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Chapter 5 Fluency Disorders INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Introduction The peculiarity of stuttering is undeniable and is on...

Chapter 5 Fluency Disorders INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Introduction The peculiarity of stuttering is undeniable and is one of the most identifiable communication disorders. Some of the world’s leading experts in stuttering were drawn to the field of speech-language pathology because they themselves have a fluency disorder. INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Terminology & Definitions Fluency: the effortless flow of speech. Disfluency: a disruption or breakdown in the flow of speech. Two primary fluency disorders are: Stuttering Cluttering INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Some Famous People Known to Stutter In the Present: Rowan Atkinson, actor who plays Mr. Bean Bruce Willis, actor (films include 'Die Hard') Samuel L. Jackson, actor (films include Star Wars: Episodes 2 and 3) James Earl Jones, voice of Darth Vader in 'Star Wars' Sam Neill, actor (films include 'Jurassic Park 3') In the Past: Marilyn Monroe, (1926-1962) actress King George VI, (1895-1952), King of England Winston Churchill, (1874-1965), PM of Britain during World War II Lewis Carroll, (1832-1898), author of Alice in Wonderland Charles Darwin, (1809-1882), British naturalist George Washington, (1732 -1799), first president of the USA Isaac Newton, (1643-1727), scientist who developed the Law of Gravity INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Historic Aspects of Fluency Disorders Jean-Marc Gaspard Itard (1774-1838) Rudolf Schulthess (1802-1833) Johann Friedrich Dieffenbach (1792-1847) Charles Van Riper James Yearsley (1805-1869) Lee Edward Travis (1896-1987) Charles Van Riper (1905-1994) Wendell Johnson (1906-1965) Bryng Bryngelson (1892-1979) Lena Rustin (1928-2004) Wendell Johnson INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Types of Fluency Disorders: Developmental Stuttering Stuttering is found to occur in all languages of the world. Occurs in 1 out of every 100 individuals. Onset of stuttering occurs from 2-5 years of age. Involves overt (observable) and covert (non-observable) behaviors. INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Stuttering Overt Behaviors Primary Stuttering Behaviors: Interjections Sound/Syllable Repetition Word Repetition Phrase Repetition Audible Sound Prolongation Inaudible Sound Prolongation (Block) Revision Combination of any of the above INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Disfluency Notation Systems INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Stuttering Covert Behaviors Secondary Behaviors Bodily Movements: facial grimaces head movements loss of eye contact Psychosocial Behaviors: Fear Frustration Embarrassment Anger Word avoidance INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Types of Fluency Disorders: Non-developmental Stuttering Neurogenic Stuttering: results from conditions affecting various areas of the brain. Psychogenic Stuttering: a condition referring to people in whom a psychological disturbance is clearly diagnosed. Cluttering: a disorder of speaking rate. INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Stuttering & Cluttering INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Popular Theories Regarding Stuttering Demands and Capacities Theory (Starkweather, 1997) Covert Repair Theory (Postma & Kolk, 1993) Neuropsycholinguistic Theory (Perkins, Kent & Curlee, 1991) INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Assessment of Fluency Disorders Are Speech Disfluencies Present? Speech Sample Disfluency Count What is the Nature of the Speech Disfluencies? Occurrence of within-word disfluencies (SLD) Stuttering Severity Scales Occurrence of secondary behaviors INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Severity Scales Iowa Scale 9-pt Scale INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Treatment of Fluency Disorders Traditional Approaches – Fluency Shaping: designed to modify all aspects of the client’s speaking behavior. – Stuttering Modification: designed to address individual moments of stuttering, as opposed to changing the entire pattern of speaking behavior. INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Treatment of Fluency Disorders Nontraditional Treatment Approaches – Hypnotherapy: a psychologically based approach to the treatment of stuttering. – Drug Therapy: use of antianxiety medications to reduce moments of stuttering – Electronic Devices: closely resemble hearing aides that provide an auditory distraction to help alter the individual’s overall speaking behavior. INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Cultural Considerations and Fluency Disorders Careful considerations are required in the diagnosis and management of fluency disorders among individuals from diverse cultural backgrounds. Use of fluency shaping versus stuttering modification therapy needs to be considered from a cultural perspective. Bilingualism and stuttering is a complex issue. INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Current Research Communication Restriction Genetics Smartphones INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.