What does SAAND stand for?
Stuttering Associated with Acquired Neurological Disorder
What is SAAND also known as?
Acquired/cortical stuttering
What are the causes SAAND?
TBI
Stroke (CVA)
Neurological or some disease process (tumor)
When is SAAND going to be transient?
if it is unilateral damage
When will SAAND not be transient?
If it is persistent bilateral damage
What information will you gather rather than get the % disfluent?
an extremely detailed medical case history, along with all medical documents
What questions should you ask?
Has the person always been disfluent (developmental stuttering)?
Because SAAND is an acquired Neurological dx…..
don’t just interview the client
get medical documents and interview family/caregiver/friend, etc.
What will you ask the family?
- is it developmental
- has it happened recently
- what precipitating events led to the stuttering (looking for medical trauma/emergency)
What types of stuttering should you be differentiating between?
- developmental
- psychological
- brain injury (neurological)
- malingering (litigation seeking money)
Observation and testing:
what do you need to rule out?
- is it a word finding issue?
- rule out motor speech issues (apraxia)
- rule out cluttering
- where do the disfluencies occur in the word?
What are two standard aphasia batteries?
- Boston
- aphasia profile
Check for the Loci of disfluencies? What is different between developmental and SAAND?
- developmental disfluencies occur in the word initial ONLY!
- SAAND can be in any position
Concomitant behaviors?
There are no concomitant features in SAAND
What is the adaptation effect?
For example a developmental stutterer will stutter on a reading passage, but when they read it the second time they will not stutter at all
-when SAAND tries this they will always stutter (repeated reading will never get better)
Automatized task
for example a developmental stutterer will be able to count or say the flag solute without stuttering. Someone with SAAND can’t do this.
Palilalia
disintegration of the substantia nigra
It is when some with Parkinsons will do rep’s faster and faster and it will fade out.
- this does not happen in SAAND
- but someone with parkinsons can have palilalia and SAAND
What details will the malingers not know?
- Palilalia
- automized tasks
- adaption effect
- concomitant behaviors
- loci of disfluencies
What are the 7 areas to assess and observe?
- standard aphasia battery
- loci of disfluencies
- concomitant behaviors
- adaptation effect
- automized tasks
- palilalia
- malingers
What kinds of words will SAAND be disfluent on? And what is the loci?
- they will be disfluent on the content and the functor words.
- they will be disfluent on all positions
Tx for SAAND
-depends on other details like how handicapping is the SAAND VS other issues, like comprehension, receptive/expressive skills.
Some interventions other than speech therapy?
- Surgical: endarterectomy (rotorutering the carotid artery) can lead to perfusion (lack of oxygen to the brain) which can result in SAAND and dementia.
- Pharmacology: anti-censure medication. Ceasures caused by a TBI can lead to SAAND.
- DAF: can help
- Biofeedback and relaxation: reduce SAAND but don’t eliminate it.
- Speech Pacing: reduced speech rate can help unlike with developmental stuttering
Outcomes for treatment
hard to predict and hard to research because it is all caused by something different
Stroke will usually be?
transient because it is usually unilateral
