Answer 52

Internal- increasingly complex thoughts | External- parents interrupting or using big words, rushed household

Question 53

What are the child's capacities?

Answer 53

Qualities that make the child develop more fluent speech. | Develop in spurts, environment tends to advance- when environment doesn't, could be when stuttering tends to decrease.

Question 54

What are the four areas of behavior?

Answer 54

Motor, linguistic, socio-emotional, and cognitive

Question 55

Describe motor demands and capacities.

Answer 55

Demand- faster speech movements made, greater muscle activity. Trade off between speed and precision. Capacity- ability to move the vocal tract rapidly and smoothly, especially in regards to timing

Question 56

Describe linguistic demands and capacities.

Answer 56

Demands- can occur in all areas of language Capacities- word finding, formulation of sentences, socially appropriate interactions, generation of phonologically appropriate syllables

Question 57

Describe socio-emotional demands and capacities.

Answer 57

Demands- emotions like excitement and anxiety lead to increased levels of muscle activity Capacities- ability to move slowly and smoothly when excited, anxious or angry. In children, the ease of separation and level of shyness

Question 58

Describe cognitive demands and capacities.

Answer 58

Demands- more complex thoughts may detract from motor performance Capacities- knowledge that some things happen better when you don't try so hard. Perceptions, beliefs, and attitudes toward stuttering, speech, and socialization are of vital importance

Question 59

Describe the Multidimensional Models of Stuttering.

Answer 59

Stuttering is composed of complex timing and spatial relations. Variability of emotional, perceptual, and/or physiological events.

Question 60

Who is associated with the Dynamic Multifactorial Model?

Answer 60

Smith and Kelly

Question 61

Describe the Dynamic Multifactorial Model.

Answer 61

Multiple factors impact fluency by directly or indirectly affecting the speech motor processes.

Question 62

Who is associated with the Synergistic Approach?

Answer 62

Bloom and Cooperman

Question 63

What are the three components of the Synergistic Approach?

Answer 63

Speech-language, attitudes and feelings, and environment

Question 64

What are the three components of the Speech-Language aspect of the Synergistic Approach?

Answer 64

Physiological, attitudes and feelings, and learned

Question 65

What are the three components of the Attitudes and Feelings domain of the Synergistic Approach?

Answer 65

Self-Esteem, locus of control, and assertiveness.

Question 66

What are the three components of the Environmental domain of the Synergistic Approach?

Answer 66

Communication, family, and cultural

Question 67

Describe the physiological subcomponent of the Synergistic Approach.

Answer 67

They're the physical factors. Genetics, central nervous system (reduced ability to generate temporal patterns), peripheral nervous system (respiration, phonation, and articulation)

Question 68

Describe the psycholinguistic subcomponent of the Synergistic Approach.

Answer 68

Language factors. Syntactic-semantic structures can affect fluency, linguistic complexity, pragmatic complexity, individual differences in stuttering patterns, interacts with physiological factors

Question 69

Describe the learned factors subcomponent of the Synergistic Approach.

Answer 69

Multidimensional and synergistically learned elements

Question 70

Describe the Self-esteem subcomponent of the Synergistic Approach.

Answer 70

How much we like and approve of our self-concept.

Question 71

Describe the Locus of Control subcomponent of the Synergistic Approach.

Answer 71

Internal- events are within our control External- events controlled by resultant factors other than ourselves Demonstrated in children (loving family, independence), adolescents (greater peer contact), and adults (positive and active role in healthy behaviors)

Question 72

Describe the assertiveness subcomponent of the Synergistic Approach.

Answer 72

Assertive- ability to stand up for oneself Nonassertive (passive)- behavior that allow ones's own rights to be violated by others Aggressive- standing up for oneself, but violating another's rights in the process

Question 73

Describe the Communication subcomponent of the Synergistic Approach.

Answer 73

Teaching our clients to be effective communicators: attending, exploration, listening and empathetic responses, summarizing, encouraging the use of 'I' statements

Question 74

Describe the Family subcomponent of the Synergistic Approach.

Answer 74

Understanding and improving the interactive communication patterns and communicative skills of the family Used of counseling, family therapy, and understanding the dynamics and interactions of the family

Question 75

Describe the Cultural subcomponent of the Synergistic Approach.

Answer 75

Understanding and respecting the cultural diversity toward communication, learning, and values of our clients. Clinicians must understand and respect the ethnicity of their clients, cultural influences of their clients