Part 1 Flashcards
(27 cards)
What are some rules for communication etiquette?
Do not finish sentences or interrupt
Maintain posture, facial expression, eye contact and focus on what person is saying to de-focus from stuttering bx
Why do SLPs report lack of confidence with fluency?
Low prevalence
ASHA deregulation of clinical experience and coursework
Counseling component
High rate of relapse
Where can patient look after treatment has begun?
ASHA, stuttering foundation for self-help literature
What is the clinician’s role?
Induce initial changes and coach speech-motor programming
Counsel and empower client to become their own clinician
Calibrate to client and notice details of stutter, anxieties…
Become less inhibited by practicing voluntary stuttering and modeling risk taking bx
What is the client’s role?
Main agent to sustain change!
What is the nature of stuttering?
Occurs in presence of perceived other, and likely to occur under high pressure, including conversation (bidirectional comm)
Often brought on when person is not talking yet, but knows they will have to…
How is stuttering different and distinct from typical dysfluency?
Typical dysfluency is tension free, rythmic, brief and without secondary bxs.
Stuttering is involuntary with environmental and neurochemical triggers, difficulty initiating and moving across syllables
Variable and cyclical
When are dysfluencies counted as SLDs?
Sound repetitions with more than 2 units per repetition… are they dysrythmic?
Variety of atypical dysfluencies (prolongations, blocks, repetitions, and clusters)
Pitch or loudness increase is sign of laryngeal tension/pushing
Evidence of struggle bxs
More than 10 words per 100 stuttered
When is onset of stuttering? Why?
2-7 is likely, 2-5 is typical!
There is an increase in lexicon and grammaticality
There’s only a 50% chance that if child has not stuttered at age 4 they will stutter after…
What is the incidence? Prevalence?
Incidence is new cases over time period: 5%
Prevalence is % at any given time: 1%
Preschool is a time of great…
Vulnerability- parents have large influence, resources scarce
Potential- plasticity, lack of experience with stuttering, high self efficacy
High stakes- most natural stuttering will resolve within a year
How often do children recover from stuttering?
32-85% will recover on own
Spontaneous recovery ends at age 5
What is the issue with existing explanations for stuttering?
Some account for etiology, and others for moments of stuttering
What are some research strides in last 30 years?
Predictors of natural recovery v chronicity
Neuromotor bases of stuttering in adults
Response to altered auditory feedback conditions
What are research needs?
Neuromotor bases among children?
Multicultural/multilingual contexts
What are the biological bases of stuttering?
Genetic links!- 1/3-1/2 report family history. Males greater risk than females. Severity not familial, just presence. Greater rate with mono than dizygotic twins, with bio than adopted parent, and with males than with females (esp with recovery). Male from mothers who stutter at greatest risk!
Atypical neurology- atypical cerebral dominance, now, irregular neural organization due to reduced lh white matter, myelin covering, rh hyperactivity, reduced grey matter in subcortical areas, and atypical dopamine levels.
Auditory dysfunction- altered feedback causes improvement, difficulties with sound localization
Speech motor discoordination- slower and less coordinated speech motor execution
What are the implications and issues of atypical neurology?
Pharmacological treatment
Neurological evidence suggests link- but causal or adaptive??
What are the implications and issues of auditory dysfunction?
AAF was used to augment therapy, now used as an alternative to therapy as well
Neuro underpinnings not totally understood, not sure of clinical efficacy of AAF devices
What are the implications and issues of genetic links?
Close monitoring of children of parents who stutter, counseling…
Could it be genetically based even without family history?
What are the implications and issues of speech motor discoordination?
Evaluate speech motor function
Is is due to inherent capacity or learned response to stuttering?
What are some critiques of biological perspective research?
Small number participants, few replicated studies, and most with adults!
Doesn’t fit one physiological explanation!
What is the diagnosogenic semantic theory?
Stuttering is a maladaptive learned response!
Most kids go through periods of normal disfluency, child learns to approach talking with apprehension, tension…
Aberrant speech bx ID’d as stuttering after parents say it is. Clinical implication is “hands off” approach and not calling attention to it by calling it stuttering. Caused loss of research on bio basis, and parent guilt for causing.
Overall undermined by genetic involvement. BUT communicative environment was brought into focus.
What is the two factor theory?
One factor suggests explained by classical conditioning
Another is development of secondary bx are explained with operant conditioning (he agrees with this)
Application of contingent stimuli (aversive or not) appears to create a state in which stuttering tends to diminish
Summarize stuttering as a unidimensional d/o
Nature (bio) or nurture (bx explanations)
Counseling- develop skepticism for unidimensional explanation, gauge parents beliefs about stuttering, refer to contributive factors–> predisposing genetics, precipitating trigger (stage, phase, env), perpetuating (what makes it worse, environment, push/avoid)
