Test 1 (Ch. 1, 2, 4)

Question 1

How do you describe stutterers?

Answer 1

People Who Stutter preferable to stutterers
Kids Who Stutter
Disfluency preferable to disfluency

Question 2

Do all cultures have stuttering?

Answer 2

Yes. Stuttering is ancient and universal.

Question 3

What causes stuttering?

Answer 3

Not completely understood but possibly:

• genetic and congenital causes
• developmental influences
• environmental influences

Repeated negative emotional experiences with stuttering lead to negative feelings and attitudes

Question 4

5 things to consider in fluent vs. disfluent speech

Answer 4

1. Presence of extra sounds
2. location and frequency of pauses
3. Rhythmical patterning in speech
4. Intonation and stress
5. Overall rate

Question 5

General description of stuttering

Answer 5

Abnormally high frequency and/or duration of stoppages in the flow of speech

Includes the speaker’s reaction to stoppages

Question 6

What are the 3 core behaviors

Answer 6

1. Repetitions
2. Prolongations
3. Blocks

Question 7

Repetitions

Answer 7

May be single-syllable, word, or part-word repetitions

Question 8

Prolongations

Answer 8

Sound of airflow continues but movement of articulators is stopped
(1/2 second prolongations are abnormal)

Question 9

Blocks

Answer 9

Inappropriate stoppage of airflow or voicing; movement of articulators may be stopped

• blocks may occur at any level (respiratory, laryngeal, articulatory)
• blocks may be accompanied by tremors of lips, tongue, jaw, and/or laryngeal muscles

Question 10

On average how often do stutters stutter when reading?

On average, how long do stutters last?

Answer 10

10% of words

1 second

Question 11

What are Secondary Behaviors?

Answer 11

Learned behaviors that are triggered by the experience of stuttering or the anticipation of it
For example - escape and avoidance

Question 12

Escape behavior

Answer 12

escape behaviors occur when the speaker is stuttering and attempts to terminate the stutter and finish the word

Question 13

Avoidance

Answer 13

Avoidance behavior occurs when the speaker anticipates a stutter and tries to avoid it by, for example, changing the word to uh

Question 14

Feelings and attitudes

Answer 14

The experience of stuttering often creates feelings of embarrassment and frustration in a speaker
Feelings become more severe at the speaker has more stuttering experiences
Fear and shame may develop eventually and may contribute to the frequency and severity of stuttering
Attitudes are feelings that have become more permanent and affect the person’s beliefs
Beliefs may be about oneself or others

Question 15

Disability and handicap

Answer 15

The disability of stuttering is the limitation it puts on individual’s ability to communicate
The limitation is affected by the severity of stuttering as well as stutterers’ feelings and attitudes about themselves and how listeners have reacted to them

The handicap is the limitation it puts on individual’s lives
This refers to lack of fulfillment they have in social life, school, job, and community

Question 16

Prevalence vs. Incidence

Answer 16

Prevalence is how many people stutter at any given time - at kindergarten it’s 2.4% and after its 1%

Incidence is how many people have stuttered at some point in their lives and that is 5%

Question 17

Recovery without treatment

Answer 17

Between 70-80% of children who begin to stutter recover without treatment

Question 18

Onset

Answer 18

May start as gradual increase in normal childhood disfluencies or as a sudden appearance of severe blocks
Often sporadic at outset, coming and going for periods of days or weeks before coming persistant

Question 19

attributes that make spontaneous recovery less likely

Answer 19

• having relatives that are persistent stutterers
• being male
• onset after 3.5 years
• stuttering not decreasing during first year after onset
• stuttering persisting 1 yr after onset
• multiple repetitions (li li li li like this)
• continued presence of prolongation and blocks
• below normal phonological skills

Question 20

Recovery is associated with..

Answer 20

• being right handed
• growing up in a home with a mother who is non-directive and uses less complex language when speaking to child
• having a slower speech rate and more mature speech motor system

Question 21

Sex Ratio

Answer 21

Sex ratio is almost even at (1:1) on onset
Girls start to stutter earlier than boys and recover more frequently so that they time they are school aged its 3 boys to every one girl

Question 22

Anticipation

Answer 22

Stutterers can predict which words they will stutter on in a reading passage

Question 23

Consistency

Answer 23

Stutterers tend to stutter on the same words each time they read a passage

Question 24

Adaptation

Answer 24

Stutterers stutter less each time they read a passage up to about six readings

Question 25

Adults who stutter do so more frequently on..

Answer 25

- consonants - sounds in word-initial position - sounds in contextual speech - nouns, verbs, adjectives, and adverbs - longer words - words at beginnings of sentences - stressed syllables

Question 26

Language factors

Answer 26

Stuttering in preschool children occurs most frequently on pronouns and conjunctions (these occur frequently at the beginning of utterances in young children) Stuttering most frequent;y occurs as repetitions of parts of words and single-syllable words in sentences-initial position The trigger seems to be linguistic planning and prep because it occurs at the beginning of syntactic unit

Question 27

Fluency inducing conditions

Answer 27

- when alone, relaxed - in unison with another speaker - to an animal or infant - in time or a rhythmic stimulus or when singing, in a different dialect - while simultaneously writing - while swearing - in a slow, prolonged manner - under loud masking noise - under DAF - When shadowing another speaking - when reinforced These reduce demands on speech-motor control and language formation

Question 28

A model of stuttering

Answer 28

- A disorder of neuromotor control of speech - Influenced by language production - Perpetuated by temperament and complex learning, and the response of their environment to their speech

Question 29

3 Approaches to heredity and stuttering

Answer 29

1. Family studies 2. Twin studies 2. Adoption studies

Question 30

Family studies

Answer 30

- Males tend to be more at risk for persistent stuttering - Females recover from stuttering more easily - study family trees and occurrence

Question 31

Twin Studies

Answer 31

- Stuttering in identical/fraternal twins - Greater concodinance among identical twins - Stuttering is 2/3 genetics and 1/3 environment

Question 32

Adoption studies

Answer 32

Heredity plays a slightly stringer role than environment

Question 33

Important Heredity Findings

Answer 33

- Stuttering appears to be inherited | - Single gene for transitory stuttering, two or more genes for chronic stuttering

Question 34

Factors that predict natural recovery

Answer 34

- Female - No family history of persistent stuttering - Early onset - Good language, articulation, and intelligence

Question 35

Clinical implications

Answer 35

- parents should be told stuttering is often inherited, not a result of bad parenting - prognosis for natural recovery is related to number of recovery factors

Question 36

Genes

Answer 36

- Genes associated with stuttering found on chromosomes 1, 7, 9, 12, 13, 15, 16, 18 - Persistant and recovered stuttering associated with 9 - persistant stuttering only associated with 15 - mutations of 12 associated with stuttering

Question 37

Congenital and Early Childhood Factors

Answer 37

``` 40-70% of stutterers have no family history of stuttering Stuttering associated with - brain injury before or soon after birth - premature birth - surgery - head injury - mental retardation - intense fear ```

Question 38

Brain structure and Function

Answer 38

No matter the etiology, brain structure and function is affected Stutterers showed more right brain activity Speech shifted to left after treatment

Question 39

Brain differences caveat

Answer 39

difference in brain structure may be because of brain structure not what caused it

Question 40

Sensory Deficits

Answer 40

- poorer CAP - Auditory evoked potentials have longer latencies and lower amplitudes, especially for linguistically complex stimuli - Less right-ear advantage in processing linguistically complex sounds - may be poorer at processing tactile and visual information - Masking and DAF reduces stuttering

Question 41

Sensory-motor deficits

Answer 41

- Slower reaction times - slower speech during fluency - slower on non speech sequencing - poorer at auditory motor tracking

Question 42

Emotion effects

Answer 42

- emotion may increase stuttering, and stuttering may increase emotion - stutterers are not more anxious than non stutterers, but more anxiety produces more stuttering - autonomic arousal associated with stuttering - Stutterers may have more inhibited temperaments, emotions may be more trainable

Question 43

Developmental Factors

Answer 43

- children deal with limited neural resources handling a multitude of tasks - Physical and motor development: rapid developmental changes in vocal tract stress the development of speech

Question 44

Speech and Language Development

Answer 44

- stuttering seems to have its most frequent onset when the child is mastering more complex language children predisposed to stuttering may have deficits in areas responsible for planning and production of speech and language - Rapid speech and language development may stress these weak areas, resulting in stuttering - some children may develop stuttering as a response to extra difficulty because of a speech or language delay and the stress it puts on speech production

Question 45

Cognitive development

Answer 45

- Intensive cognitive development may compete with fluency - The ups and downs in a child's fluency may reflect spurts of cognitive development - after age 3, children may be self-conscious enough to have negative emotions about stuttering

Question 46

Social and Emotional Development

Answer 46

- Emotional arousal increases stuttering and normal disfluency - Emotional stress during childhood may trigger or worsen stuttering - Some children who stutter may be more vulnerable to childhood stresses - Individuals who stutter appear to be normal in terms of psychosocial traits

Question 47

Environmental factors

Answer 47

- Environmental factors may interact with developmental factors to trigger or worsen stuttering - Parents Research: mixed results about whether parents of stutterers are more anxious etc. Theory: Children with vulnerable temperament may have inherited it from one or both parents, thus parents may be perfectionistic, anxious, etc.

Question 48

Speech and Language Environment

Answer 48

- Research unclear: do families of kids who stutter have stressful speech and language models? - Speculation about some variances causing stress for vulnerable children Basically stressful speaking situations

Question 49

Children who stutter may be helped by making communication easier

Answer 49

- more one on one time when parent can listen slower speech rate language complexity not too far above child's level

Question 50

Life events

Answer 50

Stressful life events may precipitate or worsen stuttering in some children

Question 51

Classical Conditioning of Stuttering

Answer 51

Stuttering elicits feelings of dread and tightening of speech muscles Stuttering occurs repeatedly on the phone Phone elicits dread and muscle tension

Question 52

Operant conditioning

Answer 52

- If behavior is followed by a reward, it increases - If behavior is followed by a punishment, it decreases - If a behavior reduces negative stimulation, it is "negative reinforcement" or escape, and it increases the behavior

Question 53

Avoidance Conditioning

Answer 53

Anticipating a stutter and doing something to keep it from happening

Question 54

To deal with classical conditioning you need to..

Answer 54

Decondition -> have client keep stuttering until fear is gone Counter condition -> what has been classically conditioned (have client stutter and receive praise for keeping it going

Question 55

To deal with operant conditioning...

Answer 55

Stop reward for unwanted behavior (have client not release word after secondary behavior) Start reward for wanted behavior

Question 56

To deal with avoidance conditioning..

Answer 56

Decrease fear of stuttering | Reward non avoidance