Stuttering Test Marshall
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Stuttering Test Marshall
Who studied cerebral dominance
What is the cerebral dominance theory?
PWS were left handed
What did Robert West do?
Believed stuttering dealt with genetics and lead to early genetic research in stuttering.
What study shows the risk of having a son/daughter that stutters based on the sex of the parent that stutters?
Those that recover from stuttering typically have one of these 5 characterisitcs:
- No relatives that stutter
-Score higher on tests
If child copies stuttering from another child
When does stuttering typically develop?
Between ages 2-5
What is the resource allocation model?
The brain can only do so many tasks at
once. If it does more than one, it will run slower and less efficiently
What is anticipatory struggle?
Bloodstein- a child decides it is something that requires extra effort and struggle. Once this decision is made, the child anticipates
having difficulty and struggles
The parents diagnosed/misdiagnosed children with stuttering and there is no actually difference in CWS and CWOS (stuttering is a learned behavior)
Who points out that parents of CWS are "sensetive"
How has the theory of stuttering evolved
Van Riper first talked about stuttering
as a disorder of “timing” and Kent picked up on the theme and advanced it. Neilson found that stuttering individuals
have trouble learning the sensory-to-motor and motor-to-sensory movements
needed for speech
Who believes the voice has an integral role
Where PWS perform inferior to PWOS
-Sensory auditory processing
How are the levels of RH and LH in a PET in PWS compared to PWOS
PWS shows more RH on PET and less LH than PWOS
What are Guitar's two points for what the cause of stuttering is?
1. genetic or neurologically amiss
2. an inherited temperament for tolerance of stress, being anxious, and reactions to
Borderline Stuttering Stage
-Begins between 2-5 y/o
-Minimal awareness of speech
-No tension in blocks
-variable fluent speech
Beginning stuttering stage
-Child is school age
-Child is aware of problem
-May have some tension in blocks
-Do not have negative communication feelings yet
Intermediate and advanced stages of stuttering
-Interferes with day-to-day
-Attitudes overt and covert about speaking have developed
-Much time spent avoiding, and adjusting speech for stuttering.
What are the five parts of assessment
-address areas of concern (referrals)
-talk about stuttering
-obtain a speech sample
Referral process for borderline or beginning stuttering
Referred by the parent or teacher
Referral process for intermediate and advanced stuttering
Have been in treatment and have been stuttering for a while. (self referred)
Obtaining history of borderline and beginning stuttering
Obtained by parents before treatment session (speech and language development, medical/health history, social history, temperment)
Obtaining history for intermediate and advanced stuttering
Obtain information from the client directly, and find out how stuttering affects the clients life
Interview for borderline and beginning stuttering
Parents are seen first, parental permission needed to interview child, teacher may be interviewed as well.
Interview for intermediate and advanced stuttering
Talk to the client about stuttering directly
What is the process for obtaining a speech sample from those with borderline and beginning stuttering
Obtain tape from parent, play situation, view interaction in waiting room
What is the process for obtaining a speech sample from those with intermediate and advanced stuttering?
Job description, picture description, reading
What 4 things do you measure with stutterers
-Amount of disfluency
-Type of disfluency
-Duration of blockages
Measuring the amount of disfluency (3 steps)
-Make mark at beginning and end of utterance
-Check for accuracy
Measurement of amount of disfluency (3 step)
-Time length of sample (their speech only) 2x
-Count syllables or words produced
-Divide # of syllables by total time
How many syllables do normal speakers produce per minute?
How many syllables to normal children from ages 6-12 produce per minute?
How do you measure percent of stuttered syllables?
# of syllables stuttered/total syllables
What does % syllables stuttered not take into acount
Stuttering like dysfluencies
-Part word repetitions
-Repetitions of one syllable words
Non- stuttering like dysfluencies
-Revisions or abandoned utterances
-Multisyllabic phrase repetitions
What are the treatment goals for borderline and beginning stuttering?
-No conscious effort in stuttering
What are the treatment goals for intermediate and advanced stuttering?
-Improved attitude toward communication
What is stuttering modification
-Minimal data collection
-Techniques to regain control of stutter
What is fluency shaping
-Little emphasis on feelings
-Heavy data collection
-Techniques to eliminate stuttering
Indirect approaches to borderline stuttering
Do not talk directly about stuttering, and may not work with child (works with parents, environment, etc)
Direct approaches to borderline stuttering
Non-programmed behavioral approach addressing disfluencies, teaching control of speech musculature
-watch and see approach
-used w/ child who has been stuttering a year or less (no add'l speech problems)
-recordings should be made monthly and analyzed to see if changes are
being made in the right direction.
Zembrowski Plan A
Basically indirect approach
Zembroqski plan B
PLan A + direct approach (directly treat child) if there is a family history of stuttering
Signs that an indirect approach is not working
-no reduction of disfluencies
-increase awareness of stuttering to child
-increased tension and struggle on childs part
-increased parental concern
question asking hierarchy (5 levels)
-tell me everything you know about _____
-tell me a story about this
Behavioral treatment of stuttering
requires clinicians who do what two things
1. understand the concepts of how to eliminate stuttered speech
2. use these concepts flexibly and creatively to formulate clinical procedures.
responses that can be controlled by the consequences that follow them
a consequence that results in an increase
in the frequency of the desired behavior
Presentation of a positive stimulus
contingent on occurrence of desired behavior
Removal of an aversive stimulus
after occurrence of the desired behavior
What is "oops, that was a bumpy word" an example of?
What are the four treatment targets
1. Stutter free speech
reduction of stuttering in the clinic
reduction in stuttering in situations outside the clinic (particularly social settings)
verification of reduced stuttering by an independent observer in an outside situation
Continued reduction of stuttering even after treatment has ended
Non programmed behavioral treatment
-operant procedures but in no set order
-start with speaking approprite to child then progress on
Programmed behavioral treatment
-use operant in small systematic steps
-Child must make certain amount of progress before moving onto the next step
-GILCU and ELU
: stutter free speech by eliminating stuttering and increasing the length of the speech intervals not containing stuttering
In convo parent asks child to repeat phrases stuttered, and reinforces non-stuttered words
Gradual Increase in Length and Complexity of Utterance
54 steps from reading to monologue
Extended Length of Utterance
20 graduate steps
No imitative utterances
Reinforce fluent speech
Time out for stutter
Criterion to move from step to step
Fluency Rules Program
Universal, primary, secondary rules
Reminded of rules by hand signals
Made into pleasurable activity for child
Taught to all children, focus on slowing speech rate, 1 word at a time,
speech breathing, mr voice box running smoothly, and speech helpers (let your lips touch like a butterfly) are examples of what
This method uses only the speech helpers and show that the secondary behaviors have nothing to do with talking
How is FRP implemented?
Use gestures and old ears/happy ears
shows how to alter tense moments
Describe what speech is like objectively