When is the onset of childhood stuttering the highest?
Between the 2nd and 4th birthday
Stuttering usually begins in childhood between what ages?
30 and 36months
What is the most efficient and effective strategy for preventing stuttering?
early identification and treatment
What percent of preschoolers continue to stutter after the first year or two of onset?
20-25%
If stuttering persists past…….
puberty it can become a life long disability
A substantial percentage of young preschoolers who stutter are later reported to have what 4 things?
- immature articulatory or phonological skills
- speech
- language
- learning difficulties
INDICATORS OF EARLY CHILDHOOD STUTTERING:
What kinds of speech disruptions are eliciting parental concerns?
- monosyllabic whole-and part word repetitions
- sound prolongations and tense pauses
- fixed artiulatory positions
- single syllable repetitions
Remission of stuttering can happen at any age but at least half occurs when?
within 2 years
Is there a family history of persistent stuttering?
A child from a family with a history of persistent stuttering is much more likely to continue to stutter for at least 3 year post onset.
Indicators of early childhood stuttering, what are 4 questions?
- what kinds of speech disruptions are eliciting parental concerns?
- Have the child’s speech disruptions changed since parents first became concerned?
- How long have parents been concerned about child’s fluency?
- How valid do parents’ concerns about stuttering appear to be?
INDICATORS OF NEED FOR TREATMENT
What are 4 questions?
- Is there a family history of persistent stuttering?
- Are the child’s speech and language abilities age-appropriate?
- Have the child’s speech disruptions changed from predominantly tow- or three-unit, seemingly effortless repetitions, to sound prolongations, tense pauses, and lengthy repetitions that are often accompanied by muscle tension and ancillary facial and body movements?
- Does the child often react emotionally or express concern about his or her disfluent speech?
INDICATORS OF NEED FOR TREATMENT:
T or F
Kids who stutter are more likely to have speech, language, and learning disabilities?
T
INDICATORS OF NEED FOR TREATMENT:
If a child’s disfluencies are accompanied by what 5 things for more than a year, the child has an increased risk that stuttering will persist for life?
- muscle tension
- interruptions
cessation of: - articulator movement
- airflow
- phonation
What do emotional responses potentially tell us about therapy?
The stuttering is evolving into a more complex/severe problem that can be more challenging to treat.
CLINICAL OBSERVATIONS AND TESTING:
4 steps for a diagnostic plan for preschoolers?
- observe/ video recording of child/parent interaction
- clinician joins parent child interaction (see how child responds)
- alternate speech-language tests with games (assess receptive language first)
- compare child with clinician VS child with parent
CLINICAL OBSERVATIONS AND TESTING:
What are 4 things you can do if the child has not stuttered or stuttered infrequently?
- story retell
- increase communicative stress by rushing the child
- stimulate emotionally or excite the child
- audiometric screening
Record samples on _______ _____ with _______ ________ and while engaged in different speaking tasks.
different days
different partners
How many syllables should you count in a sample?
500 to 1000
Word count may be better for two and three year old children, but syllable might be better for who?
children whose utterances include a sizable percentage (>25%) of multi-syllable words.
Procedure A
- count each syllable or word only once (and calculate the number of disfluencies)
- count the number of SLD’s (stutter like disfluencies)
SLD
Stuttering-like disfluencies
within-word repetitions, monosyllabic word repetitions having two or more iterations, sound prolongations or dysrhythmic phonation, tense pauses, or any other type of disfluency that is perceived to involve excessive muscle tension or effort in it’s production.
Procedure B
- only syllables are used in assessing a sample’s disfluencies
- must include a minimum of 500 syllables
Supplementary measures
- the % of total disfluencies that were SLD’s
- the % of SLR’s (two or more iterations)
- average # of iterations found in 10randomly selected SLR’s and the largest # found i one SLR
- the % of disfluencies clustering on the same or adjacent syllables or words, and the average # of disfluencies per cluster
- the % of SLD’s that were accompanied by accessory behaviors in 10 randomly selected SLD’s
- mean duration of 10 randomly selected, dysrhythmic phonation and of 10 tense pauses
Mairi 1997
Children who stop stuttering without receiving treatment within 2 years of stuttering onset evidence decreases in their SLD’s during the first 15 months following stuttering onset.
