Communication Science > Fluency Disorders > Flashcards

Fluency Disorders Flashcards

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1
Q

What is fluency

A

Effortless flow of speech
Ability to produce speech
with normally long strings of sounds
at a normally rapid rate
without pausing or hesitation
normal amount of effort

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2
Q

What is disfluency

A

Dis is the perfered spelling and fluency
Dys is negative connation
Disruption or breakdown in flow of speech

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3
Q

What is normal disfluency

A

Everyone experiences minor interruptions inthe flow of speech at times
especially common in young children as they are starting to produce sentences

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4
Q

What is stuttering

A

Interruption in the flow of speaking, characterized by specific types of disfluencies, including
repetitions of sounds, syllables and words
prolongations of consonants when it isn’t for emphasis
blocks inaudible or silent fixation or inability to initiate sounds

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5
Q

Normal disfluency

A

repetitions
- sentences
- phrases
- words
interjections
revisions
hesitations
no awareness or frustration
mostly fluent

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6
Q

What are some possible stuttering

A

Repetitions
syllables
individual sounds
sound prolongations
sound blocks
tense pauses
bursts of speech
clusters of disfluency
associated body movements blink eyes alot

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7
Q

How do you look at stuttering in children

A

In the first 6 months after onset, groups can look very similar
Strong decline in disfluencies within 1st year in the normal disfluency group
More likely to stutter if there is a family history of stuttering

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8
Q

What is developmental stuttering

A

Vast majority of people with fluency disorders usually a syllabal word or phrase repetition

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9
Q

What is non-developmental stutuerring and the two types

A

Neurogenic stuttering which is caused by damage to cerellbelum and brain stem high number of involuntary repetitions

Psychogenic stuttering is linked to their psychological stress; if you treat psychological issues stuttering can go away

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10
Q

What are some facts about developmental stuttering

A

A small percentage of the population currently stutters
small percentage will stutter during the course of their development
More prevalent in boys
Onset between 2-5 years

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11
Q

What are some facts about developmental stuttering

A

It is heritable, where it is more often in twins and runs in families and suggesting genetic predisposition

Variable
within utterances
day to day
across situations if tired or hungry or angry and nervous

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12
Q

when does stuttering decrease

A

Novel speaking manner
While alone speaking to animals or kids
disruptions in auditory feedback

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13
Q

Where does stuttering increase

A

anticipating stuttering
having to say specific words
talking on the phone

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14
Q

What is part word repetition

A

mi milk ddd dog

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15
Q

What is single syllable word repetition

A

I….I want that

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16
Q

What is multi syllabic word repetition

A

lassie lassie is a good dog

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17
Q

What is prolongation

A

I’m tiiiiiimy thompson

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18
Q

What is an interjection

A

he went to the uh circus

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19
Q

What is the revision or incomplete phrase

A

I lost my… where’s mommy going

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20
Q

What are bodily movements/struggles with secondary behaviours

A

Facial grimaces
Head movements
Loss of eye contact
Body movements

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21
Q

What are psychosocial behaviours

A

Avoidance
fillers, pretending to think, avoiding situations and people, appearing shy and quiet

Emotional responses before speaking, fear of loss of speech control

Emotional responses after stuttering,
embarrassment, shame, anger,frustrataion

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22
Q

What are etiology of neurogenic stuttering

A

Neurological damage or disease
Exposure to toxins

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23
Q

What makes nuerogenic stutering different than developmental or other types

A

Equally disfluent across different speaking situations
Secondary behaviours less common
Negative emotional response less common

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24
Q

What is psychogenic stuttering etiology

A

Psychological trauma, anxiety, depression other psychological disorder

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25
What are the distinctions of psychogenic stuttering and non-developmental
May be intermittent Unusual or bizarre speech/language patterns May respond quickly to behavioural treatment
25
What are the cluttering speech characteristics
Frequent whole-word and phrase repetition Rapid rate of speech Irregular rate of speech Misarticulations - Slurred or deleted phonemes Substitutions Cant generate next words quiet quick enough
26
What are the distinctions between cluttering from stuttering
Part word repetitions are infrequent Secondary behaviours are not really present Lack of awareness of or a negative emotional response to the problem Often, more fluent in conditions where the person who stutters is less fluent, sometimes, they actually clutter less when under stress conditions
27
What is the demands and capacities theory
Intrinsic and extrinsic social demands exceed the child's capacities for fluent speech like wanting to have perfect speech and high-stress environments
28
What is the covert repair theory?
Children have trouble organzing and planning the sounds of words in their head
29
What is neuropsycholinguistic
Stuttering = disruption in the timing of linguistic formulation and speech movement
30
What are the likely causes of stuttering
Genetic predisposition neurological dysfunction atypical cerebral organization (over-activation in the right hemisphere; under-activation in left) difficulty with auditory feedback Environmental stressors
31
What is the nature of the speech disfluencies
Occurrence of within word disfluencies Stuttering severity scale Occurrence of secondary behaviours Speaking rate
32
What are some other considerations
context feelings/attiudes
33
Using indirect methods how
changes in environment to stabilize fluency reinforcing fluent speech family involvement - deal with anxiety
34
What is the lidcombe program
Clinician mediated Parent implemented Behavioural treatment - preschoolers - adapted for school age The goal no stuttering
35
What is fluency shaping
Designed to modify all aspects of client's speaking behaviour Behavioural modification reearning speech motor movements to produce fluent speech Goal = stutter free speech
36
What are some parts of fluency shaping
Speak at a reduced rate Prolong voewl portions of words Use slow and smooth onsets of words continuous phonation
37
What are some problems with fluency shaping
Abnormal/artficial speaking pattern Skills may mot easily transfer out of therapy context Attention to speaking pattern ongoing
38
What is stuttering modification
Designed to address individual moments of suttering as opposed to changing entire pattern of speaking behaviour
39
What do clients learn to do in stuttering modificaiton
Stutter more fluently with less tension Use light articulatory contacts during speaking reduce situational fears and negative association with stuttering feel in control of stuttering
40
What are some problems with stuttering modification
Slower observable change May still have moments of stuttering
41
What are some non traditional treatment approaches
Hypotherapy controversial Drug therapy some success with dopamine blockers Electronic devices closely resemble hearing aids delayed auditory feedbacl
42
What are some considerations for multilingual speakers
Likely to stutter in multiple languages but more in the less proficient language Research is needed to support assessment and treatment in this population
43
How can listeners help with stutters
Listen to what the person is saying, not how they are saying it Maintain natural eye contact Wait until the person is finished (do NOT finish sentences or fill in words) Be especially patient on the telephone Don't give advice You speak in a slow and relaxed way
44
What is craniofacial abnormality
An abnormality of the face and /or head Abnormal growth patterns in soft tissue and bones
45
What is a cleft
Abnormal opening in an anatomical structure Due to disruption in embryological development - usually follows normal embryological fusion lines
46
What is a cleft lip and or palate
Craniofacial anomaly/abnormality Congenital malformation involving head and face Elongated opening resulting from failure of parts of the mouth to fuse or meger Occurs in utero during 1st trimester of pregnancy Interferes with basic biological functioning and communication risk for aesthetics feeding speech and resonance and hearing
47
When does the development of face and the anterior aspects of the mouth occur, and where do they fuse in normal development
5-8 weeks gestation Start to grow toward midline and lips fuse together
48
What is formed at 8-12 weeks gestation
Lip and palate meet at midline and develop from front to back
49
When do lip and palate fuse
Week 6, the lips fuse, and the soft palate fuses by week 12
50
What are some characteristics of cleft lip and palate
More common in combination of cleft lip and palate then just lip or palate varies according to racial group Varies according to sex 2:1 males to females have cleft of lip with or without a cleft palate 2:1 females to males have isolated cleft palate
51
What are the different types of cleft lip
Unilateral cleft lip or Bilateral cleft lip Complete cleft lip or Incomplete cleft lip Microform cleft small indentation in vermillion
52
What are some other aspects of cleft lip
Could have flattened nose flaring nostril Columella short,misaligned Most commonly left unilateral If bilateral usually also a cleft palate
53
What is complete cleft palate
Involved both hard and soft palate Extends through uvula
54
What is incomplete cleft palate
Cleft of soft palate and uvula only Hard palate fully developed
55
What is the submucous cleft palate
Cleft of muscular region of the soft palate thin layer of mucosal tissue which covers cleft Signs bifid uvula notch in hard palte
56
What is the most servere
Bilateral cleft of lip and palate which most servere
57
What causes cleft lip and or palate
Multifactorial causation (genetic environment) Known etiologies Chromosomal and genetic disorders Family history environmental factors such as teratogens, maternal nutritional deficiencies Higher in teen pregnancies with increased parental age
58
What are some complex issues with CL/P
Early feeding and nutritional problems dentofacial and orthodontic abnormalities hearing loss speech and resonance issues aesthetic issues Requires cooperation among many professionals
59
What are some typical team compostion
Audiology Genetics Orthodontis Otolaryngolgy Peadiatricain Peadatric dentis Psychology social work speech language pathology surgery
60
What are issues with feeding
Could impact infants ability to suck and swallow ability to squeece nipple with ips between tongue and alveolar ridge ability to maintain suction during swallowing may require obturatior
61
What is dentition
May have missing or malformed teeth particulary when cleft affects alveolar ride retursion is common
62
What are issues with hearing
Middle ear infection due to eustachian tube dysfunction Pressure equalization tubes if necessary
63
4 areas that are impacted in communication
History oral mechanism evaluation Voice/resonance articulation
64
What do you do in history
Surgery surgeris Nasal regurigation Swallowing diffculties Milestones Parent concerns and priorties VPI clinic Team
65
What is involved in the OME
examine structures and functions of the face ears nose lips tongue alveolus hard/soft palates uvula tonsils and pharnyx
66
What is apart of the voice and resonance
Difficulty regulating airflow through the nasal cavity ability to regulate air flowing through nasal cavity during speech production aka resonance cleft palate leads to velopharyngeal insufficiency which leads to hypernasal speech
67
How do you asses nasal speech
Mirror below nose M N O G listening and rating endoscope Measuring nasal airflow with a nasometer
68
What are some persistent problems can include
Nasal emission stop constants Fricative consonants Compensatory articulation errors Glottal stop Pharyngela lateral fricatives
69
What are example of assessment tools
Goldman fristoe test of articulation GFTA DEAP Speech sample
70
What can surgery involve | And what age are things repaired
Structural repair of the lip and palate Pharyngeal flap of sphincter pharyngoplasty to support VP function Lip repaired at 3 months (feeding) Palate repaired 9-15 months (speech)
71
What is treatment for dental
Orthodontics for malocclusions Prosthodontics obturtator speech bulb palatal lift
72
What are treatments for hearing
preventive or therapeutic insertion of myringotomy tubes for otitis media
73
What does speech-language focus on for the treatment of cleft lip and palate
Major focus is typically on reducing hypernasal resonance not many kids have a communication disorder following surgical reapair of cleft articulation goals may include differentiation between oral nasal sounds rduction of lgottal stop Traditional ariculation therapy approach visual feeback via electroplatography
74
What are some treatments of psychology
Psychoscoial issues Teasing/bulling - education/counselling Issues with education May result in heavioural problems dperession and anxiety
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