CSD 405 Test 2
what percent of PWS have a family history of stuttering?
30-60%
world health organization (WHO) stuttering definition (1977)
"disorders in the rhythm of speech in which the individual knows, precisely what she/he wishes to say, but at the same time is unable to say because of an involuntary reception, prolongation, or cessation of a sound
What was the nickname given to King Louis II of France because of his speech?
"le begue" or "the stammerer"
common myths about stuttering?
- PWS are not smart - nervousness causes stuttering - stress causes stuttering - stuttering can be "caught" through irritation or by hearing another person stutter - it helps to tell a person to "take a deep breath before talking" or "think about what you want to say first"
in what conditions might the context of talking decrease stuttering frequency?
-alone -in unison -to animals and infants -with delayed auditory feedback -with masking noise
what components are necessary to complete an assessment and diagnosis of stuttering?
-background information -observe client -interview -diagnosis -meet with client or family to review options for treatment
following the neuropsycholinguistic theory, what is the problem causing PWS to experience a "loss of control"?
-fluent speech: needs correct timing between the formulation of language and motor execution of speech movements -stuttering: disruption in timing linguistic information and speech movement
what are some examples of primary (or overt) stuttering behaviors?
-interjections -sound/syllable repetition -word repetition -phrase repetition -audible sound prolongation -inaudible sound prolongation (block) -revision
what is the underlying problem that causes stuttering in the Covert Repair Theory?
-internally disordered phonological system (people who stutter have this) -frequency planning errors in speech organization -interruption of ongoing speech to repair errors 1. frequency repetitions and pauses 2. repairs do not occur at a conscious level ---they are not aware that they are doing the repairs
examples of capacities:
-neurological development -speech articulation development -language stage -temperament (disposition)
within-word disfluencies
-part-word repetition -single syllable word repetition -multisyllabic word repetition -dis-rhythmic phonation (sound prolongation) -tense pause (silent prolongation or block)
between word disfluencies
-phrase repetition -interjection -revision incomplete
in what conditions might the manner of talking decrease stuttering frequency?
-singing -in rhythm (to a metronome beat) -imitating a dialect -whispering -speaking slowly
how many individuals out of 100 experience stuttering?
1 in 100
what is the average age of onset for stuttering?
2-5 years of age
phrase repetition
Between word disfluencies OD "I want-I want- I want to go home"
what are some examples of secondary (covert) stuttering behaviors?
Bodily movements: i. Facial grimaces ii. Head movements iii. Loss of eye contact Psychosocial behaviors i. Fear ii. Frustration iii. Embarrassment iv. Anger v. Word avoidance
Who thought that stuttering was caused by a spasm due to muscle weakness?
Jean-Marc Gaspard Itard
Which assessment tool records the personal experience of the person who stutters?
OASES
Which standardized stuttering assessment compares an individual's score based on percentile rank?
SSI-4
Charles Van Riper stuttering definition (1971)
Stuttering occurs when the "forward flow of speech is interrupted by a motorically disrupted sound, syllable, or word or the speaker's reaction thereto"
What important idea did Lee Edward Travis have about hemispheric organization relative to stuttering?
Thought that PWS have speech centers in both cerebral hemispheres of their brain instead of just the left hemisphere i. They competed for dominance because they cause for a stutter to occur ii. People who write with their left-hand are more likely to stutter
what is psychogenic stuttering?
a condition referring to people in whom a psychological disturbance is clearly diagnosed - speech disfluencies are strongly linked to psychological distress - has been some psychological diagnosis
what is cluttering?
a disorder of speaking rate - speech and language formulation affected - very fast speaking - treatment is mainly to reduce the speaking rate and increase the general clarity of speech
disfluency
a disruption or breakdown in the flow of speech i. A change in any of the 4 things under fluency can cause disfluency ii. Fast speaking may affects vowels or consonants of speech iii. It is really important to remember that speech disfluency is normal and doesn't mean that the person has a stutter iv. Clinicians job is to determine whether speech is normal or unnatural
what structural brain differences have been observed in PWS?
a. Gray matter volume (reduced): temporal lobes (bilateral), Broca's area (language area for motor control of speaking; left hemisphere) b. White matter connectivity (reduced): premotor and motor and auditory systems i. There is an error in the two hemispheres because of this reduced connectivity ii. Less connectivity is those who stutter
Neurogenic stuttering vs Developmental stuttering
a. Neurogenic: i. Usual adult onset ii. Confirmed neurological lesion iii. Stutter event locations anywhere in sentences iv. Stuttering frequency varies little across situations v. Adaptations effect less common 1. When you give someone an oral test, the stutter typically stays throughout the test b. Developmental: i. Usual childhood onset ii. No neurological lesion iii. Stutter event locations mainly on first 3 words of sentences iv. Stuttering frequency varies across situations v. Adaptation effect more common 1. When you give someone an oral test, the stutter typically goes away as the sentences are read more
psychogenic stuttering vs. developmental stuttering
a. psychogenic i. Usually adult onset ii. Diagnosed psychological trauma iii. Often apathetic toward stuttering iv. Stuttering occurs in singing, unison, delayed auditory feedback v. Rapid remission with reduced emotional stress b. Developmental i. Usually childhood onset ii. No psychological trauma iii. Often anxious about stuttering iv. Stuttering less in singing, unison, delayed auditory feedback v. Remission at adult age is rare
what is the prevalence of stuttering among adults and school aged children?
about 1% worldwide
what is the prevalence of stuttering among preschoolers?
about 5% worldwide
how are these stuttering assessment questions answered?
are speech disfluencies present? -speech sample -disfluency count what is the nature of the speech disfluencies? -really involves further analysis of the details -occurrence of within-word disfluencies (SLD) -stuttering severity scales -occurrences of secondary characteristics (bodily movements, psychological behaviors)
what questions need to be answered during a stuttering assessment?
are speech disfluencies present? what is the nature of the speech disfluencies?
duration
average of the 3 longest stutters
interjection
between word disfluencies OD "I um, well, un, want to go home"
revision-incomplete
between word disfluencies OD "my too..my molar hurts"
what emotions might a PWS experience during stuttering?
blankness, being trapped, panic, frustration
does stuttering occur more often in boys or girls? By how much?
boys, 3:1
which fluency disorder is characterized by disorganized expressive language and irregular speaking rate?
cluttering
How did Johann Friedrich Dieffenbach recommend stuttering be treated?
cut out portions of the tongue to treat stuttering
what are the subcategories of stuttering?
developmental and acquired
what emotions might a PWS experience before stuttering?
fear, dread, anxiety, panic
how does disfluency differ from fluency?
fluency: the effortless flow of speech disfluency: a disruption or breakdown in the flow of speech
In order to formulate a diagnosis, which three areas are being considered using the SSI-4?
frequency, duration, physical concomitants
incidence
have stuttered in their life
cluttering
i. Late talker ii. Repetition of phrases iii. Never very fluent iv. Poor articulation v. Poor reading and writing vi. Poor prosody and musicality vii. Unaware of disfluency viii. Speech improves with pressure
cluttering diagnosis
i. Late talker ii. Repetition of phrases iii. Never very fluent iv. Poor articulation v. Poor reading and writing vi. Poor prosody and musicality vii. Unaware of disfluency viii. Speech improves with pressure ix. Usually do not have an awareness of their stuttering or disorder x. Very fast speaking rate
stuttering diagnosis
i. Precocious talker ii. Repetition of sounds and syllables iii. Fluent episodes iv. Good articulation v. Good reading and writing vi. Good musical ability vii. Aware of disfluency viii. Speech gets worse under pressure ix. Typically is aware of their disorder or stuttering
stuttering
i. Precocious talker ii. Repetition of sounds syllables iii. Fluent episodes iv. Good articulation v. Good reading and writing vi. Good musical ability vii. Aware of disfluency viii. Speech gets worse under pressure
neurogenic stuttering diagnoses
i. Usual adult onset ii. Confirmed neurological lesion iii. Stutter event locations anywhere in sentences iv. Stuttering frequency varies little across situations v. Adaptation effect less common vi. Secondary behaviors less common vii. No recorded history of any fluency disorder viii. All word classes are being affected ix. Reading something repeatedly has the chance that they will still stutter and not change x. Typically is not as embarrassed when speaking
psychogenic stuttering diagnoses
i. Usual adult onset ii. Diagnosed psychological trauma iii. Often apathetic toward stuttering iv. Stuttering occurs in singing, unison, delayed auditory feedback v. Rapid remission with reduced emotional stress
developmental stuttering diagnoses vs neurogenic
i. Usual childhood onset ii. No neurological lesion iii. Stutter events locations mainly on first 3 words of sentences iv. Stuttering frequency varies across situations v. Adaptation effect more common vi. Secondary behaviors more common vii. More fluent with counting or other automated tasks
developmental stuttering diagnoses vs psychogenic
i. Usual childhood onset ii. No psychological trauma iii. Often anxious about stuttering iv. Stuttering less in singing, unison, delayed sudatory feedback v. Remission at adult age is rare
what is the incidence and prevalence of stuttering in the united states?
incidence: 16,000,000 prevalence: 2,240,000
what is the incidence and prevalence of stuttering worldwide?
incidence: 362,500,000 prevalence: 50,400,000
examples of demands:
internal demands external demands
Who advocated for the removal of tonsils as a treatment for stuttering?
james yearsley
Iowa Scale for Rating the Severity of Stuttering - level 3
mild to moderate: stuttering on 2% to 5% of words
Iowa Scale for Rating the Severity of Stuttering - level 2
mild: stuttering on 1% to 2% of words
Iowa Scale for Rating the Severity of Stuttering - level 5
moderate to severe: stuttering on 8% to 12% of words
If 5% to 8% of words were stuttered, what severity rating would be given according to the Iowa Scale for Rating the Severity of Stuttering?
moderate, severity ranking 7
Iowa Scale for Rating the Severity of Stuttering - level 4
moderate: stuttering on 5% to 8% of words
what are the subcategories of acquired stuttering?
neurogenic and psychogenic
Iowa Scale for Rating the Severity of Stuttering - level 0
no stuttering
OD
other disfluencies
what functional brain differences have been observed in PWS?
overactivity: right hemisphere underactivity: left hemisphere
what is the meaning of the iceberg analogy about stuttering?
overt behaviors are observable covert behaviors are not observable
clutter vs stutter
people who stutter know that they have problems with their articulation, but people who clutter are often not aware they are doing this
which terms are considered preferred when referring to stuttering?
people who stutter over stutterer disfluency over dysfluency
What terms did Rudolf Schulthess recommend be used relative to stuttering?
phonophobia or lalophobia
physical concomitants
rating of 4 types: distracting sounds, face movement, head movement, extremity movement
what is neurogenic stuttering?
results from conditions affecting various areas of the brain (neurological lesion) - repetitions or elongations that are not a language disorder or have psychological problems - can be a factor to an undiagnosed neurological disorder
famous people who stutter?
rowan atkinson emily blunt lewis carroll winston churchill cameron daddo charles darwin king george VI bruce willis james earl jones marilyn monroe sam neill isaac newton ed sheeran john stossel megan washington
Iowa Scale for Rating the Severity of Stuttering - level 6
severe: stuttering on 12% to 25% of words
what emotions might a PWS experience after stuttering?
shame, humiliation, anger, resentment
What variables besides stuttering should be considered when performing a stuttering assessment?
speaking rate phonology language abilities
what are some possible causes of neurogenic stuttering?
stroke, traumatic brain injury (TBI), brain tumor, neurological disease (Parkinson's disease), drug toxicity
prevalence
stutter currently
which fluency disorder is characterized by good articulation and awareness of the disorder?
stuttering
are stuttering and stammering different?
stuttering = stammering
what are the different types of fluency disorders discussed in this class?
stuttering and cluttering
in what conditions might stuttering frequency increase?
stuttering in adults occurs more often - on word initial than on word final sounds - on consonants than on vowels - on long words than on short words - on content words than on function words - on sentence initial words than later words
does stuttering occur in only some languages?
stuttering is found in all languages and cultures of the world
SLD
stuttering like disfluency
What stuttering therapy model did Charles Van Riper develop?
stuttering modification therapy (reduces fears of stuttering, doesn't eliminate it)
On the 7-Point Scale for Rating Severity of Stuttering, what percentage of stuttered words would constitute a score of 7 ("very severe")?
stuttering on more than 25% of words
frequency
syllables stuttered in speaking and reading task
How did Francis Bacon recommend the "stiff and frozen tongue" be treated?
thawed with hot wine
anticipation
the ability of PWS to predict which words they will stutter on
fluency
the effortless flow of speech i. Rate of speech is the quickness ii. Pauses used in speech iii. Stress put onto different syllables iv. Intonation that someone uses v. Can think of this as the pleasant sounding, smooth sound of voice
Wendell Johnson believed that stuttering was highly influenced by what?
the environment
adaptation
the tendency for stuttering to decrease in frequency and severity when a passage is read several times
consistency
the tendency to stutter on the same words when a passage is read several times
is stuttering only caused by genes? is it only caused by environmental factors?
unknown because they do not actually know
Iowa Scale for Rating the Severity of Stuttering - level 1
very mild: stuttering on less than 1% of words
what is the demands and capacities theory?
when the intrinsic and extrinsic social demands are being placed on the child to produce at all times - too demanding for the child at their skill level - children who have stuttering usually have the genetic predisposition - should try to make the communication easier for the child
tense pause (silent prolongation or "block")
within word disfluencies SLD "....the baby is crying"
Dis-rhythmic phonation (sound prolongation)
within word disfluencies SLD "MMMMMmy tooth hurts"
part-word repetition
within word disfluencies SLD "my t-t-t-tooth hurts"
multisyllabic word repetition
within word disfluencies SLD "the ba-ba-ba-baby is crying"
single-syllable word repetition
within word disfluencies SLP "I-I-I-I want to go home"
