ASP 514 Day 2 Notes
ASP 514 Day 2 Notes AUSP 514
Popular in Stuttering
Popular in Audiology and Speech Pathology
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 2 Notes I. Causes Twin studiesthere is not 100% concordance in identical twins Concordance is higher in identical than in fraternal twins o There are instances where you can have a pair of monozygotic twins, and they are discordant for stuttering (one of them stutters, and one of them doesn’t). o Genetics are obviously implicated, but other factors probably come into play also. Stuttering tends to run in families, but not always, since there’s not 100% concordance with twins. If it can’t be explained by genetics that twins share, it has to be environmental. Genetics are implicated, but it’s not a single gene because it probably would’ve been found by now if it were. You see a lot of stuttering in children with Down’s, Tourette’s, and ADHD Tourette’suncontrolled behavior at any time. Stutteringabnormal behaviors only occur when they’re talking, but with Tourette’s, you can’t hide it. II. Brief History of Stuttering Paradigm shifta change in the explanation of something/the way of thinking about something, although that something hasn’t changed. Paradigm Shifts & Stuttering o Aristotlebelieved that when people stammer it was to the movement of the tongue, not the affection of the veins. o TreatmentDemosthenes (4 BC) used “pebble” therapy to train his “tangled tongue” and went to the ocean to speak over the waves. o Masking effectused up until the 80speople would put a masker in someone’s ears so they would use it to talk at conferences; this would drown out someone’s own speech. Problem: this isn’t good for your hearing. o 1800sa surgeon named Johann Frederick Dieffenbach believed that the tongue was too big, so he would cut a triangle out of people’s tongues and sew the rest together to make people’s tongues smaller. o Beginning of the 20 centurypeople would advertise that they had cured their own stuttering and would offer to share their ‘secret’ with others for a price. It consisted of people using a rhythm to speech, such as tapping one’s side (Bogue Institution). III. History Cont. SLP field founded at the University of Iowa at the 1920s by Sam Orton and Lee Travis. Observations: cases with defective speech, including stuttering, were also found to be lefthanded. o Theory: being left handed or ambidextrous reflects an incomplete dominance and thus indicates a danger to develop communication disorders. o Problems with this theory: 1) Because of spontaneous recovery in children, it could not predict which individuals would stutter and which wouldn’t. 2) Their treatment did not yield significant reductions in stuttering. 3) Children, whose handedness was changed, did not stutter. o Idea at the time: lefthandedness was bad (sinister), kids were treated by making them switch use of hands, but treatments didn’t yield results supporting this. BAD IDEA. o Charles Van Riper switched hands for a time. The impact of Orton and Travis is still felt in the field. Brains of stutters are different: o Both functionallystuttering shows more right hemispheric involvement. o Structurally (in adults): differences in cerebral morphology in motor and temporal lobe areas. o It’s difficult to separate causes from effectis RH use a cause or an effect? IV. Theories Psychoanalysis o Background: Freudian psychoanalysis gained popularity in the early part of the previous XX century. o Observations: probably some similarity between stuttering Psychobabble o Theory: stuttering emanates from either oral or anal needs, a covert expression of hostility, or an unconscious suppression speech that originates during childhood. What evidence would support a psychoemotional cause? o 1) Stuttering onset would frequently coincide with traumatic events. o 2) Stuttering onset would be far more frequent than gradual onsets. o 3) Recovery would frequently coincide with improved emotional adjustment o 4) Onset age would be evenly distributed across the lifespan. Johnsonian Theory o Posited the idea that stuttering is caused by the parents and it only exists because we label them that way. A parent who reacts negatively to their child as they are developing their language can cause stuttering. o Treatmentbasically, you pretend that it’s not there. It’s only there because you hear it that way. o Semantogenic—associated with a meaning o Diagnosogenic—associated with a diagnosis o Johnson’s Study Thought that stuttering was in the ear of the listener. If stuttering is caused by reactions, then bad reactions to a child speaking would cause stuttering. Monster studya master’s student of Johnson was going to orphanages and seeing if negative. o 1) No underlying organic disorder was assumed for stuttering. o 2) Normally nonfluent speech (e.g., tensionfree word repetitions, interjections or revisions) could be turned to stuttering when parents placed ‘unrealistic’ demands on a child’s speech. o 3) Stuttering was defined as an “anticipatory, apprehensive hypertonic, avoidance reaction.” o 4) Stuttering is an emotional disorder, a reaction motivated by fear to avoid stuttering. o This theory was bad science because there was no way to predict which kids would recover and which kids wouldn’t, since it was based on the parents. o 80% of kids who start out with a stutter recover later. V. Therapy Methods Behaviorism (1960s) o Classical conditioningenough to even elicit fear o Extinguishing the conditioned response (fear of introducing oneself) is part of therapy. o + or reinforcement increases frequency of a behavior. o One can reinforce avoidance behavior by avoiding a social situation, since avoidance=not stuttering. o 2 common behavioral approaches Van Riperian: stuttering modification o Your speech is something that can be brought under control and you can decrease the severity of stuttering. Focuses on stuttering more fluently and the psychological aspects of it. Fluency shaping o Training smooth, fluent speech, teaching people to talk. This assumes we need to retrain the speech system and retrains speech in a systematic sort of way. Focuses on training how to coordinate speech properly. Prolongationlearn to coordinate movements slowly. VI. What is stuttering like? Speech is a complex motor task. The presence of the core behaviors are the definitive characteristics of stuttering. VII. What is stuttering? Defined and characterized by observable speech disruptions. o Even though they are not always present. o It is intermittent. o It is an involuntary disorder. Seems like a moot point, but we should never forget this regardless of how much therapy a person has had. o Controllable or uncontrollable? It’s temporarily controllable, and some people are better at controlling it than others.
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