Fluency Disorders

Question 1

What is stuttering?

Answer 1

a communication disorder in which sounds, syllables, or words are repeated, stopped, or prolonged, disrupting the normal flow of speech.

Question 2

What is the accepted term for someone who stutters?

Answer 2

Person Who Stutters (PWS)

Question 3

what is fluency?

Answer 3

smooth speech transitions between sounds, syllables, and words

Question 4

What are 3 factors associated with fluency?

Answer 4

Rate (appropriate speech timing), effort (appropriate force), and continuity (smooth connections without unnecessary pauses)

Question 5

What is disfluency?

Answer 5

disruptions in the transitions between sounds, syllables, and words

Question 6

T/F: disfluencies are present in the speech of people who do not stutter

Answer 6

true

Question 7

When does a fluency problem become a fluency disorder?

Answer 7

when one crosses over the limits of normal disfluencies, it causes the listener to pay attention to how the person is talking, not what they are saying

Question 8

What are the 6 parts to a stuttering disorder?

Answer 8

overt speech characteristics, secondary behaviors, physical alterations, affective features, cognitive features, social dynamics

Question 9

What are some typical disfluencies?

Answer 9

phrase repetitions, whole word repetitions, interjections, and revisions

Question 10

What are some stuttering-like disfluencies?

Answer 10

sound and syllable repetitions, blocks, and prolongations

Question 11

What are secondary behaviors associated with stuttering?

Answer 11

loss of eye contact, facial movements, head movements, body movements

Question 12

What are possible physical responses to stuttering?

Answer 12

rapid heart rate, change in breathing pattern, feeling tightness in chest or throat, sweating

Question 13

What are affective features?

Answer 13

How a PWS feels about themselves, how a PWS feels about stuttering

Question 14

What are cognitive features?

Answer 14

what the PWS thinks about themselves, what the PWS thinks about stuttering

Question 15

what is lifetime incidence?

Answer 15

the number of all cases ever exhibited

Question 16

What is the incidence of stuttering?

Answer 16

8% or higher

Question 17

what is prevalence?

Answer 17

the number of all cases currently identified

Question 18

What is the prevalence of stuttering?

Answer 18

less than 1%

Question 19

what is the stuttering incidence for gender?

Answer 19

childhood: 2 males to 1 females
adulthood: 4 males to 1 female

Question 20

what is the stuttering incidence with age?

Answer 20

incidence and prevalence decline across the life span

Question 21

what is the cause of stuttering?

Answer 21

no current consensus on a cause, theories on psychological, psychosocial, and biological causes

Question 22

At what age does stuttering start?

Answer 22

Mean - 33 months

Question 23

T/F: Parents who believe that their child has begun stuttering are typically correct

Answer 23

true

Question 24

T/F: Stuttering does not appear to arise from normal disfluency

Answer 24

true

Question 25

What does early stuttering sound like

Answer 25

repetitions of initial syllable, sounds and short words are most typical (may include prolongations and blocks) 50% have tense movements

Question 26

what are the best estimates of a child developing into a CWS?(4)

Answer 26

strong family history, more boys than girls, steady or increasing SLDs, onset later than typical 33 months

Question 27

How do SLPs know who is a CWS?

Answer 27

add the SLDs and other disfluencies together, divide SLD/TD, if 40% or more of TDs are SLDs, there is a potential problem

Question 28

What percent of disfluencies in CWS are SLDs?

Answer 28

66% (2/3)

Question 29

What is some advice an SLP should give to a parent of a CWS? (5)

Answer 29

decrease various pressures decrease emotional and physical excitement more relaxed, slowed paced activities speak slower, especially to the child promote child's self confidence

Question 30

What should an SLP tell a parent to do when their child stutters? (6)

Answer 30

pay attention to the message listen patiently as a child stutters repeat child's stuttered word "say this easily again" reinforce fluency show empathy

Question 31

When is direct therapy needed for pre-school age children?

Answer 31

when the child is aware and has negative reactions secondary behaviors are present high risk family history high risk environment

Question 32

What are some therapy approaches for CWS? (3)

Answer 32

child-centered activities follow "fluency rules" (slow speech, smooth speech, soft voice, turn taking) foster child's positive self-image SLP occasionally "pseudo-stutters" and acts unconcerned

Question 33

how are adults who stutter different from children who stutter?

Answer 33

persistence of stuttering behaviors frequent increase in stuttering behaviors emotional, cognitive, and social reactions can expand over time

Question 34

T/F: Adults who stutter are more likely to have a genetically-based more resistant stuttering

Answer 34

true

Question 35

Assessment of stuttering in adults

Answer 35

1. stuttering history 2. treatment history 3. current speech description 4. secondary behaviors 5. environmental variable affecting speech 6. impact of stuttering on quality of life

Question 36

What can the severity of stuttering be determined by?

Answer 36

frequency, duration, secondary behaviors, naturalness of speech

Question 37

how can convert aspects of stuttering be measured?

Answer 37

rating scales, questionnaires

Question 38

What is the OASES?

Answer 38

Overall Assessment of the Speaker's Experience of Stuttering

Question 39

What are the sections of the OASES?

Answer 39

1. General information about stuttering 2. affective, behavioral, cognitive reactions 3. communication in daily situations 4. impact of stuttering on quality of life

Question 40

Can stuttering in older children and adults be cured?

Answer 40

No, the need for treatment can reoccur

Question 41

what is the fluency shaping approach to stuttering therapy?

Answer 41

the goal is (near) 100% fluency; PWS learns new ways of speaking; behavior modifications; gradual increase in length and complexity

Question 42

what is the stuttering modification approach to therapy?

Answer 42

the goal is to stutter more gently and less often; PWS learns to change speech as stutter happens or is about to happen; addresses covert thoughts/feelings

Question 43

what are the fluency shaping techniques?

Answer 43

decreased rate of speech gentle voice onset light touches of articulators coordinate breath and speech stringing words together

Question 44

what are the pros of fluency shaping?

Answer 44

can work well with young children positive short-term effects high % of fluency is attractive to PWS

Question 45

what are the cons of fluency shaping?

Answer 45

little to no focus on covert feelings/thoughts little to no focus on secondary behaviors speakings concerned about sounding natural difficult to maintain over time

Question 46

what are the components of stuttering modification? (4)

Answer 46

1. identification 2. desensitization 3. variation 4. approximation

Question 47

what is the identification component of stuttering modification?

Answer 47

the PWS labels and counts disfluencies

Question 48

what is the desensitization component of stuttering modification?

Answer 48

PWS freezes in stuttered moments, watch themselves in mirror, confront negative thoughts

Question 49

what is the variation component of stuttering modification?

Answer 49

PWS learns to manipulate and change disfluencies, learns to tolerate stuttering

Question 50

what is the approximation component of stuttering modification?

Answer 50

PWS learns to modify disfluent moments to stutter more easily, with less struggle and effort