stuttering

the development of children’s communication skills, and their emotions and cognitions.

• individual learning patterns,
• personality
• temperament

used to denote behaviors that are an aspect of the disorder

interruptions of speech that may be either normal or abnormal.


-Can be natural pauses, repetitions, and other hesitancies that occur in individuals with normal speech

• -Can also apply to stuttering

• -All occupations
• -Intelligence
• -Income
• -Both sexes
• -All ages
• -Traced back 40 centuries

• It's a mystery, but...
• Genetic base – gentetics make it more likely the child will stutter (Dr. Allison)
• Many think it is the way the child’s brain is organized for S and L
• Neural pathways less developed OR more easily disrupted by overflow of emotional activity in the brain.

most stuttering begins between 2 and 5 years – the same time that typical stresses of early childhood occur (new baby, move, period of rapid growth in vocabulary and Syntax

neurological PREDISPOSITION for stuttering

it may disappear- or it may get worse

• be self conscious
• develop a secondary characteristics (blink)
• have anticipation/anxiety
• try to avoid or escape interaction with others

• limiting friends
• jobs
• fun and social situations- they will stick with no demand speaking situations

• the individual is fatigues, ill, stressed.
• or...if Wait too long (after puberty) get only partial recovery.

an abnormally high frequency and/or duration of stoppages in the forward flow of speech

• Repetitions of sounds, syllables, or one syllable words
• Prolongations of sounds
• Blocks of airflow, voicing, movement of the articulators in speech

• Trying to force the words out
• Using extra sounds or movements

• >frustration,
• >embarrassment,
• >fear

• exhibit repetitions, revisions and pauses – NOT STUTTERING.
• Same for adults in a hurry – caught off guard – politicians on the spot.

• – repetitions, prolongations and blocks.
• These behaviors seem INVOLUNTARY

learned reactions to the CORE behaviors. Such as blinking.

Sound syllable or single-syllable word repeated several times.

the sound or air flow continues but movement of the articulators is stopped.

• Respiratory, laryngeal, articulatory
• Perkins thought inappropriate muscle activity at laryngeal level

blocks last longer and > more tense and may see TREMORS

end or avoid >

ESCAPE BEHAVIORS and AVOIDANCE BEHAVIORS (Guitar uses these rather than starters or postponements.

• try to finish the word
• Eye blinks, head nods, interjections of sounds, hit self
• They work > reinforcement

• in attempt to avoid, uses escape mechanisms –
• Say something different. Avoidance behaviors can become a habit

• Have negative attitudes about themselves
• Project their attitudes on listeners (believe they think he is stupid or nervous)
• Research has shown most people stereotype people who stutter as tense, insecure, fearful.
• These stereotypes affect the way stutterers feel about themselves

the limitation it puts on an individual’s ability to communicate. Refers only to the limitations on communication.

the limitation on a person’s life.

gradually – or suddenly. Appear, disappear, reappear.

USING SPOKEN LANGUAGE TO COMMUNICATE.

less than 1%

About 5% according to Guitar

growth or maturation that allows many individuals to recover from stuttering.

“spontaneous” or “natural”

• Child had no relatives who ever stuttered – or who if stuttered, recovered
• Showed earlier age of onset
• Demonstrated stronger phonological and other language skills
• Scored higher on tests of nonverbal IQ
• More like to be girls

• Had a more mature speech motor system (less variable)
• Had mother whose interaction style was non-directive and whose language was less complex (LESS STRESS, LESS NEED TO PERFORM, EASIER MODEL TO EMULATE – my points) Rommel et al – the moms had less complex syntax and used a smaller number of different words when talking to the child
• MODEL WHAT YOU WANT THE CHILD TO DO I was influenced by Lenneberg via Wood

• Speaking more slowly
• Having a more stable speech-motor system
• Having a mother who has a non-directive interaction style and uses less complex language when speaking to the child
• Being right-handed
• Having less severe stuttering
• Having relatives who recovered from stuttering or no relatives who stuttered
• Having good phonological, language and nonverbal skills
• Being female

stuttering was the result of an inefficient organization of the brain’s two cerebral hemispheres.

• Before the 30’s stuttering considered a medical disorder
• Variability of stuttering behaviors was seen as part of an organic disorder (not really important)
• IMPORTANT PART was stutterers’ brain waves, heart rate and breathing pattern (USC)
• Research then moved in the direction of social, psychological and linguistic factors (until recently with new medical tools)

• the frequency at which a behavior occurs is related to the consequences that follow.
• If a behavior is followed by a reward, it increases
• If it is followed by an aversive consequence, it decreases.
• ESCAPE BEHAVIORS are learned through operant conditioning
• POSITIVE REINFORCEMENT is a type of operant conditioning.
• PUNISHMENT is another type
• NEGATIVE REINFORCEMENT – occurs whenever a behavior is followed
• by the termination of an unpleasant situation

Classical Conditioning occurs when there is a repeated association between a neutral stimulus and another stimulus that naturally and consistently evokes a response

• Mothers spoke more rapidly (child must speak faster)
• Frequency of interrupting their children when disfluent > increase in tension
• Studied parents asking questions
• Researchers believe that it is helpful therapeutically for parents to slow their speech rate and speak in shorter sentences when talking to their children who stutter.

More critical, more protective and more domineering toward their children

• higher expectations – especially with speech –
• greater sensitivity to speech deviations and believed in early intervention

• Parents misdiagnose normal disfluencies as stuttering
• Their reaction then causes the child to try to avoid disfluencies

Environmental factors such as more achievement and conformity-oriented culturesDo not know for sure the exact environmental factors

• Evidence indicates that onset of stuttering generally occurs at ages when language growth is greatest
• Studies indicate that disfluencies increase when speakers produce longer, more linguistically complex sentencesWhen and where stuttering is likely to occur in spoken language is influenced by such linguistic factors as the lexical class of a word, its length and it location in a sentence

sensory input as well as motor output.

“a temporal disruption of the simultaneous and successive programming of muscular movements”

As a group, individuals who stutter have some difficulty using auditory, touch, and movement information to control speech.

that stutterers left hemisphere structures for speech and language have anomalies or differences from those in normal speakers

suggesting that when individuals stutter, they are NOT using auditory feedback to monitor and control their speech And research has shown stutterers have trouble with auditory processing tasks. ALSO can change fluency by changing the way stutterers hear their own speech (DAF)

• Head injury
• Neurological disease
• Intense fear

• Infectious diseases
• Diseases of the nervous system
• Injuries
• Brain damage at birth (24% developed stuttering)
• Anoxia
• Premature birth
• Childhood surgery (risks of anesthesia remember)
• Head injury
• Mild cerebral palsy
• Mild retardation
• Experiencing intense fear

Difficulty with speech motor control Language and learning ability Sensory processing – and the interactions of difficulties in these areas Vulnerable temperament IN COMBINATION WITH environmental factors

must INTERACT with the environmental factors for stuttering to appear.

– not genes alone – but a combo of heredity and the environ-ment – with element of chance thrown in. (DR. ALLISON)

• Inherited or congenital disorder that First appears when a child is learning the complex and rapid coordination of speech and language production Children who do not recover but persist in stuttering are those who learn maladaptive responses to their disfluencies. This learning is influenced by:
• Their biological temperament
• Developing social and cognitive awareness
• And the response of the environment to their speech

Stuttering is a problem of coordinating the two sides of the brain for speech HAS NOW LED TO view of stuttering as a problem of coordinating multiple brain networks for speech with those for language, cognition, and emotion. This juggling act breaks down in all speakers when the resources needed to process language, cognition, or emotion momentarily drain available CNS capacities leaving too little attention for the intricacies of rapid, smooth speech production. THE RESULT?????? NORMAL DISFLUENCY Individuals who stutter appear to have trouble allocating resources to speech production under conditions of high demand. They have inherited or acquired a more vulnerable speech production system – one less able to deal with the norm of rapid, smooth speech under a variety of conditions

EX: speaking in time to metronome decreases the demans on both linguistic and motor systems to generate the prosody for speech (ALSO DISTRACTING)

Also Speaking slowly reduces the demands on language formulation and motor coordination functions. Goes to brain organization and less need for rapid processing of motor speech and language functions.

• Speaking alone
• When relaxed
• In unison
• To an animal or infant
• In time to rhythmic stimulus (METRONOME) or when
• SINGING
• In a different dialect
• While simultaneously writing (DISTRACTION)
• When swearing (AUTOMATIC – JOHN HUGHLINGS JACKSON)

• Consonants
• On sounds in word-initial position
• In contextual speech (versus isolated words)
• On nouns, verbs, adjectives, and adverbs (versus articles, prepositions, pronouns, and conjunctions)
• THINK ABOUT – importance or these words to the message,
• Small number used frequently
• On longer words
• On words at the beginnings of sentences
• On stressed syllables

• Research showed predictability
• Stutterers knew when it would occur – consistently, and decreases with repetition Now stuttering not just neurophysiological but LEARNED BEHAVIOR > New ways of TREATING

PREDISPOSED Ex; learning disability and vulnerable temperament