Normal disfluencies: (exp age range and what the child presents with)
age range 1.5-6 years
-although a small amount of normal disfluencies continues in mature speech
Young preschoolers/borderline stuttering: (exp age range)
1.5-3.5
Older preschoolers/beginning stuttering what is the age range?
3.5-6
School-age/intermediate stuttering (age)
6-13
Advanced stuttering/older teens and adults (age)
14+
T or F you should know the severity of the client before you start treatment.
True
What are some examples of normal disfluencies? (8)
- part-word rep (mi-milk)
- single syllable word rep (I…I want that)
- multisyllabic word rep (lasie…..lasie is a good dog)
- phrase rep (I want a…I want a icecream)
- Interjection (He went to the…uh…circus)
- Revision-incomplete phrase (I lost my….where’s mommy going?)
- Prolongation (I’m TIIIIIIIImmmmmyyyy)
- Tense Pause (can i have some more (lips purse tog no sound) milk?
T or F btwn 2-5yrs old most children have normal repetition, prolongations, and pauses.
True
What are the characteristics of normal disfluency in the avg nonstuttering child?
- no more than 10 dis. per 100 words
- typically one-unit repetitions, occasionally two
- most common disfluency types are interjections, revisions and word repetitions. As children mature past 3, they will show a decline in part word reps
Normal disfluency children age 2-5 do normal disfluent children react to their disfluencies?
no they seem unaware
What are some factors that may increase normal disfluencies?
demands on lang acquisition
delayed speech motor skills
stress
competition and excitement when speaking
What are characteristics of younger preschool children (borderline stuttering age 2-3.5)
- more than 10 disfluencies per 100 words
- often more than two units in repetition
- more repetitions and prolongations than revisions or incomplete phrases
- disfluencies loose and relaxed
- still rare for children to react to disfluencies
What are the three things that help a child outgrow borderline stuttering.
resource allocation to compensate
speech and language systems mature
conflicts resolve
what are the two underlying processes that may cause stuttering?
constitutional (speech and lang dev)
environment (comm, stress/psychosocial stress)
What are some characteristics of beginning stuttering ages 3.5-6 (older preschool children)
- signs of muscle tension and hurry appear in stuttering. repit. are rapid and irregular with abrupt terminations of each element.
- pitch rise may be present toward the end of a rep/prolong.
- fixed articulatory postures are sometimes evident when the child is momentarily unable to begin a word, apparently as a result of tension in spch musculature
- escape behaviors are sometimes present (eye blinks, head nods, ums)
- awareness of diff. and feelings of frustration are present, but there are not strong negative feelings about oneself as a speaker
What are the characteristics of school age children 6-13 intermediate stutterers?
- most freq core behaviors are blocks in which the stutterer shuts off sound or voice. He may also have repetitions and prolongations.
- stutterer uses escape behaviors to terminate blocks
- stutterer appears to anticipate blocks, often using avoidance behaviors prior to feared words. He also anticipates diff situations and sometimes avoids them
- fear before stuttering, embarrassment during stuttering, and shame after stuttering characterize this level espc fear.
T or F classical conditioning can create more tension in stuttering in more situations.
True
T or F instrumental conditioning creates a more complex array of escape behaviors.
True
T or F. Avoidance conditioning creates extra sounds and behaviors before the feared word and causes child to avoid more and more words and situations.
True
At what age do children move into advanced stuttering?
13
What are some characteristics of advanced stuttering in teens and adults age 13+?
- most frequent core behaviors are longer, tense blocks, often with tremors of the lips, tongue, or jaw. Individual will also probably have repetitions and prolongations
- stuttering may be suppressed in some individuals through extensive avoidance behaviors
- complex patters of avoidance and escape behaviors characterize the stutterer. these may be very rapid and so well habituated that the stutterer may not be aware of what he does.
- emotions of fear, embarrassment, and shame are very strong. stutterer has negative feelings about himself as a person who is helpless and inept when he stutters. This self-concept may be pervasive.
Normal disfluency 1.5-6 yr……
core behaviors: 10 or fewer dis. (one unit reps/mostly reps, interjections and revisions
- no 2ndary beh
- not aware no concern
- -underlying process =stresses of speech/lang /psychosocial development
Boderline stuttering 1.5-3.5
core behaviors: 11 or more disfluencies per 100 words (more than 2 unit reps; more reps and prolongations than interjections/revisions)
-no 2ndary beh.
-attitudes/feelings: generally not aware; may occasionally show momentary surprise or mild frustration
underlying processes: stresses of spch/language and psychosocial development interactive with constitutional predisposition.
Beginning stuttering 3.5-6 yr
core behaviors: rapid, irregular, and tense repetitions may have fixed articulatory posture in blocks
- 2ndary behaviors: escape behaviors (eye blinks, increases in pitch or loudness as disfluency progresses)
- feelings and attitudes: aware of disfluency; may express frustration
–underlying processes: conditioned emotional reactions causing excess tension; instrumental conditioning resulting in escape behaviors
