Fluency Flashcards
(17 cards)
Types of Dysfluencies
- Interjections
- Revision
- Phrase Rep
- Multisyllabic whole word rep
- Monosyllabic whole word rep
- Broken word
- Sound prolongation
- Sound/syllable repetition
- Dysrhythmic phonation
- Abandoned utterance can result in Circumlocution
- Schwa insertion
- Tense pause/block
Accessory/Secondary Behaviors
- Between word phenomenon
- Normal dysfluencies
- word reps
- phrase reps
- interjections
- revisions
Cognitive & Affective Aspects of Stuttering
- Avoidance behaviors
- Almost always can feel it coming
- Ask “how does your stutter make you feel?”
Assessment of Fluency
- Dynamic
- S&L Sample
- Record of where, when & who they stutter around
- What sounds, words, situations they avoid?
- SSI - can’t be standardized
- Count words then dysfluencies
- More than 5% dysfluent?
Stuttering Modification Basics
Van Riper
Focuses on more FLUENT stuttering than increased fluency.
Stuttering Modification Techniques
- Fake/Voluntary Stuttering
- Cancellation
- Pull-Out
- Bounce (for block or prolongation)
- Preparatory Step
Stuttering Modification Characteristics
- Emotional
- Reduce tension & fear surrounding stuttering
- Doesn’t care about % fluent
- Wants client to know they have control over stutter
- Promotes relaxation
- Voluntary Stutter
- Focus on affective cognitive features of stuttering
Fluency Shaping Techniques
- Easy Onset - vowels
- Soft Contact - consonants
- Continuous Phonation
- Short Phrases
- Slow Rate!
Fluency Shaping Characteristics
Physical motor patterns that can be changed Reduce stuttering Cares about % fluent Motor, muscle, memory Intense therapy live in program Use physical techniques Counting, measuring, stopping, stuttering, Uses concrete (computer feedback) Easier to collect data
Stuttering Modification & Fluency Shaping both…
Both focus on client becoming independent, self-monitoring & self-correcting.
Fluency Facts
- Uncommon to see it begin after 12 yrs old
- More common in males
- 5% of kids before the age of 5 stutter, but only 1% will continue to stutter
- Cyclical - stutter for life
- Not cured, but we provide tools to use.
- No evidence for cause
- 3x more likely if family hx
Concomitant Features
Any physical feature that appears when dysfluency is present.
Ex: nose flaring, stomping, blinking, twitching
Delayed Auditory Feedback
Playing someone’s own speech back to them with a second delay reduces most dysfluencies.
Temporary & used for client buy-in.
Cluttering
Rapid but disoriented articulation, possibly combined with high rate of dysfluencies, disorganized lang. & thoughts.
- Reduced awareness
- Often misdiagnosed
- Treated in same way as stutterer.
- Doesn’t vary with environment
- Not sure what they want to say
- Slowed rate helps a lot.
Neurogenic Stuttering
SAND (Stuttering assoc. with Acquired Neurological Disorders
Early childhood onset but associated with neurological disorders (aphasia, AOS, PD, Dementia, Drug toxicity, seizures)
Don’t usually have concomitant features.
Incidence vs. Prevalence
Incidence: # of NEW cases within a certain period.
Prevalence: # of TOTAL people living with diagnosis.
SAND vs. developmental stuttering
Developmental stutter on nouns.
SAND stutter on functor & substantive words.
Developmental is always in initial position vs. SAND in medial/final position.
Developmental can repeat dysfluent utterance adequately but SAND are still dysfluent.
BOTH know what they want to say.
