ASP 514 Stuttering Notes Day 1
ASP 514 Stuttering Notes Day 1 AUSP 514
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This 3 page Class Notes was uploaded by Caroline Boccarossa on Friday June 17, 2016. The Class Notes belongs to AUSP 514 at University of Tennessee - Knoxville taught by Dr. Tim Saltuklaroglu in Summer 2016. Since its upload, it has received 8 views. For similar materials see Stuttering in Audiology and Speech Pathology at University of Tennessee - Knoxville.
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Date Created: 06/17/16
ASP 514 Day 1 Notes I. History of Stuttering A. From the days of Demosthenes up until 1800s people thought it was a tongue problem B. Marbles in mouth] C. certain techniques applied, such as sensorimotor: it changes the way you talk, and changes the way that you hear yourself D. automatic speechthings that pop out automatically that are rote, don’t carry a lot of meaning, etc. E. Speaking in unison (achoral speech)if two people who stutter speak together, they are fluent. F. Helpfulimposing an external rhythm, speaking in rhythm II. What is stuttering? What you think a disorder is affects how you treat it. There’s a difference between a neurogenic, developmental, and psychological St D. Developmentalnot a psychological cause, but psychology plays a role in its development. Among SLPs, it is cited as being one the least favorite disorders to treat. o Why? A relapse is very common, people can be variable, unknown cure. o Sometimes the clients don’t feel natural with the techniques the SLPs could employ, i.e. robot voice. The SLP may get a patient who has been in therapy a lot and is jaded. This can be one of the biggest sources of frustration. What makes it worse? Lack of sleep, anxiety. Confidence is the number one thing. The longer that you stutter for, the longer that you will be a persistent stutterer. o Many children who start to stutter recover from it naturally. III. What to define? The two meanings of “stuttering” o Overt (observable), momentary, disrupted speech events o A complex disorder that includes speech, physiological, cognitive, and emotional factors IV. Fluency, nonfluency, disfluency, dysfluency, stuttering Fluencytalking with the appropriate o rate (appropriate speech timing), continuity (smooth connections), tension effort (appropriate force), volume, suprasegmentals Nonfluencythe normal nonfluent behaviors that children exhibit as they develop speech o Children may repeat a phrase, say an “um” or “ah,” it’s not stuttering, but sometimes stuttering is present too and it’s difficult to separate Disfluencygeneral term for all speech disruptions, normal and stuttered; you may see this in children or adults Dysfluencyrefers to a kind of dysfunction. Aberrant, often associated with stuttering behaviors. V. Continuum of fluency / stuttering Repetitionssound/syllable, partword, whole word (when the word is a single syllable, like ‘the’) Whole words with several syllables that are repeated aren’t considered stutteringthese fall into the disfluency category Think: do people who don’t stutter exhibit these behaviors? That is, do they VI. Behaviors That Count Core behaviors, stutteringlike disfluencies, dysfluencies (typically only seen in PWS Person Who Stutters) o Sound, partword, or syllable repetitions o Audible prolongationswhen you hold out a sound for a long time, like Ww whopper o Silent prolongations (silent blocks, postural fixations)most severe behaviors, these are the silent blocks; the flow of speech is blocked off; air stops moving through the vocal tract; the system has stopped moving; when the system is shut down, it’s a sign that certain behaviors have gotten bad; postural fixation means your face is fixated, and that is the most severe on the continuum. o Rrrepetitions, prolongations, and blocks are the three main behaviors. Stuttering behaviorwhen you start talking really fast and you trip over your words, so typical people can demonstrate stuttering behaviors Other disfluencies (found in PWS and PWNS) o These things interrupt the flow of speech, but they are normal nonfluency. o Whole word repetitions o Phrase repetitions o Revisions o Starters/interjectionslots of people say “um” before the beginning of a phrase VII. What we Count Versus What Stuttering Is We have to look at syllables and make a decision on whether the syllable was stuttered or fluent. o Mmmy nnnname iiis Tttim. 4/4 syllables. My name is T……im. 1 in 4 syllables, yet it was worse. When we count, we think of every syllable, which is either stuttered or not. With more severe behaviors, there is more tension in the vocal folds. It’s a lot easier for someone with typical speech and disfluency to easily recover. VIII. Difference between a typically fluent person and a person with a stutter Perkins (1990) defined stuttering as “loss of control of the ability to voluntarily continue a disrupted utterance is the essence of stuttering.” Demonstrates that this is something occurring at the neurological level. Sense of loss of control, you feel everything tighten up. IX. Things to Consider Is the fluent speech of PWS the same as the fluent speech of normally fluent individuals? No, even the fluent speech is affected. If you don’t hear or see me stuttering, is stuttering still affecting me? Yes. X. Areas affected by stuttering Overt speech characteristics (these are the first to develop) Physical concomitantsother observable physical behaviors that aren’t directly related to speech Physiological activityheart races Affective featuresrefers to how you feel; it can make you sad, frustrated, angry, ashamed Cognitive processeshow does that change how I think Social dynamicsaffects personal relationships, communication, etc. We are working to retrain speech. A lot of people need help dealing with all of these issues, not just speech, but our main concern is speech. XI. Secondary Behaviors (physical concomitants), not an exhaustive list Limb tension Lip biting Pinching Head jerking Looking awaybreaking eye contact Blinking Distortions of the mouth Quivering of the nostrils Other signs of struggling Sometimes people may acquire secondary behaviors that they used once before to push a word out, and they gain a habit from it. These usually come later in the kid’s development, and they are different from kid to kid. XII. Iceberg Analogy o Stuttering is on the surface, and the huge part below the surface is the bulk of the pathology/the most important part, they are all consequences of doing these things o Overt (visible behaviors)on the surface (SLDs, other disfluencies, visible secondary behaviors) o Covert behaviors (invisible behaviors) below the surface o Physiological, affective, cognitive (avoidance, substitution, circumlocution) o Social dynamics
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