CSD 115 1st EditionLecture 21Outline of Last Lecture I. Fluency DisordersII. Types of Disfluenciesa. Stuttering-like Disfluencies (SLD)b. Normal Type DisfluenciesIII. Secondary BehaviorsIV. Additional Impacta. Emotional Reactionsb. Cognitive Processesc. Social DynamicsOutline of Current Lecture (Fluency Disorders Continued)I. Developmental StutteringII. Spontaneous/Natural RecoveryIII. Genetics and StutteringIV. The Brain and StutteringV. Evaluating StutteringVI. Treatment for ChildrenVII. Treatment for AdultsCurrent LectureDevelopmental Stuttering- Most common type of stuttering - 95% of stuttering cases begin before age 4- 5% of population has stuttered at some point in their lives (incidence)- 1% of the population is stuttering at any given time. (3 million people in the US) Spontaneous/Natural Recovery- About 80% of preschool children who stutter will recover without therapy within 5 years of onset- Largely due to growth and maturation- Environment may also play a part - Good Prognosticators (more likely to recover):o Femaleo No family history of stutteringo Family history of spontaneous recoveryo If number of stuttering moments drops during the first year post-onset These notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.Genetics and Stuttering- Stuttering runs in families/genetic component- More common in identical twins than fraternal (although only 2/3 of identical twins bothstutter) - More common in boys than girls (4:1)- Research has identified 3 specific genes have been identified as causing stuttering.- Many people who stutter have an extra gene on the 14th chromosome, which is good evidence for geneticsThe Brain and Stuttering- In People Who Stutter (PWS) o Greater activation of right side for speech (changes with therapy)o Information tracts (white matter) reduced; suggesting weaker connection between motor and linguistic areas of the brain - Left side of the brain is what controls speech and language- Almost all PWS, have their right side of the brain controlling speech and language (it will switch to the left side with therapy)Evaluating Stuttering- Case History – important to determine onseto Social/Emotional/Cognitive Assessmento Feared words, sounds, situationso Reactionso Limitationso Personal Goals- Assessment of Primary & Secondary Behaviors- Assessment of respiration, phonation, articulation Treatment of Stuttering in Children- Reduce environmental stressors- Assist parents in supporting fluencyo Reduce questioningo Reduced demandso Increase positive reinforcement; attentiono Build self-esteem- Slow-Easy-Speech (SES)- Environment and stress does not cause stuttering, stress can make it harder for the person who does stutter to speak in front of others (all PWS have signs of fight or flight response going on in their bodies when it is time to speak in front of others)Treatment of Stuttering in Adults- Must focus on all dimensions of stuttering- Modifying speech production – resp/phon/artico Easy onsets/light touches Easy onsets: Begin to produce word by being conscious of air in vocal folds and just letting the word come out Light touches: position articulators before saying the word and lightly say the soundo Slides Holding the first sound a little longer prolongationo Stretches Position articulators for the first sound, but focus on the second soundo Pacing and pausing Speak 3 or 4 word phrases then pause before speaking again This is done to slow down speech- Developing healthy emotional and cognitive processeso Desensitization to reduce stigmao Reduction of avoidance behaviors - Practice in relaxation- Generalization of
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