March 24 2008
24 March 2008
3/24/2008 12:49:00 PM
Stuttering Questions Audio and Videos Stuttering in life a 2-minutes/100-word speech sample from a client What is stuttering? A speech pattern involving audible sound/syllable repetitions and/or prolongations that yield a distinctive hesitancy or failure to proceed with the "normal" stream of speech (from listener's point of view) Now when people who stutter are asked what defines stuttering to them they come up with alternative definitions o The repetitions and prolongations characteristic of most stuttering are usually called core features. o Core features may be accompanied by "bizarre" gestures (grimaces, twitches, shifts in gaze) - - so-called secondary features that Persons Who Stutter may add to break blocks and restore the flow of speech. Acquired stuttering developed into adulthood, they do not have the secondary features that are used to release the blocks. Secondary features are in developmental stuttering, they are developed early on with children who stutter --Speakers Point of View A speech pattern always associated with a momentary sense of loss of control, and often powerful attitudes and feelings relating to the fundamental difficult of speaking, and the speaker's (in)ability to succeed at it o For example, many people who stutter will develop specific word fears. (in the clip, Diane feared the word "name") These episodes become anxiety induced --Yet another definition of stuttering From Listener and Speaker points of view:
Stuttering is a disorder of fluency (i.e., of the "time aspect" of speech) in which the speaker's behavior does not meet societal expectations for speech production within an "acceptable" time frame. --What do we know about PWS (people with stuttering) ... in terms of their physical abilities and physiology? A: there are no differences known ... in terms of their personality and psychological make-up? ... in terms of their family backgrounds? A: No evidence about the family predicts who is going to be a person who stutters The bottom line: PWS are NOT unusual people (aside from the obvious fact that they stutter) Stuttering is a learned behavior --Top 9 Facts about Stuttering: At any on time, STing exists in ~1% of the population (prevalence). Over the lifetimes within a population, STing occurs in ~5% of its members (incidence) Incidence relates to over the lifetime of a group of people, not at a single given point in time. STing occurs in ALL cultures, languages, and social strata. The prevalence of Sting (but possibly not its incidence is modified by sex. Little girls tend to grow out of STing, whereas males it tends to not. STing runs in families STing is (maddenly?) variable in form and severity, within talkers, by situation; across talkers, by features, by situation, response by to therapy. STing may develop from "normal" disfluencies that are characteristic of language acquisition.
o Ages 2-5 , when kids have explosion of language skills. And stuttering is somehow described by this rapid gain of speech. STing can have a profound effect on quality of life among those who "suffer" from it. STing is a object of intense, and continuous research. In the sense of modern behavioral research, this has been true for at least 80 years. The top (#1) fact about stuttering is ... We Do Not Know What Causes It. --Why do we care about cause? Communicative Disorders is one of the so-called "medical allied health" fields. In general, those who work in such fields often accept and try to follow a MEDICAL MODEL when they think about, and try to treat disorders that vex affected individuals. --The MEDICAL MODEL . . . If you want to get rid of a problem, find a cause and treat it Asserts that the effects of disorders are best righted (cured?) when we attack causes rather than symptoms. (We "solve" an infection by administering antibiotics, not by cooling the fever.) A key article of faith: If and when we disorder the cause of a disorder, we then have the best chance of wiping it out of the life of the sufferer, and perhaps off the face of the earth. --Modern Views (caus & treatment) Theory o Genetic Predisposition, stemming from some as-yetundefined CNS deficit? Follows the fact that stuttering runs in family o Learning?
The fact that you learn to be a person who stutters usually by negative feedback about childhood disfluencies
Treatment o Behavioral treatment are very common, treatments that deal with the symptoms, they don't deal with the cause (we don't know it) Speech Pathologists try to learn how to stutter easy. Reduce the blocks and word fears. A lot of the therapies are successful. The frequency and attitude the person has involving stuttering is reduced Motor Learning Stimulus-response contingencies Is an old idea that a certain stimulus produces a response. The people who stutter develop certain fears about certain words like name or telephone number. There is a therapy that reinforces
(reward) for not stuttering after fear word o Cognitive "restructuring" Attitudes and feeling about themselves and speech. (I am worthless, people with think I am dumb, people wont take value to what I say) This therapy changes the attitudes and works at a level that is more psychological. Trying to teach that people who stutter is not a reflection of person o Efficacy: DOES TREATMENT WORK? It works to reduce symptoms, but does NOT cure the stuttering problem. Some individuals get some control over fluency issues, and some individuals where the therapy does not work at all.
3/24/2008 12:49:00 PM
3/24/2008 12:49:00 PM