Stuttering From Comps

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Stuttering Definition

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A disorder of fluency and of rhythm

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Stuttering Types

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Anticipatory, apprehensive, hypertonic, avoidance reaction; What a person does to avoid stuttering; Social role conflict

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Stuttering Facts

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; Both genetic factors and environmental factors play a part in the etiology; Onset is between 3-6 years of age. Adult onset is rare; Onset may be sudden or gradual; Incidence is 1% in the U.S. population; More males than females. Ratio 3:1 in elementary, 4:1 in higher grades; Family prevalence is higher than the general population, especially in families that have a female who stutters as opposed to a male; Concordance rate in identical twins is 30-80%

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Different Types of Dysfluencies

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1. Repetitions: Part/whole or phrase; 2. Sound prolongations; 3. Silent propogations: articulatory postures held for a duration longer than average without vocalization; 4. Interjections; 5. Pauses; 6. Broken Words; 7. Incomplete Sentences; 8. Revisions

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Spontaneous Recovery

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Stuttering disappearance without professional help. Recovery rate has been reported at either 30-35% or 60%

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Associated Motor Behaviors: (accidentally reinforced)

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Excessive muscular effort ; Various facial grimaces ; Various hand and foot movement (tapping the foot); Rapid eye blinking; Knitting of the eyebrows; Lip Pursing; Rapid opening and closing of the mouth; Tongue clicking

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Associated Breathing Abnormalities: (stuttering symptom complex)

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Attempts to speak on inhalation; Holding breath before talking; Continued attempts to speak even when air supply is exhausted; Interruption of inhalations by exhalations and vice versa; Speaking without first inhaling a sufficient amount of air; Rapid and jerky breathing during speech; Exhaling puffs of air during stuttered speech; Generally tensed breathing

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Loci of Stuttering: Adults and School Age Children

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Consonants more than vowels; First sound or syllable of a word; First word in a phrase or sentence; First word in a grammatical clause ; Longer words; Less frequently used words; Content words; Preschool Children: Same as adults except more on function words rather than content words; More whole word repetitions

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Stimulus Control

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Variations found in the frequency of stuttering are due to variations in stimuli which suggest a strong environmental control

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Adaptation Effect

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The systematic reduction in the frequency of stuttering when a short printed passage is repeatedly read aloud. (Most reduction had occurred by the fifth reading.) Adaptation is due to a deconfirmation of the expectancy of stuttering, which results in reduced anxiety and reduced stuttering or reduced fear, or the rehearsal effect

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Consistency Effect

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The occurrence of stuttering on the same word or loci when a passage is read aloud repeatedly

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Adjacency Effect

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The occurrence of new stuttering on words that surround previously stuttered words

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Audience Size Effect

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The observation that the frequency of stuttering increases with an increase in audience size

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Genetic Hypothesis

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A potential genetic basis of stuttering is suggested by the following observations: High familial incidence; Gender ratio in the prevalence of stuttering; Higher concordance rate among identical twins; No gene or chromosomal abnormality responsible for stuttering has been identified

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Neurophysiological Hypothesis

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People who stutter have an abnormal neurophysiological or neuromotor organization

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Laryngeal Hypothesis

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Due to aberrant laryngeal functions

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Hypotheses on the brain & speech & language mechanisms & stuttering

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The auditory portion of the brain may not be working properly or there may be an auditory processing problem

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Learning, Conditioning, and Related Hypotheses:Stuttering as an operant behavior

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(changed by changing its consequences=learned.)

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Learning, Conditioning, and Related Hypotheses: Stuttering as speech disruption due to classically conditioned negative emotion

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Stuttering can only be reduced by counter-conditioning more positive emotional reactions that replace the negative emotions

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Learning, Conditioning, and Related Hypotheses: Stuttering as avoidance behavior

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Parents punish a child’s normal nonfluencies, the child develops anticipatory, apprehensive and hypertonic avoidance reactions that are indeed stutterings

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Learning, Conditioning, and Related Hypotheses: Stuttering as approach avoidance

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A stuttering person’s hesitations and repetitions indicate a conflict in the desire to approach speaking situations and an equally strong desire to avoid them

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Learning, Conditioning, and Related Hypotheses: Stuttering as a reaction to tension and fragmentation

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Communicative pressure leads to communicative failures. A child believes that the speech task is too difficult

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Learning, Conditioning, and Related Hypotheses: Stuttering due to demands exceeding capacities

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Stuttering can result when a child faces demands for communication that he/she cannot meet because of limited capacities

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Learning, Conditioning, and Related Hypotheses:Stuttering as a form of psychoneurosis

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May be a psychological disorder

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Psychological Methods of Treatment

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Psychotherapy and counceling

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Fluent-Stuttering Method: (Van Riper)Aka Stutter-more-fluently approach:

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Modifying the severity and visible abnormality of stuttering is the most realistic goal for many people who stutter

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Fluency Reinforcement Method:

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Positively reinforce fluent speech in young children in a naturalistic conversational contexts

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Masking and Delayed Auditory Feedback Techniques

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Altered auditory feedback of speech. Uses delayed auditory feedback (DAF), to induce a slow speech with reduced prosodic features, syllable prolongation, and prolongation of vowels

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Direct Stuttering Reduction Methods

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To reduce stuttering directly without teaching specific fluency skills or modifying stuttering into less abnormal forms. The behavior methods of time-out (pause after each dysfluency) and response cost (a positive reinforcer is taken away) may be used

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Cluttering

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A disorder of fluency characterized by rapid but disordered articulation, possibly combined with a high rate of dysfluencies & disorganized thought & lang. It tends to coexist w/ stuttering, but not the other way around. Excessive amounts of dysfluencies, rapid reps of syllables, clearer artic with slower rate of speech, monotone, jerky/stumbling, reduced awareness/anxiety