Stuttering 1

Front 1

goals

Back 1

1. obtain sample of speech under normal circumstances
2. obtain sample under fixed circumstances
3. use samples to generate descriptions
4. find variables that affect client's fluency
5. obtain information about client's development relevant to fluency
6. obtain information about variables that affect outcome or prognosis
7. obtain information about relevant or non-relevant concommitant disorders
8. generate descriptions of assessment for other professionals and laypersons

Front 2

process for goal 1: obtain normal speech sample

Back 2

observe and record client:
- talking to friend or relative before interview
- during interview with clinician
- during daily activities (home, work, play)

Front 3

process for goal 2: obtain generated speech sample

Back 3

observe and record client:
- describing stimulus picture
- reading passage
- playing barrier game
- during structured interview
- describing something familiar

Front 4

process for goal 3: generate descriptions

Back 4

- administer standardized tests
- use protocols for coding samples
- transcribe samples
- find frequency, type and duration of disfluencies
- find speaking rate
- note physiological issues related to fluency
- describe secondary and attitudinal behaviors qualitatively

Front 5

process for goal 4: find variables that affect fluency

Back 5

- test different variables
- interview client/family
- tape client's interactions
- use trial treatment procedures (DAF, rate change, whispering)

Front 6

process for goal 5: find information about client's development

Back 6

- use questionnaires
- interview client/family

Front 7

process for goal 6: find variables that influence outcome or prognosis

Back 7

- read reports of other formal tests
- develop informal tests

Front 8

process for goal 7: concommitant disorders

Back 8

- read reports of or administer formal tests for other communication issues
- make informal observations

Front 9

process for goal 8: describe assessments for others

Back 9

- write reports of assessments for various audiences
- explain results to client, family and/or teacher

Front 10

stuttering definition

Back 10

an interruption in the forward flow of speech, characterized by primary core behaviors (repetitions, prolongations, interjections, blocks, etc.)

Front 11

forms of intervention

Back 11

- fluency shaping
- stuttering modification

Front 12

fluency tools

Back 12

- easy-onset for laryngeal tension
- soft articulatory contacts for oral motor tension
- stretching
- blending

Front 13

cancellation

Back 13

stutterer cancels out disfluency by repeating feared word using fluency tools

Front 14

pull-out

Back 14

stutterer "pulls out" of stuttering moment by using fluency tools

Front 15

preparatory set

Back 15

stutterer uses fluency tools when anticipating a feared word

Front 16

laryngeal vs. oral-motor stuttering

Back 16

- larnygeal: often consonantal
- oral-motor: often vowel oriented

Front 17

normal adult speaking rate

Back 17

150 wpm

Front 18

capacities and demands

Back 18

theory used to explain the phenomenon of normal childhood stuttering, states oral motor capacities are limited when it comes to linguistic demands (morphological inflections, MLU, increased speaking rate, etc.)

Front 19

spontaneous recovery

Back 19

outgrowing normal developmental disfluency

Front 20

secondary behavior

Back 20

way for a stutterer to break free from a stuttering moment, begins as deliberate behavior, becomes stronger and less controlled after repeated use, divided into two categories: escape and avoidance

Front 21

escape vs. avoidance behaviors

Back 21

escape: head nods, eye blinks, interjections, etc.
avoidance: circumlocution, substitutions, starters

Front 22

anti-expectancy device

Back 22

using high pitched voice, foreign accent, etc. to produce a feared word

Front 23

prevalence/incidence/ratio

Back 23

prevalence: 1-3% in children, estimated <1% in adults
incidence: 5%
ratio: 3:1

Front 24

most frequently stuttered

Back 24

- consonants
- sounds in word-initial position
- contextual speech (vs. isolated words)
- nouns, verbs, adjectives, and adverbs (vs. articles, prepositions, pronouns and conjunctions)
- longer words
- words at the beginnings of sentences
- stressed syllables

Front 25

methods of empowerment

Back 25

- bouncing back
- pseudo-stuttering
- freezing

Front 26

core behaviors indicating stuttering per Guitar

Back 26

- part-word repetitions
- monosyllabic whole-word repetitions
- sound prolongations
- blockages of sounds or airflow

Front 27

SLD

Back 27

- stuttering-like disfluency
- associated with within-word, part-word, single syllable repetitions, blocks and prolongations
- less than half of disfluencies in typical children are SLDS
- about two-thirds of disfluencies in stutterers are SLDS

Front 28

speech sample

Back 28

- ideally would obtain two samples: one clinic, one recorded in natural environment
- videotaping ideal, audiotaping essential
- length: 300-400 syllables of conversational and 200 of reading

Front 29

assessing frequency

Back 29

- percentage of syllables stuttered (perferred)
- percentage of words stuttered
- number of stutters per 100 words

Front 30

assessing type

Back 30

- count both types (typical and atypical)
- if <50% are SLDs, child is most likely to be normally disfluent (per Yairi)
- children who stutter have 3+ SLDs per 100 words

Front 31

assessing duration

Back 31

- record three longest disfluencies
- calculate mean

Front 32

assessing severity

Back 32

- use SSI
- examines sum of frequency, duration and physical concomitants

Front 33

assessing speaking and reading rate

Back 33

speaking rate thought to affect severity of stuttering

Front 34

when to reassess

Back 34

- after every 10 hours of treatment
- use diagnostic probe rather than full test
- take 5 minutes worth of data per session

Front 35

good prognostic indicators

Back 35

- decrease in SLDs during first 12 months
- female gender
- no stuttering in family history
- good language and articulation skills, no phonological problems
- good non-verbal intelligence scores
- good temperament

Front 36

SSI-4

Back 36

- use 150-500 syllable sample
- tests frequency, duration, and physical concomitants
- poor interjudge reliability due to subjective factors while assessing secondaries
- validity not convincingly demonstrated
- tests severity only, does not differentiate between normal disfluency and stuttering

Front 37

how to score SSI-4

Back 37

- count: sound or syllable repetitions, prolongations, blocks
- do not count: rephrasing, phrase or whole word repetition, pausing without tension