Chapter 8 fluency

• Fluency

  Effortless nature of speech
• Stuttering

  Atypical disruption in the flow of speech, including repetition of parts of words or sounds, prolonged sounds, and inaudible sound prolongation
• Stuttering


  • Involves excessive mental and physical effort to produce speech
  • Causes the speaker to lose their train of thought and focus on the stuttering
• what is the 3 part of the 3 part definition developed by Guitar to define stuttering.

  
  

  Young children, older children, and adults who stutter have negative perceptions of their communication abilities, leading to low self-esteem, suicidal thoughts, and depression
• Basic facts about stuttering

  • About 1% of the school-age population stutters
  • 5% of the population report having stuttered for 6 months or more
  • Stuttering is more likely to occur in males than females (3:1 ratio)
  • 50% or more of people who stutter have family members who also stutter
  • 90% of people who stutter started by 7 years of age
  • 70% of people who stutter had a gradual onset
  • Onset of stuttering includes physically non-tense repetitions, physically tense sound prolongations, and/or blocks
  • At least 50% of children who stutter have a spontaneous recovery
• Primary stuttering behaviors

  • Part-word repetitions
  • Interjections
  • Prolongations
  • Blocks
• Secondary stuttering behaviors

  • Looking away
  • Limb movements
  • Jaw opening
  • Lip posing
  • Eye blinks
  • Facial grimaces
  • Word changes
• Prevalence


  The percentage of individuals who stutter at any given point
• Incidence


  The percentage of people who report having stuttered for 6 months or more at some point in their lives
• Differences between stutterers and non-stutterers

  • Self-concept: Stutterers may have more negative concepts of themselves as speakers
  • Language: Involves formulating what to say and organizing words/sentences
  • Motor systems: Planning, initiating, and executing the motor movements to speak
  • Neurological differences: Stutterers have more activation in the right hemisphere and less in the left
• Myths about stuttering


  • People who stutter are more introverted than people who do not
  • People who stutter are more anxious and nervous than people who do not
  • Parents of children who stutter are more anxious and sensitive than parents of children who do not stutter
  • People who stutter have lower intelligence than people who do not
  • People who stutter have less self-confidence than people who do not
  • People who stutter are more sensitive than people who do not
• Stuttering is not a Nervous Reaction
• Nervous disorders and other psychiatric discibilities are more common in people who stutter
• Increased anxiety


  May increase stattering
• Stutters stuttter even relaxed
• Wendall Johnson's Diagnasogenic Theory

  Stuttering is caused by overly sensitive parents, parental anxieties, overprotectiveness, and overly critical
• Similarities between families of stuttering and nonstuttering children

  • Socioeconomic status
  • Number of children
  • Parent personalities and emotional adjustment
  • Parent's general attitudes and childrearing
  • Parent's styles and speech rate
• Differences between families of stuttering and nonstuttering children

  • Children who stutter may grow up in less close families
  • Parents of stuttering children are more anxious about their children's speech
  • Parents of children who stutter are more protective
  • Parents sometimes criticize their child's disfluent speech
• The cause of stuttering is unknown
• Stuttering is usually gradual in the early years (children)
• Bilingual children who don't stutter tend to have stuttering-like disfluencies
• Characteristics of stuttering that are more common in billingual children that don’t stutter


  • Repetitions of sounds
  • Repetitions of syllables
• Children may become frustrated with their speech abilities can be developed into stuttering
• Stuttering can develop suddenly - fluent one day and disfluent the next day
• Stuttering errors are more common in bilingual children
• Indicators of Early Stuttering in Children

  • An average of 3 or more sound repetitions, prolongations, or blocks per 100 words
  • An average of 3 or more stuttering-like disfluencies (i.e., single-syllable word repetitions, syllable repetitions, sound repetitions, prolongations, or blocks) per 100 words
  • Seventy-two percent or more stuttering-like disfluencies per total disfluencies
  • Twenty-five percent or more of the total disfluencies are prolongations or blocks
  • Instances in which repetitions, prolongations, or blocks occur in adjacent sounds or syllables within a word
  • Increases in the rate and irregularity of repetitions
  • Signs of excess tension or struggle during moments of disfluency
  • Secondary behaviors such as eye blinks, facial tics, or interjections immediately before or during disfluencies
  • Feelings of frustration about disfluencies
• Four interrelated mechanisms contribute to the capacity for fluency

  • Neurological development that supports sensor- motor coordination
  • Language development
  • conceptual development.
  • emotional development
• Studies show that twins are more likely to develop stuttering than fraternal twins
• A person is at risk of developing stuttering if they have a family member who does
• 15% of first degree relatives on both sides of parents have a stutter
• Disfluencies are likely to occur in children's speech due to an imbalance of demands of fluency and child's capacity
• Chronic stuttering


  When children's stuttering does not get better as they reach adolescence and adulthood
• 60%-80% of stutters recover from stuttering before adolescence
• Chronic stuttering Contribution factors

  • Negative feelings and attitudes
  • Avoidance
  • Speech motor control
  • Difficulties with language formulation (phonology, semantics, syntax)
• People with chronic stuttering tend to tense the face, neck, chest, and larynx before talking
• People with chronic stuttering report feeling frustrated, embarrassed, and self-conscious about their speech
• Individuals with chronic stuttering tend to avoid stuttering by changing words or avoiding speaking situations where they might stutter
• People with chronic stuttering evidence unusual patterns of breathing, vocalizing, and speaking, even if they are not currently stuttering
• How to interact with a person who stutters

  • Maintain reasonable eye contact
  • Do not finish the person's words or sentences
  • Do not interrupt
  • Pay attention to what they are saying, not how they say it
  • Pause at least one second before responding
  • Do not allow common stereotypes to override your opinion of the person who stutters
• Assessments of stuttering

  Evaluations of individuals who are excessively disfluent