Stuttering Slp Praxis

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Developmental stuttering age of onset

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Age 2-6, occasionally later

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Cluttering

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Age 2 to 6, more notable as speech and language skills develop in school years

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Neurogenic stuttering age of onset

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Usually after early childhood and associated with a neurological event or condition

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Psychogenic stuttering

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Usually after early childhood and more common in adolescents and adults

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Developmental stuttering key causal factors

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Neurophysiology factors plus environmental conditions

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Cluttering key causal factors

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neurologic causes

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Neurogenic stuttering key causal factors

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Stroke, tbi, tumours, and other neurologic conditions

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Psychogenic stuttering key causal factors

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Develops in reaction to stressful or emotional situations or a traumatic event

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Developmental stuttering speech characteristics

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Prolongation, repetitions, blocks, secondary behavior are present; variable fluency under different conditions

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Cluttering speech characteristics

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High frequency of dysfluency, rapid and irregular speech rate

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Neurogenic stuttering speech characteristics

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Few or no secondary behaviors, attempts to modify speech are less successful

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Psychogenic stuttering speech characteristics

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Atypical and unusual; short-term Therapy may produce a dramatic improvement

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Developmental stuttering self-awareness

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Very aware, especially 1 to 2 years after onset; fear and embarrassment

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Cluttering self awareness

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Often (not always) unaware or not concerned

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Neurogenic stuttering self-awareness

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Varies; less likely to be embarrassed

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Psychogenic stuttering self-awareness

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Variable; may show exaggerated concern

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Normal dysfluency

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Occurs on less than 10% of words

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Borderline stuttering

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Greater than 10% of words stuttered

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Simple phrase repetitions, simple phrase repetitions, grammatical interjections (you know), and nongrammatical repetitions (umm)

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Normal dysfluency

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Normal dysfluency has no

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Secondary behaviors and it is rare for the child to notice dysfluency Es

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Begins to use sound or syllable repetitions of greater than three iterations, word repetitions of greater than three iterations, sound prolongation longer than one second, blocks longer than one second, circumlocutions, motor actions, emotional responses to stuttering

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Borderline stuttering

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In borderline stuttering

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There may be greater than 2 units of repetition and children show little awareness or concern

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Beginning stuttering

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Occurs when dysfluencies become more stutter-like and he or she begins to show more secondary behaviors in speech

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Escape devices and starters become obvious at this stage and children start to show the first signs of feeling surprised or threatened

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Beginning stuttering

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Happens when the child (usually in elementary or middle school) is afraid of his or her stuttering and is beginnng to use methods of avoidance

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Intermediate stuttering

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Intermediate stuttering

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Children begin to show blocks in addition to repetitions and prolongation. The child can also show anticipation of stuttering and show tension before a block becomes evident

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Child may be embarrassed and develop more complex forms of avoidance

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Intermediate stuttering

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Percent of children who exhibit stuttering at an early age who will recover

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80

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Conditions that can diminish stuttering

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Singing or reading in unison, delayed auditory feedback, speaking in less stressful situations

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The stuttering diagnostic approach

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Is to determine the prescence of stuttering or not, to differentiate the he type of fluency disorder, to o twin a careful history, to describe the core and secondary behaviors along with their severity, and understand the individuals attitudes and beliefs about his stuttering

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Ratio of males to females who stutter

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2:1 at onset and 5:1 in adulthood

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Consistency effect

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In successive speaking attempts of the same material, people who stutter are likely to stutter on the same words.

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Anticipation effect

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People who stutter are able to predict those words on which they are most likely to stutter

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Adaptation effect

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The overall amount of dysfluency decreases with repeated successive readings.

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Assessment of preschool children

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Determine whether or not the child has a speech disorder; obtain a history, speech samples to determine types of dysfluencies and amount of dysfluencies and any secondary behaviors, observe child with parent, also assess speech and language skills.

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Assessment of school-age children

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Focus on level of stuttering present, the type and severity of dysfluencies, and secondary behaviors; parent and teacher interviews, determine effect on school performance

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Assessment of adolescents and adults

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Determine the effect of stuttering on daily activities, communication, and quality of life. Assess the degree and severity, frequency and type of stuttering and any secondary behaviors. Self-assessment tools can be used to assess attitudes and avoidances.

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The best treatment for stuttering is

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One that considered the unique features and the liens background.

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Treatment for a young child with normal dysfluency or beginning stuttering

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Indirect methods: parent education, modeling relaxed speech, slower rates, and less linguistic complexity, reducing demands

Direct methods: teaching child how to respond to dysfluencies

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Treatment for school-age children who stutter

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Stuttering modification. Or fluency shaping

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Stuttering modification

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Focuses on reducing tension at the moment of stuttering, developing healthy communication attitudes and equipping the child who stutters for a variety of speaking situations.

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Fluency shaping

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The goal is to replace stuttered speech with fluent speech. This is done by rate modification, easy onset of phonation, light contact of the articulation, continuous phonation

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Treatment for adolescents and adults who stutter

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Building a trusting relationship, fluency shaping, stuttering modification, open discussion and reflection