Chapter 1: Introduction to Stuttering (Chapter objectives, vocabulary, and review questions) PDF

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This document has the chapter objectives for chapter 1 for the CDS405 course. It also contains the vocabulary with definitions and end of chapter review questions with full, in-depth answers to each question....

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Chapter 1 – Introduction to Stuttering Objectives 1. Explain why it is good practice to use the term “person who stutters” rather than “stutterer” 2. Describe factors that may (1) predispose a child to stutter, (2) precipitate stuttering, and (3) make stuttering persistent 3. Name and describe the core behaviors of stuttering 4. Name and describe the two major categories of secondary stuttering behaviors 5. Name and describe different feelings and attitudes that can accompany stuttering 6. Describe the elements of the new International Classification of Functioning Disability, and Health (ICF) system that are most relevant to stuttering 7. Discuss the age range of stuttering onset and the types of onset, and explain why the onset of stuttering is often difficult to pinpoint 8. Describe the meaning of the terms “prevalence” and “incidence,” and give current best estimates of each of these characteristics for stuttering 9. Give an estimate of the number of children who recover without treatment, and describe factors that predict this recovery 10. Give an estimate of the sec ratio in stuttering at onset and in the school-age population 11. Explain what is meant by “anticipation,” “consistency,” and “adaptation” in stuttering 12. Explain some relationships between stuttering and language, and suggest what they mean about the nature of the disorder 13. Describe several conditions under which stuttering is usually reduced or absent, and suggest why this may be so

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Adaptation: The tendency for speakers to stutter less and less (up to a point) when repeatedly reading a passage Anticipation: An individual’s ability to predict on which words or sounds he or she will stutter Attitude: A feeling that has become a pervasive part of a person’s beliefs Avoidance behavior: A speaker’s attempt to prevent stuttering when he or she anticipates stuttering on a word or in a situation. Word-based avoidances are commonly interjections of extra sounds like “uh,” said before the word on which stuttering is expected Block: A disfluency that is an inappropriate stoppage of the flow of air or voice and often the movement of articulators as well Consistency: The tendency for speakers to stutter on the same words when reading a passage several times Core behaviors: The basic speech behaviors of stuttering – repetition, prolongation, and block

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Developmental stuttering: A term used to denote the most common form of stuttering that develops during childhood (in contrast to stuttering that develops in response to a neurological event or trauma or emotional stress) Disfluency: An interruption of speech – such as a repetition, hesitancy, or prolongation of sound – that may occur in both individuals who are developing typically and those who stutter Escape behavior: A speaker’s attempts to terminate a stutter and finish the word. This occurs when the speaker is already in a moment of stuttering Fluency: The effortless flow of speech Heterogeneity: Differences among various types of disorders Incidence: An index of how many people have stuttered at some time in their lives Normal disfluency: An interruption of speech in a typically developing individual Prevalence: A term used to indicate how widespread a disorder is over a relatively limited period of time Prolongation: A disfluency in which sound of air flow continues but movement of the articulators have stopped Repetition: A sound syllable, or single-syllable word that is repeated several times. The speaker is apparently “stuck” on the sound or syllable and continues repeating it until the following sound can be produced Secondary behavior: A speaker’s reactions to his or her repetitions, prolongations, and blocks in an attempt to end them quickly or avoid them altogether. Such reactions may begin as random struggles but soon turn into well-learned patterns. Secondary behaviors can be divided into two broad classes: escape and avoidance

Study Questions Q: What might make some children’s core behaviors progress from repetitions to prolongations to blocks? A: Children start repeating a word or syllable such as “li-li-li-like” and this occurs in children who begin to stutter which progresses to prolongation. Prolongation is when a child says a word or syllable and they feel stuck through the prolonged sound such as “m-m-my name is Beth”. The last core behavior that progresses from prolongation is “block” which is when a child stops inappropriately during their speech. Core behaviors may move from repetitions to prolongations to blocks as stuttering persists. Repetitions and prolongations are usually behaviors of more advanced stutters but as well as children who begin to stutter. As stuttering persists, blocks often grow longer and more tense and tremors may become evident. Q: What are the differences between core and secondary behaviors in stuttering? A: A core behavior is the basic speech behaviors of stuttering – repetition, prolongation, and block. While a secondary behavior is a speaker’s reactions to his or her repetitions, prolongations, and blocks in an attempt to end them quickly or avoid them altogether. Such

reactions may begin as random struggles but soon turn into well-learned patterns. Secondary behaviors can be divided into two broad classes: escape and avoidance. Q: From what other kinds of hesitation should stuttering be distinguished? A: Stuttering should be distinguished from disfluency. Disfluencies are interruptions of speech that are found in both people who stutter and people who do not. Some examples of disfluencies are filter words, interruption of speech, hesitancy, or prolongation of sound. Once syllables are repeated more than three times, it is no longer a disfluency, it is stuttering. Q: What are some feelings and attitudes people who stutter might have, and what is their origin? Are these feelings and attitudes ever experienced by people who don’t stutter? A: A person’s feelings can be as much a part of the disorder of stuttering as speech behaviors. Feelings may precipitate stutters, just as stutterers may create feelings. In the beginning a child’s positive feelings of excitement or negative feelings of fear mat result in repetitive stutters that they hardly notice. Then, as they stutter more frequently, that may become frustrated or ashamed because they can’t say what they want to say – even something as simple their name – as smoothly and quickly as others. These feelings make speaking harder, as frustration and shame increase effort and tension and impede fluent speech. Feelings that result from stuttering may include not only frustration and shame but also fear of stuttering again, guilt about not being able to help oneself, and hostility towards the listener as well. These attitudes and feelings are certainly experienced by people who do not stutter, not only in speaking but in everyday activities as well. Q: What is the age range for the onset of stuttering (the youngest and oldest ages at which onset is commonly reported)? Why might it occur at that time? A: Currently, studies show that the onset of stuttering falls between ages 2 and 3.5 years. Children with later onset are more at risk. Also, if stuttering persists longer than a year after onset the risk of persistence increases. During the first three years, child development and language acquisition are emerging rapidly which could lead to an increase of developmental stuttering during this time. Q: What is the difference between “incidence” and “prevalence”? A: Incidence is an index of how many people have stuttered at some point in their lives (like the individual has had a single “incidence” of stuttering). Incidence is regarding how many people have stuttered at some point in their life. However, everyone has a different definition of stuttering and this definition encompasses stuttering at one point in their life. Prevalence is a term used to indicate how widespread a disorder is over a relatively limited period of time (how often if occurs amongst the general population at a random time). Prevalence relates to how many people are currently stuttering. This varies as time passes and accurate, updated results are needed to maintain prevalence rates. Q: What problems do researchers encounter when they try to determine how many stutterers recover without treatment?

A: It is difficult to determine how many people spontaneously recover because a retrospective method is used and this can be difficult for people to remember when they started stuttering and how they stopped. They may have had a poor definition of stuttering at the time because they were young children and may have not been aware of it. Also, some people only stuttered for a limited amount of time. Q: Why might the ratio of male-to-female stutterers change with age? A: Male-to-female stutters may be lower and closer to 1:1 in very young children. Sex ratio is about 3:1 in the first grade and increases to 5:1 in fifth grade. The ratio of male-to-female stutters change with age as a result of an increasing proportion of boys beginning to stutter in the late preschool and early school-age years. According to studies, girls recover as the years progress while most boys stutters have a harder time recovering. Q: In what ways is stuttering predictable? In what ways does it vary? A: Stuttering can be predictable because individuals have the ability to predict the words or sounds on which he or she will stutter. Studies also show that some language factors (e.g. consonants, longer words, stressed syllables, etc.) can cause those to stutter more frequently Additionally, different environments can cause individuals to stutter more as opposed to when they are in a familiar environment. Stuttering can vary in that it can experience a natural recovery, for example in some young toddlers under the age of 3, or it can persist and become more severe overtime even with treatment. Individuals who stutter may also experience fluctuation in the severity of their stuttering, depending on the environment around them. Incidence of stuttering is difficult to gage in individuals. Q: Why is it difficult to answer the question, “What is the cause of stuttering?” A: It is difficult to come up with the exact cause because there are various factors that can contribute to stuttering. Some factors that can contribute to stuttering are genetic or environmental, such as presenting with traumatic events or stuttering being a genetic factor. It is difficult to determine a cause when some individuals have certain risk factors but they do not present with a stutter, compared to those who are influenced by risk factors. The exact cause remains a mystery but researchers look for various commonalities among people who stutter. Currently, there are only theories to support the causes to stuttering. Q: The International Classification of Functioning Disability, and Health (ICF) indicates that with some conditions, interpersonal interactions may be affected. How might stuttering affect these interactions? A: Stuttering affects interpersonal interactions by limiting engagement with others. Due to the restrictive nature of stuttering, it is likely that speaking and conversing will be limited. For this reason, a person who stutters may refrain from socializing, and participation in different social roles will be affected. Further, friends and family who are unsupportive of the person may contribute to the lack of confidence people who stutter experience when having to engage in conversations. Lastly, personal factors may impact a person’s interpersonal skills as well.

Q: How can stuttering treatment help change factors affecting the individual in the ICF area called “Contextual Factors”? A: Stuttering treatment can help change factors affecting the individual by helping with personal factors such as; assertiveness and confidence and environmental factors such as supportive family/friends. Q: How would you describe the etiology of stuttering to a parent who has had limited education and is not used to discussing abstract concepts? A: While describing the etiology of stuttering to a parent who has had limited education and is not used to discussing abstract concepts, we would relay the information that there is still a lot of research to be done on the exact cause of stuttering, but for now we only have theories on why stuttering happens. Research shows that stuttering seems to be something that is passed down from parent to child, but that isn’t the case all the time, and no one is at fault because there are other factors that may contribute as well. If there are no other relatives who stutter, then we can also take the child’s surrounding environment into account. Either way, they can encourage their child to speak more smoothly and with less hesitation by encouraging a low pressure speaking environment. This can be done by making sure they’re speaking at a slower pace and without too many difficult words....