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ASP 514 Day 2 Notes

by: Caroline Boccarossa

ASP 514 Day 2 Notes AUSP 514

Caroline Boccarossa

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About this Document

These notes cover a brief history of stuttering, different theories for stuttering, and different methods to treat stuttering.
Dr. Tim Saltuklaroglu
Class Notes
speech, pathology, stuttering
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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 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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