Interview Information
- when did stuttering begin/in what type of speaking situation?
- family history of stuttering?
- why do you think you stutter?
- what do you do to try to stop stuttering?
- what situations do you stutter the most/least?
- do you avoid certain speaking situations/words/sounds?
- describe disfluencies when problem started/how it changed over time?
Typical Disfluencies
- occasional repetition of sound/word
- mid-utterance pauses
- interjected syllables (uh)
Atypical Disfluencies
- disfluencies that cause anxiety in speaker/listener
- impair communication of message
Types of Disfluencies
- repetitions (part/whole/phrase)
- prolongations (sound/syllable/silent)
- interjections
- silent pauses
- broken words
- incomplete phrases
- revisions
Stuttering
- most common among males
- onset usually before 6
- some people genetically predisposed
- stuttering is variable
- some disfluencies more indicative of disorder
- can cause grief, fear frustration, anxitey
Speech Sampling
- gather within more than one session in more than one setting (home, clinic, school, playground, etc.)
- from variety of speaking contexts (reading, dialogue, monologue)
- materials (pictures, narratives, reading passages)
Formal Assessment Tools
- Stuttering Severity Instrument 4th Edition
- Stuttering Prediction Instrument (children & adults)
Analysis of Speech Samples
- total # of disfluencies
- frequencies of different types of disfluencies
- duration of instances of disfluency
- speech rate
- types/frequencies of secondary behaviors
Secondary Behaviors
-behaviors that have developed in response to or in anticipation of stuttering (learned responses that have been reinforced)
Ex: associated motor behaviors, physiologic responses, avoidance behaviors, expectancy behaviors
Associated Motor Behaviors
- extraneous body movements (legs, arms)
- extraneous facial movements (eye blinking, nose/forehead wrinkling, head shaking_P
- extraneous movements of oral mechanism (lip quiver, tongue click, teeth grind, jaw clench, neck twitch)
Physiologic Responses
-respiratory factors (shallow breathing, prolonged inhalation, gasping)
-phonatory factors (pitch breaks, hard glottal attacks, alternating loudness)
articulatory factors (articulatory contacts of normal, easy hard, & misarticulations)
-prosodic factors (prolonged speech sounds, excessive stressing)
-rate of speech
Avoidance Behaviors
- learned response to unpleasant stimuli
- circumlocutions around sounds/words/topics
- avoidance of certain people, situations, events
- can be primary (alter verbal output) or secondary (reduce verbal output)
Expectancy Behaviors
- anticipating disfluency before occurring
- occurs for sounds, words, people, situations
- observe & obtain info from client
Diagnoses
- developmental stuttering
- episodic stress reaction
- psychogenic stuttering
- neurogenic stuttering
- cluttering
Stimulability
client’s ability to produce fluent speech
- elicit fluent speech using treatment techniques:
- prolonged speech
- gentle onset/airflow
- reduced speech rate
- reduced articulatory effort
