Study Guide 5 SPA200104 02 2012 Bolded Terms Definitions and Lilac Boxes in Each Chapter Chapter 8 Fluency Prevalence and Incidence Rates for Stuttering Stuttering is involuntary repetitions of sounds and syllables sound prolongations and broken words Stuttering incidence rate is about 1 The number of adults who report that they had stuttered at some time in their life is 5 However this 5 incidence rate includes the high percentage of children who naturally recover from the disorder before the age of 6 Relatively new information indicates that 65 to 75 of children will recover within the next few years Females appear to recover from stuttering more frequently than males The reported sex ratio difference ranging from 2 3 to 1 to 3 0 to 1 more males than females Stuttering has a high degree of familial incidence 50 of people who stutter report that they have a relative who stuttered at some time in his her life 15 of 1st degree relatives of people who stutter are current or Types of Normal Within word vs Stuttered Between Word Disfluencies and Recognize Examples of recovered stutterers each type The type of disfluency exhibited by the normally developing child changes between the ages of 25 and 37 months At approximately 2 years of age typical disfluencies are whole word repetitions i e I I I want a banana syllable repetitions i e I like ba baseball and interjections i e Can we uhm go now At age 3 revisions are the dominant disfluency type Normal Disfluences persist throughout life Fluent speakers may repeat whole multisyllabic words interject a word or phrase repeat phrases or revise sentences Stuttered speech involves audible or silent repetitions and prolongations Tense pauses and hesitations within and between words may also be regarded as stuttering Within word and some between word disfluencies are believed to be the universal features of stuttering DISFLUENCY TYPE WITHIN WORD BETWEEN WORD EXAMPLES X X X X Sound syllable repetitions Sound prolongation Broken word Monosyllablic whole word repetitions Multisyllablic whole word repetitions repetition interjection Phrase Revisions X X X X He s a b b boy G g g go away Ssssssee me swing Base pause ball I I I hit the ball I m going going home She hit she hit me I like uh ya know big boats Developmental stuttering is whole word repetitions and other self conscious nonfluency that is apparent in Developmental vs Neurogenic Stuttering many young children Most common form of stuttering Begins in the preschool years Exhibit secondary characteristics such as anxiety Onset gradual increasing in severity Usually occurs on content words nouns verbs initial syllables Neurogenic stuttering is disorder of fluency associated with some form of brain damage Typically associated with neurological disease or trauma Usually occurs on function words conjunctions prepositions widely dispersed through utterance No secondary characteristics No improvement with repeated readings or singing Summary of Bloodstein s four phases of the onset and development of stuttering Phase 1 2 6 years Stuttering is episodic Most stuttering occurs when the child is upset or excited Sound syllable repetitions are dominant speech feature Child seems unaware of the stuttering Phase 2 Elementary school age Stuttering is chronic Stuttering occurs on content words nouns verbs Child regards himself or herself as a stutterer Phase 3 8 years to adulthood Stuttering is situational speaking on the telephone speaking to large groups Certain words are regarded as more difficult than others Circumlocutions roundabout or indirect ways of speaking and word substitutions are frequent Phase 4 8 years to adulthood Stuttering is at its apex of development There is fearful anticipation of stuttering Certain sounds words and speaking situations are avoided Increased circumlocutions and word substitutions are present Theories and conceptualizations of Stuttering Etiological theories of stuttering can be classified into three categories organic behavioral and psychological Organic theory Proposes an actual physical cause Many have been proposed all have failed to explain stuttering satisfactorily Renewed interest in cerebral dominance theory structural and functional differences in the brains of adults with chronic developmental stuttering i e theory of cerebral dominance assumed that when neither cerebral hemisphere was dominant both would send competing neural impulses to their respective muscles of speech resulting in discoordination Behavioral theory Stuttering is a learned response Diagnosogenic theory o Overly concerned parents react negatively to normal speech hesitations and repetitions causing anxiety in the child and increased stuttering o There is contrary evidence to this theory o Natural recovery may actually be due in part to parents explicitly telling her child to slow down stop and start again or think before speaking Psychological theory Contends stuttering is a neurotic symptom with ties to unconscious needs and internal conflicts o Treated most appropriately by psychotherapy Research indicates psychotherapy is not an effective treatment of stuttering Current Conceptual Models of Stuttering Covert Repair Hypothesis stuttering is a reaction to a flaw in the speech production plan Stuttering is not the error rather stuttering is a normal repair reaction to an abnormal phonetic plan Demands and Capacities Model stuttering develops when environmental demands to produce fluent speech exceed child s physical and learned capacities o DCM is not a theory of stuttering and it doesn t suggest a cause rather it is a useful tool that helps clinicians to understand the dynamics of forces that contribute to the development of stuttering EXPLAN Model fluency failures occur when linguistic plans are sent too slowly to the motor system EX execution PLAN speech planning o An account of the production of spontaneous speech that applies to both fluent speaker and speakers who stutter o In this model speech planning is the linguistic process of language formulation and execution is the motor activity related to the production of the language formulation o Stuttering results from a failure in normal interactions between the PLAN and EX processes Therapeutic Techniques with young children The Evaluation of Stuttering Detailed analysis of speech behaviors Average number of each type of disfluency e g within word repetitions sound prolongations 3 or more within word disfluencies per 100 words spoken