exam 1 Flashcards
(35 cards)
What are “normal disfluencies” and how do they differ from Stuttering-Like Disfluencies (SLDs)?
SLD include part word repetition, prolongations and blocks with fragmentation (middle of the word)
Normal disfluencies are stuttering on the first sound of a word a phrase or a breath. →repetition
With very young children, why might it be important to ask the parents to bring a recording of the child’s speech in the home environment to the evaluation?
The child may fail to exhibit the behaviors that concern parents on the day of the evaluation.
to make preliminary analysis of the child’s speech.
What do you do if a child you are evaluating is producing no disfluencies?
introduce stressors to make them loose control and be more natural to start displaying disfluencies. E.g. time pressured tasks → rapid naming
red flags for chronic stuttering
Male
Stable or increasing no of SLD within a year
Increasing severity ratings by SLP/parents
Stable or increasing occurrence of secondary behavior
Few repetitions
Rapid rates of repetitions
Strong reaction to stuttering by child/parents
Concomitant learning or communication problems
Late onset of stuttering (3-4 years and delays in phonological development)
questions to ask in order to know if recovery is unlikely to occur?
how long? family history of stuttering/recovery?
follow-up questions you might ask for chronic stuttering
Follow up questions could be forms on speech fragmentation
What kinds of documentation should the SLP present in an IEP meeting?
- Document that the child meets the state and local eligibility criteria
- SLP should go well beyond a detailed documentation of the child’s overt stuttering behavior (frequency and form)
- Occurrence of coping behaviors (impact on social interaction & restricted participation
What do we know about most adult PWS?
The vast majority does not seek treatment, but rather make through life by coping with the problem in more or less effective ways.
These people are not part of the research sample There are some techniques that have been effective
What impact does the variability of stuttering have on adult evaluations?
result in assessments that are unrepresentative providing only a glimpse of the depth and breadth of the problem.
How is the client’s desire for change important?
It is the key feature for successful treatment; it provides the indication of the progress we can expect once treatment is initiated.
“two principles of assessment” for adult PWS described by Manning.
- What a client does because of stuttering? The more an individual who stutters alters his choices and narrow the options available in life the greater the influence handicapping effects of stuttering likely to be.
- What a client does when stuttering? the more a speaker reacts to his stuttering by trying to prevent it from occurring the greater the impact of the problem.
Why is “loss of control” an important issue to discuss in an adult fluency evaluation
Clinician will stutter along with patient
identifying the speaker’s loss of control
pt will consider that it is possible to stutter and not be helpless
Severity= distressuncontrollabilityfrequency
How are scales such as the LCB Scale, the S-24 Scale, and the PSI are useful?
Communication attitude and perspective (counseling), severity of stuttering to the client
Severity= distressuncontrollabilityfrequency
How might a client’s coping strategies impact your assessment of that client’s stuttering problem?
It will give a false picture of the stuttering problem
How might obtaining a fluency count during an evaluation for an adult PWS be misleading?
They could be using coping strategies, leading the clinician to believe that there are actually less disfluencies
How would an evaluation with an adult PWS differ from an evaluation with a young child who is suspected of stuttering?
Counting disfluencies work for children but not for adults
Children haven’t developed the stutterer self image,
Why is it important for clinicians to be able to answer the question “What causes stuttering?”
It is the way the clinician can demonstrate his competence in understanding concerning the problem, setting the stage for the client’s interpretation of him/her.
treatment choices
What is the current thinking with regard to the cause of stuttering?
It is a multidimensional problem that has repeatedly and successfully defied unidimensional solutions. To suggest that we know the absolute cause of stuttering is intellectually, ethically and professionally dishonest.
Know the contributions of some of the people who historically treated stuttering
- Wendell Johnson: The Diagnosogenic Theory
- Oliver Bloodstein: Communicate failure and anticipatory struggle theory C FAST
- Mary Tudor: told kids at an orphanage that they were stutterers and told the caregivers that they should treat them differently and some began to stutterer
- Gottwalk, Starkweather: The Demands and Capacities Model
- Brutten and Shoemaker : The Two-Factor Theory
What is the repressed need hypothesis?
It is a neurosis and PWS do so as a result of a repressed, neurotic, unconscious conflict (undressed psychological problem). Stuttering is seen as a symptom that is symbolic.
What do we know about the parents of children who stutter?
• They do not have attribute that could have negative effects on CWS
• May have some higher level of anxiety than normal
• Are perceived as less accepting by their children
• Set lower goals for CWS than for non-stuttering
• Parents attitudes are not causally related to stuttering for counseling purposes
Less possessive and less to likely exert hostile control
Diagnosogenic Theory of Stuttering
Wendell Johnson
Stuttering evolves from normal fluency breaks to which the parents overact to and mislabel as stuttering. Stuttering is created by the listener→ You cannot create stutterers,
Calling someone a stutter makes him or her a stutterer
the Two-Factor Theory
People’s bad reaction to normal disfluencies created bad stuttering via classical conditionning
the Covert Repair Hypothesis
(Kolk & Postma)
Cybernetic→auditory and tactile feedback helps people adjust their speech, and it doesn’t apply to pws because they are slower. Partly true because it doesn’t explain why stuttering is variable
