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ASP 514 Stuttering Notes Day 1

by: Caroline Boccarossa

ASP 514 Stuttering Notes Day 1 AUSP 514

Caroline Boccarossa

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These notes explain the differences among fluency, non-fluency, disfluency, and dysfluency in relation to stuttering as well as areas affected by stuttering and secondary behaviors to stuttering.
Dr. Tim Saltuklaroglu
Class Notes
stuttering, speech, pathology, disorders
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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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