Atypical Cerebral Asymmetries and Stuttering

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Questions and Answers

What is the main premise of the Diagnosogenic Theory?

Negative reactions to normal disfluencies can lead to stuttering. (correct)

Stuttering is a behavior reinforced by rewards.

Stuttering is primarily caused by genetic factors.

Stuttering occurs only in children who avoid speaking.

What does operant conditioning explain regarding disfluencies?

They are only caused by listener reactions.

They are unaffected by external consequences.

They result in only positive behaviors.

They can lead to an increase in avoidance behaviors. (correct)

Which type of reinforcement is associated with an increase in behavior?

Negative reinforcement

Punishment

Avoidance reinforcement

Positive reinforcement (correct)

What is stated about listeners' responses to a child's disfluencies?

They reinforce disfluencies and can lead to greater struggles. Signup and view all the answers

What does the content suggest about the effectiveness of the Diagnosogenic Theory?

It is considered invalid in explaining stuttering onset. Signup and view all the answers

What does the neurodiversity movement suggest about bodies?

Bodies are diverse and variable. Signup and view all the answers

How does the neurodiversity perspective view stuttering?

As a natural variation mismatched with the environment. Signup and view all the answers

What does the medical model claim about stuttering?

It is a pathology requiring medical intervention. Signup and view all the answers

Which of the following statements aligns with the social model of disability concerning stuttering?

Stuttering arises from an impairment in the individual. Signup and view all the answers

What is the primary focus of the neurodiversity movement regarding conditions like stuttering?

To advocate for the acceptance of diverse communication styles. Signup and view all the answers

What does the multifactorial dynamic pathways theory of stuttering emphasize?

Variability and ongoing assessment Signup and view all the answers

How is the social model of disability described?

Disability arises from societal discrimination and stigma Signup and view all the answers

What is a primary difference between the medical model and social model of disability?

The medical model seeks to cure individuals, while the social model addresses societal barriers Signup and view all the answers

What does neurodiversity emphasize?

Natural variation and unique traits of individuals Signup and view all the answers

What common question might parents ask regarding their child's stuttering?

Is it due to a specific event like a pet's death? Signup and view all the answers

Which of the following statements reflects a misconception regarding stuttering?

Every child stutters due to anxiety Signup and view all the answers

What is one advantage of multifactorial models in discussions with parents?

They acknowledge the complexity of stuttering and its causes Signup and view all the answers

What might be considered a vulnerability or threat in discussing stuttering with parents?

Minimizing the child's experience with stuttering Signup and view all the answers

What is suggested to cause disruptions in timing for individuals who stutter?

Less developed left hemisphere Signup and view all the answers

How does increased stress affect individuals who stutter?

It increases the likelihood of cross-hemispheric interference Signup and view all the answers

Which factor is identified as a basic deficit in stuttering?

Sensori-motor control of speech Signup and view all the answers

What can increase the likelihood of a breakdown in speech systems for stutterers?

High language demands Signup and view all the answers

What effect does increased linguistic complexity have on stutterers?

It increases brain activity and resources required Signup and view all the answers

According to clinical implications, what may help decrease stuttering in children?

A decrease in linguistic complexity Signup and view all the answers

What role does emotion potentially play in speech for those who stutter?

It may disrupt timing functions Signup and view all the answers

Which hemisphere activity is stutterers particularly vulnerable to when under stress?

Right hemisphere activity Signup and view all the answers

What is considered the source of conflict in the neurotic explanation of stuttering?

Psycho-sexual development stages Signup and view all the answers

Which of the following statements reflects Freud's view on psycho-analytical approaches to stuttering?

Freud believed the psycho-analytical approach was ineffective for stuttering. Signup and view all the answers

What does classical conditioning imply about the development of stuttering?

Emotional responses can trigger stuttering based on learned associations. Signup and view all the answers

Yairi's statement on the causal relationship between parents' attitudes and stuttering is best summarized as

Declaring it null and void for treatment purposes. Signup and view all the answers

Classical conditioning involves which of the following processes?

Associating a neutral stimulus with an emotional response. Signup and view all the answers

What might indicate a potential area for change in therapy for children who stutter?

Unlearning negative emotional associations with speaking situations. Signup and view all the answers

Which of the following is NOT associated with the psycho-analytic explanation of stuttering?

Excessive parental support in speech therapy. Signup and view all the answers

The emotional response evoked by a neutral stimulus in classical conditioning can lead to what consequence in stuttering?

Increased likelihood of stuttering during speaking. Signup and view all the answers

Study Notes

Atypical Cerebral Asymmetries in AWS

Foundas et al (2001; 2003) researched atypical cerebral asymmetries in AWS
The text does not state if atypical cerebral asymmetries is a cause or a result of stuttering

Temporal Processing

Kent (1984) proposed inability to perform precise timing functions due to left hemisphere underdevelopment
Could lead to issues with processing speech output due to fine motor control
Kent also suggests emotion may play a role in timing disruption
Peters and Guitar (1991) found that when individuals who stutter are stressed, there is cross-hemispheric interference

Linguistic Processing

De Nil (2004) found the basic deficit in stuttering to be in the sensori-motor control of speech.
High linguistic demands cause speech systems to breakdown more frequently in people who stammer (Kleinow and Smith, 2000)
Stutterers have limited extra neuronal resources due to their s/m defect (De Nil & Bosshardt, 2001)
This means stutterers are more likely to require more brain activity to compensate for their stuttering
Stuttering is more likely when linguistic complexity is increased (Starkweather, 1981)
Johnson and Rosen (1937) found individuals who stutter exhibit increased speech rate
Reducing linguistic complexity may decrease stuttering in children.

The Neurotic/Psycho-analytic Explanation of Stuttering

Stuttering was originally seen as a neurosis, a result of repressed need and symptom of conflict
The source of conflict was posited to be psycho-sexual (Glauber, 1982)
The psycho-sexual hypothesis also suggests inadequate interpersonal relationships could lead to stuttering (Barbara, 1965, 1982; Wyatt 1969)
Proposed reasons for stuttering include gaining attention, sympathy and avoiding responsibilities
Freud himself did not believe in the effectiveness of a psycho-analytical approach with stuttering

The Diagnosogenic Theory

Also known as the "stuttering begins with its diagnosis" theory
This theory proposes that negative reactions from those around children experiencing disfluency can cause the disfluency to become stuttering
Van Riper (1982), Yairi (1997), and Yairi and Ambrose (1999) found that both stutter-like and normal disfluencies occur at stuttering onset, making this theory invalid

Learning

Classical conditioning can evoke negative emotional responses (Pavlov's dog)
This can occur through repeated associations: a neutral stimulus (phone) and another stimulus (dysfluency) that consistently evokes a response (emotional arousal)
The repeated associations result in the neutral stimulus (phone) evoking the emotional response associated with stuttering, even if stuttering hasn't yet happened.
The emotional response can actually trigger stuttering.
This theory has clinical implications: a child may learn that certain speaking situations are challenging
Unlearning these associations has potential for change in therapy e.g. avoidance reduction therapy, family communication skills

Learning: Operant conditioning

Skinner (1953) proposed the association between a behaviour and a consequence
Positive reinforcement increases behaviour, negative reinforcement decreases behaviour
Operant conditioning suggests disfluency is shaped by the response it elicits, and listeners’ responses to a child’s disfluencies reinforce their occurrences
In this theory, disfluencies are shaped into greater abnormality with associated struggle and secondary characteristics (avoidance and escape behaviours)
Operant conditioning is better at explaining how stuttering evolves, not explaining the onset of stuttering.

Multifactorial Dynamic Pathways Theory of Stuttering

This theory was proposed by Smith and Weber (2017)

Constantino (2018) suggests a social model of disability where impairment is a medical or physical condition and disability is a social condition.
Within the social model, disability is imposed on top of impairment through discrimination, stigma and prejudice.
Individuals who stutter are disabled by societal expectations of fluency, discrimination against nonstandard speech, and speaking time constraints.
The medical model suggests individual who stutters has a deficit in functioning that can be researched, identified, modified, and cured.
The main difference between the two theories is that the medical model positions the deficit within the individual, while the social model positions the disadvantage within society.

Neurodiversity

Constantino (2018) proposes that neurodiversity emphasizes natural variation and the unique skills, experiences, and traits of neurodivergent individuals.
Neurodiversity rejects the medical model’s claim that stuttering is a pathology and the social model’s claim that it is an impairment.
Rather, there is a mismatch between stuttering and an environment not designed for the individual.

Resources

StutterTalk Podcast
Film: When I Stutter
Play: Unspoken
Spotify: Vivian Sisskin

Additional Resources

Campbell, P., Constantino, C.& Simpson, S.(2019).Stammering pride and prejudice: Difference not defect.J&R Press.Constantino, C.(2018).What can stutterers learn from the neurodiversity movement?Seminars in Speech and Language, 39(4).Dr Soo-Eun Chang interview on StutterTalk: https://stuttertalk.com/what-causes-stuttering-with-dr-soo-eun-ch ang-568/ (5.30-8.10) Cluttering: https://www.youtube.com/watch?v=LfXgh3dQH1M Singer, C.et al.(2020).Clinical Characteristics Associated With Stuttering Persistence: A Meta-Analysis.Journal of Speech, Language, and Hearing Research, (63) 2995–3018.

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Description

Explore the research findings on atypical cerebral asymmetries and their relationship with stuttering as presented by Foundas et al and other key studies. Delve into the implications of temporal and linguistic processing deficits in individuals who stutter. This quiz will test your understanding of how brain asymmetries affect speech production and processing.