STUTTERING - PowerPoint Presentation

Slide1

STUTTERINGSlide2

WARNING SIGNS

FIRST THREE INDICATORS-disturbance in speech production

-Multiple repetitions, especially parts of words or first syllables

-Use of schwa vowel that delays or disrupts flow of speech

-prolongations- especially first sound

LAST FIVE INDICATORS WHEN CHILD REACTS TO INTERRUPTIONS IN THEIR SPEECH

-tremors

-rise in pitch and loudness

-struggle and tension with lips and throat

-moment of fear when the child can’t say a word correctly

-avoidance of a word the child cannot say without stutteringSlide3

CAUSES

Cerebral dominance theory:

predisposition to stutter; neither side of the brain is dominant in controlling motor activities involved in talking

Biochemical/Physiological Theories:

Inherited predisposition and Physiological

related to epilepsy

problems with phonation, respiration, and

articulationSlide4

Cont.

Approach-avoidance conflict:

stutterer desires to talk and be silent; anxiety builds up and conflict is manifested in stuttering

Anticipatory-struggle theory:

diagnosis of “stuttering” is made by the parents based on normal developmental

dysfluencies

which creates an environment of “difference”; child begins to speak abnormally in response to the parents’ anxieties, help, and corrections Slide5

Cont.

Auditory Monitoring Theory:

stutterers hear themselves differently

Psychoneurotic theory:

stutterer has some unconscious need that he/she has difficulty expressing, therefore represses; creates conflict which results in stuttering

Learning theory:

operant conditioning-as a reaction to other people’s reaction, frustration builds effort to decrease

dysfluent

behavior and creates child to become a stuttererSlide6

PHASES OF STUTTERING

Stage 1 (preschool years 2-6)

Most

dysfluent

at age 3-4

Dysfluencies

usually begin with initial sound/syllable repetition, word repetitions, and pauses

Chis is usually not aware of the

dysfluency

and not bothered by it

Stuttering usually occurs at the beginning of a sentence, clause, or phrase on both content and function words

Stage 2 (elementary school age)

Core behavior is established

Begin to see “struggle behavior

Speech is forced and prolonged

Child is still not avoiding talking

Stuttering is more chronic, less periods of fluent speech

Occurs primarily on content words and increases under periods of excitementSlide7

Stage 3 (8- young adult)

Avoidance of stuttering

Child is aware of

dysfluent

behavior

Begins to build up strong aversions to certain words (certain words are regarded as more difficult than others)

Anticipate trouble; attempt to

circumlocute

, delay, or put off words

Begin to have difficulty speaking with certain people (e.g. teachers, parents, people with authority)

Stage 4 (most advanced form)

Associate feelings

Self-esteem decreases

Fear and anxiety

Child now identifies him or herself as a stuttererSlide8

TREATMENT AND THERAPY

Fluency Shaping Techniques

Goal is to reduce or eliminate stuttering

Change speed/timing patterns

Light articulatory contact

Pausing/phrasing

Examples: Response contingent Stimulation, Gradual Increase in Length of Complexity of Utterance program,

Lidcombe

ProgramSlide9

Cont.

Stuttering Modification Techniques

Goal is to change type of

disfluency

while teaching one to react to his or her own stuttering calmly

3 techniques

Cancellations:

stutter word, pause 3 seconds and repeat again slowly

Pullouts:

once criterion for cancellations met, do this during actual stutter

Preparatory Sets:

once pullout criterion met, do this in anticipation of stutter