Fluency Exam 1

Front 1

What are three of the earliest historical examples of stuttering existing?

Back 1

-egyptian hieroglyphics
-bible (moses)
-Demosthenes

Front 2

What are 5 historical explainations of stuttering?

Back 2

-punishment for sin
-physiological (Hippocrates: comingling of the humors, Mercurialis: brain humidity)
-defects in sp. mech/structure
-symptom of psychopathology
-learned behavior

Front 3

What does "epidemiology" mean? How does it apply to stuttering?

Back 3

-both incidence and prevalence in large populations
-prevalence = 1%
-incidence = 5%

Front 4

What are the 3 P's in regards to stuttering etiology?

Back 4

Predisposing Factors
Precipitating Factors
Perpetuating Factors

Front 5

What are some predisposing or constitutional factors of stuttering?

Back 5

-genetics (predisposition runs in families)
-psych, social, linguistic factors

Front 6

What are some precipitating or devel/environ. factors of stuttering?

Back 6

-stressors (internal/external)
-rapid lang. growth
-sibling competition for attn/convo.
-transitions/life changes
-structural abnormalities

Front 7

What are some perpetuating factors of stuttering?

Back 7

-strength of habit
-criticism of speech by others
-inappropriate lang. models
-unrealistic expectations of fluency
-feelings/attitudes/ anticipation of failure

Front 8

What % of kids who stutter have a stuttering relative in their...
--extended family?
--immediate family?
--parent?

Back 8

ex: 68%

imm: 39%

par: 27%

Front 9

How does gender factor in to stuttering incidence and recovery?

Back 9

-male:female bigger with age (1:1 at start, 3:1 at age 6, 5:1 at age 10)
-females recover earlier and more frequency

Front 10

How do we study PWS using behavioral genetics?

Back 10

-Family studies (Pedigree, case-control)
-familial incidence (twin, familial aggregation studies)

Front 11

What are some issues with sampling a population to determine incidence/prev. of PWS?

Back 11

-inconsistent definition of "stuttering"
-inaccurate long term mem. account from subjects
-false + with too broad a definitions, false - with too narrow
-need for standardization of procedures!

Front 12

What are the 3 factors to consider when characterizing stuttering?

Back 12

Frequency of stuttered moments
Intensity of the stutter
Duration of the stutter

Front 13

What are 5 helpful characteristics when considering whether speech is fluent?

Back 13

-presence of extra sounds (rep., prol., filler., revis)
-location and freq. of pauses
-rhythmical patterning of speech
-intonation and stress
-overall rate

Front 14

Describe the idea of stuttering as a physiological deficit

Back 14

-abnormal CNS functioning
-biochem imbalance
-physical predisposing cause
-incomplete cerebral dominance

Front 15

Describe the idea of stuttering as a Neurotic response (repressed need)?

Back 15

-oral or anal fixation
-mental conflict, desire to both speak and be silent
-Freud
- no longer considered plausible

Front 16

Describe stuttering as a communicative failure and anticipatory struggle behavior

Back 16

-diagnosogenic theory: because parents "hear" stuttering, the kids stutter
-worry about stutter, makes the stutter worse

Front 17

What is the continuity Hypothesis of stuttering?

Back 17

-result of the person anticipating and dreading stuttering
-normal disfluencies become tense and fragmented and frustration and failure increase
-anticipatory struggle
-trying too hard-->stuttering

Front 18

Describe stuttering as a learned behavior

Back 18

-prepatory set (van riper)
-conflict theory and avoidance reduction (sheehan)
-operant conditioning (shames)
-instrumental avoidance act theory (wischner)
-2 factor learning theory (brutten & shoemaker)

Front 19

Differentiate classical vs. instrumental learning

Back 19

cl: motivationally stimulated by a previously neutral stim.

inst: stress messes up body--disfluency

Front 20

Describe stuttering as a result of disturbed feedback

Back 20

-auditory feedback defect
-servomechanism feedback model

Front 21

Describe stuttering as a physiological deficit

Back 21

-timing disorder (planning)
-sensory motor model (can't use inverse internal model of sp. prod)
-cerebral loc. (delay in L. hemi. growth)
-neurophys. (difficulty devel. automaticity in speech)

Front 22

Describe the idea of "sensitive temperment"

Back 22

-may have a lower threshold to react to threats
-leads to inc. tension, esp. in larynx-->stuttering!
-if emo. are lateralized right, then high emo. rx. leads to high avoidance, fear, etc.

Front 23

Describe the demands and capacities model

Back 23

-demands for speech (much to say, pressure to say it right) exceed capacities (motor speech control, lang. formulation, soc/emo maturity, cog. skill)

Front 24

What are the 4 capacities for fluent speech (starkweather etc)?

Back 24

motor speech production
lang. formulation
soc/emo maturity
cog. development

Front 25

What are 3 categories of demands for fluent speech?

Back 25

-time pressures (parents too fast, on-demand speech, high excitement)
-uncertainty (move home, new sib, parents divorce)
-avoidance (inadvertent neg. listener responses)

Front 26

What are 3 theories based on developmental / environmental factors in stuttering?

Back 26

-diagnosogenic
-stutt. as comm. failure and antic. struggle
-capacities and demands

Front 27

What are some developmental precipitating factors of stuttering?

Back 27

-physical maturity
-cog. ability
-soc/emo maturity
-sp./lang maturity

Front 28

What are some environmental factors of stuttering?

Back 28

-parents
-sp/lang environment (time, competition, etc)
-major life evetns

Front 29

What are the top 10 life events that can influence stuttering?

Back 29

-family relocates
-parents divorce
-death
-family member sick
-loss of job
-sibling hospitalized
-birth of sibling
-another person lives in home
-extended travel for parents
-holiday stress

Front 30

Describe instrumental conditioning

Back 30

-escape behaviors are positively reinforced because they lead to fluency
-they are negatively reinforced because the frustration leaves when behavior is used

Front 31

What is the most common type of dysfluency in normally developing kids?

Back 31

-WWRs

Front 32

What are some categories of NORMAL disfluencies?

Back 32

-PWRs (single and multi-syllable)
-WWRs (most common in kids)
-phrase reps
-fillers
-revision of inc. phrases
-prol
-tense pauses

Front 33

What are some signs that stuttering is developing , based on the characteristics of the disfluencies?

Back 33

-PWRs > WWRs
-PW repeat more than 2x
-short vowel added in PWRs
-sound held > 1sec
-more than 1 prol. in 100 words
-excessive muscle effort, struggles

Front 34

What characteristics of a disfluent moment differentiate normal and abnormal disfluency?

Back 34

-frequency
-intensity
-duration

Front 35

What are the 4 subcategories of stuttering?

Back 35

1. core behaviors (rep/prol/blk)
2. 2ndary behaviors
3. feelings/attitutdes
4. underlying processes (stressors, psych/soc, conditioned emo. rx.)

Front 36

How can you ddx normal and abnormal disfluency?

Back 36

>10% disfluent syllables
> 1 or 2 reps or filers in a row
-type of disfluency (fill, rev., WWR most common until age 2

Front 37

Describe 2ndary behaviors, feelings/attitudes and underlying processes of the normally disfluent child

Back 37

-2ndary: none
-feelings: unaware
-bio & devel. factors compete for cerebral factors, prag. affect disfluency, environ. stressors

Front 38

Describe the ___ of Borderline Stuttering
-core behavrios?
-2ndary
-feelings
-underlying proc.

Back 38

c: >10% disf., mostly reps and prol., >2 units in a disf.
2: few or none
F: mostly unaware
U: mostly like PND, predisposed to stutt., demands > capacity, psych conflict of desiring independence and security

Front 39

Describe the ___ of Beginning Stuttering
-core behavrios?
-2ndary
-feelings
-underlying proc.

Back 39

C: rapid/irreg. patterns, inc. tension, blocks, inc. # disf.
2: inc. muscle tension, escape behaviors
F: aware, tense, frustrated
U: const. & environmental factors