fluency

Question 1

what are the forms of dysfluency

Answer 1

1. repetitions
2. prolongations
3. interjections
4. pauses
5. broken words
6. incomplete sentences
7. revisions

Question 2

what are the different types of repetitions

Answer 2

1. part word (sound or syllable repetitions). s-s-s-ssaturday
2. whole word repetitions. I I I am fine
3. phrase repetitions: repetition of more than one word

Question 3

what are the different types of prolongations

Answer 3

1. sound prolongations: lllllikeit

2. silent prolongations: articulatory posture held with no vocalization (block)

Question 4

what are interjections

Answer 4

1. sound or syllable. um
2. word interjections: like, okay, well
3. phrase interctions: you know, I mean

Question 5

what are broken words

Answer 5

pauses between syllables or intralexical pauses

Question 6

revisions

Answer 6

changing in wording that does not change the overall meaning

Question 7

what is concordance

Answer 7

occurrence of the same clinical condition in both twins

Question 8

what populations have higher prevalence of stuttering

Answer 8

1. ID especially Downs

2. brain injury

Question 9

what population has a lower prevalence

Answer 9

hearing loss

Question 10

where are repetitions most common

Answer 10

beginning of sentences and phrases

Question 11

what words do children mostly stutter on

Answer 11

function words such as pronouns, conjunctions, and articles as well as content words

Question 12

what words do adults mostly stutter on

Answer 12

content words

Question 13

what are typical secondary behaviors

Answer 13

1. excessive muscular effort
2. facial grimaces
3. hand and foot movements (wringing, tapping)
4. rapid eye blinking
5. knitting eyebrows
6. lip pursing
7. rapid opening and closing mouth
8. tongue clicking

Question 14

what is needed for a diagnosis of stuttering

Answer 14

excessive frequency and duration of dysfluencies

secondary behaviors not crucial but assure a diagnosis

Question 15

what breathing abnormalities are associated with stuttering

Answer 15

1. speaking on inhalation
2. holding breath before talking
3. attempts to speak when air supply gone
4. interruption of inhalations by exhalations
5. speaking without first inhaling enough air
6. rapid and jerk breathing during speech
7. exhaling puffs of air during stuttered speech
8. tensed breathing

Question 16

what is the loci of stuttering

Answer 16

the location in a speech sequence where stuttering typically observed

Question 17

what is the loci of stuttering for adults and school aged children

Answer 17

1. consonants rather than vowels
2. first sound or syllable of a word, first word in a phrase, sentence or grammatical class
3. on longer less frequently used words
4. content words

Question 18

what is the loci of stuttering for preschoolers

Answer 18

same as adult except on function words which are often at the beginning of phrases
children also have more whole word repetitions

Question 19

when is adaptation greatest

Answer 19

during first few oral readings
by 5th time the most reduction will have occurrred
there is no transfer from one passage to the next

Question 20

what is the consistency effect

Answer 20

when a passage is reread after 6 weeks and the stuttering remains
indicator f the strength of the stuttering stimuli

Question 21

what is the adjacency effect

Answer 21

measured in oral reading

occurrence of new stuttering on words surrounding stuttered words

Question 22

what is the audience size effect

Answer 22

frequency of stuttering increases with increase in audience size
stuttering may be absent when they talk to themselves

Question 23

what is the genetic hypothesis of stuttering

Answer 23

genetic basis to stuttering

currently no genetic transmission theory is universally accepted

Question 24

what is the neurophysiological hypothesis of stuttering

Answer 24

differences in the neurophysiological organization

Question 25

what is the laryngeal dysfunction hypothesis

Answer 25

stuttering aused by slightly delayed VOT may be associated with increased tension in laryngeal muscles, simultaneous activation of abductors and adductors and excessive laryngeal muscle activity during stuttered speech

Question 26

what is the brain dysfunction hypothesis

Answer 26

lack of dominant hemisphere 2. impaired cerebral blood flow 3. aberrant brain waves 4. CNS dysfunction 5. auditory feedback issues

Question 27

what is the learning, conditining and related hypotheses

Answer 27

stuttering is a learned behavior stuttering is an avoidance behavior due to parental punishment stuttering is a cultural phenomenon that exists in some societies stuttering is a social role conflict

Question 28

what is the mismatch hypotheses

Answer 28

capacities and demands model

Question 29

what is the leading edge hypothesis

Answer 29

speech disruptions of typically developing children tend to occur on more advanced sentence structures

Question 30

what is necessary in a case history for fluency

Answer 30

1. specific behaviors at onset 2. development over the years 3. variability 4. family prevalene 5. prior treatment 6. education and occupation aspirations 7. general health, language and speech development

Question 31

what needs to be assessed for fluency

Answer 31

1. frequency and types of dysfluencies through a sample 2. variability of stuttering in different environments, assessed through verbal reports from family 3. associated motor behaviors and avoidance behavior 4. speech and artic rate 5. negative emotional reactions 6. stuttering severity 7. QOL

Question 32

how are associated motor behaviors assessed

Answer 32

1. note during assessment 2. family member describe 3. administer a behavior assessment battery

Question 33

how are avoidance behaviors assessed

Answer 33

1. have client list sounds, words, situations and audiences he avoids 2. take note of words and sounds avoided during interview 3. family members list 4. behavior assessment battery

Question 34

how is speech rate assessed

Answer 34

count number of words or syllables spoken per minute for 3 two minute samples

Question 35

how are negative emotions assessed

Answer 35

1. have client describe her emotions about speech 2. ask family or friends 3. administer behavior assessment battery

Question 36

what are some behavior assessment batteries

Answer 36

1. Behavior Assessment Battery for Adults who Stutter 2. Behavior Assessent Battery for School-Age Children Who Stutter 3. Communication Attitude Test for Preschol and Kindergarten Children Who Stutter

Question 37

what is the diagnostic criteria for stuttering

Answer 37

1. 5% of spoken words 2. frequency of part-word repetitions, speech-sound repetitions and broken words at least 2% 3. excessive duration. 1 second or longer 4. dysfluencies on at least 3% of syllables, prolongations, schwa vowel in syllable repetitions and associated tension

Question 38

what is the fluent stuttering method

Answer 38

1. Van Ripers approach | 2. stutter more fluently approach

Question 39

what is included in the fluent stuttering method

Answer 39

1. desensitize: voluntary stuttering | 2. modify through cancellations, pullouts, and preparatory sets

Question 40

what is the fluency shaping method

Answer 40

1. goal is to establish normal fluency through management of airflow, slower rate through syllable prolongation and gentle onset of phonation

Question 41

what are the targets for the fluency shaping method

Answer 41

1. airflow management: inhale and immediate slight exhale before phonation. Maintain airflow through utterance 2. easy onset 3. reduced rate through syllable prolongation. No breaks in phonation. The vowel following the initial consoant is prolonged

Question 42

what is Camperdown

Answer 42

fluency shaping program that includes only prolonged speech at a reduced rate as a target. 2. clients practice with prolonged speech with a model video 3. rate gradually increased

Question 43

what is the limitation of fluency shaping

Answer 43

generates slow, unnatural speech | relapse common when rate increased

Question 44

what is the fluency reinforcement method

Answer 44

positive reinforcement of fluent speech in naturalistic conversational contexts 2. used for young children 3. speech evoked with books, toys etc 4. positve reinforcement for fluent utterances 5. modeled slow, relaxed speaking rate 6. Lidcombe Program

Question 45

what are direct stuttering reduction methods

Answer 45

reduce stuttering directly, without specific fluency or modifying skills 2. methods include time-out and response cost

Question 46

what is pause-and-talk or time out

Answer 46

1. person taught to pause after each stutter and then resume talking 2. clinician says stop or gives another signal when dysfluency observed 3. avoids eye contact with client for 5 seconds 4. re-establishes eye contace and lets client continue 5. socially reinforces fluent speech (smiles etc) 6. preferred for older children and adults

Question 47

what is the response cost method

Answer 47

clinician takes away a token which is awarded for every fluent production 2. progress from words and phrases to conversational speech 3. fade tokens when fluency is susained at 98% or better across 4 sessions then maintain with verbal praise alone 4. preferred for young children

Question 48

what should be considered when treating preschool children

Answer 48

1. parent counseling and consultation 2. counseling about bullying 3. select effective reinforcers for the child 4. fluency reinforcement in naturalistic play often effective 5. child should enjoy therapy. Generously reinforce fluency, minimizing corrective feedback

Question 49

what should be considered when treating older students and adolescents

Answer 49

1. teach self monitoring skills; child counts stutters 2. fluency shaping and time out are good choices 3. oral reading reinforces reading rate 4. teach child to talk frankly about their stuttering to reduce teasing 5. parent counseling and patient training important 6. train teachers to prompt and reinforce fluency, be patient, and support clinicians effort

Question 50

what should be considered when treating adults

Answer 50

1. teach self monitoring skills 2. explain treatment and the evidence for it 3. fluency shaping and time out good choices 4. counsel spouse to reinforce fluency

Question 51

how do you generalize the treatment

Answer 51

1. when a certain level is reached, have unfamiliar people come to the session for conversation 2. take client out of clinic into other settings to reinforce fluency 3. reinforce fluency in various settings 4. teach self monitoring skills

Question 52

What is the etiology of neurogenic stuttering

Answer 52

1. Cerebral vascular disorders that cause stroke 2. Right hemisphere disorder 3. Extrapyramidsl disorders such as Parkinson’s 4. Drug toxicity 5. Bilateral brain damage 6. TBI 7. MS

Question 53

What are chacteristics if neurogenic stuttering

Answer 53

1. Evidence of neuropathologies 2. Increased rate of dysfluencies 3. No adaptation effect 4. Minimal variability 5. Few associated behaviors 6. Minimal effects if delayed feedback, choral reading, singing 7. No anxiety or associated behaviors

Question 54

What do you assess for neurogenic stuttering

Answer 54

. Coexisting aphasia, apraxia, dysarthria, or dementia | 2. Rule iut preexisting developmental stuttering

Question 55

How do you trest neurogenic stuttering

Answer 55

Symptomatically by reducing rste, delayed auditory feedback, pacing board

Question 56

What is cluttering

Answer 56

Fluency disorder that coexists with stuttering 2. Characterized by reduced intelligibility, rapid and irregular speech, imprecise artic, disorganized language, poor prosody and discourse 3. No obvious concern about problem 4. Rate variations 5 frequent pauses 6. Omission and compression of sounds 7 jerky or stumbling rhythm 8. Spoonerisms: interchanging sounds in a sentence ( many thinkle peep vs many people think

Question 57

How do you treat cluttering

Answer 57

Reduce rate of speech | Increase clients awareness of problem through video

Question 58

what are Van Der Merwe's 5 origins of stuttering

Answer 58

1. frontoimbic: intent to speak 2. Linguistic-planning: choosing words 3. Motor Planning: establishing temporal and spacial specifications 4. motor programing: instructions to muscles 5. Execution

Question 59

what is a preperatory set

Answer 59

prolongation that is used in expectation of upcoming difficult word creates a change in segmental duration which is a change in motor planning

Question 60

what are the Van Riper's 4 stages of stuttering modification

Answer 60

1. identification 2. desensitization 3. modification: cancellation, pullouts, preparatory set 4. stabilization: patient becomes own therapist

Question 61

what is cancellation

Answer 61

after a stuttered word, pause and say it again before going on

Question 62

what is Webster's theory on the Disorder of Brain Organization

Answer 62

1. PWS have normal localization of speech in left hemisphere but the supplementary motor area is vulnerable to disruption by activities in other areas

Question 63

what is the covert repair hypothesis

Answer 63

stuttering is the repair of phonological errors

Question 64

what are normal dysfluencies

Answer 64

revisions: where are....can I go with you interjections: uh repetitions of 2 extra units or less: he... he is my friend

Question 65

what is borderline stutterine

Answer 65

``` more than 7 stuttered words per 100 part word repetitions and prolongations frequent repetitions of more than one extra sound age: 1.5-3.5 no tension or struggle ```

Question 66

what is beginning stuttering

Answer 66

repetitions more hurried characterized by neutral vowel: muh muh Mike blocks appear tension exhibited but no strong negative feelings older preschool age

Question 67

what is intermediate stuttering

Answer 67

most notable behavior is block child begins to fear stuttering age 6-13

Question 68

what is advanced stuttering

Answer 68

tension, escape, avoidance longer blocks affects school, work and social lives

Question 69

how do you identify covert behaviors in the classroom

Answer 69

disparity between written and oral performance

Question 70

what are ways to bring about fluency

Answer 70

1. prolongations 2. chorale speech 3. shadow speech: spoken directly after

Question 71

describe the Lidcombe Program

Answer 71

Stage 1: 1. assess severity, explain rating to parents, teach parent to conduct daily treatment conversations 2. structured treatment: sit with child 15 minutes a day, read with them to bring about speech, start at their linguistic level 3. after progress for 2-3 weeks begin unstructured treatment and fade structured treatments Stage 2: 1. when parent and clinician ratings are all 1-2 for 3 weeks in a row2. reduced verbal contingencies takes about 1 year

Question 72

how do you teach fluency skills

Answer 72

1. flexible rate: slowing 2. pause: preparatory set 3. easy onsets: 4. light contacts 5. proprioception: conscious attention to movements of articulators