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CETP – Fluency Exam Questions and Answers – 2023/2024
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CETP – Fluency Exam Questions andAnswers – 2023/2024
Disorders of Fluency
(HINT: There are 3) - -1) Stuttering
2) Cluttering
3) Neurogenic stuttering
-Fluency - -- Smooth, relatively easy (low tension/effort)
- Flowing
- Continuous
- Relatively rapid
- Normally rhythmic
- Free from an excessive amount or duration of dysfluencies
NOTE: Fluency is not as extensively studied as stuttering (i.e., dysfluencies)
NOTE 2: Characteristics of fluency contrast with those of stuttering
-Characteristics of Stuttering (i.e., dysfluent speech) - -- Produced w/
greater than normal effort
- Halting (no flow)
- Discontinuous (not smooth)
- Slow (possibly d/t multiple dysfluencies)
- Rhythm is abnormal
-Most researched fluency disorder - -Stuttering
Also defined as a disorder of rhythm
-Primary speech characteristics of stuttering - -1) Sound/part-word/syllable
repetitions (e.g., S-s-s-s-saturday or Sa-sa-sa-saturday)
2) Prolongations (e.g., Sssssssaturday)
3) Blocks (i.e., Silent prolongations)
-Defining stuttering w/ nonspeech behaviours - -- An anticipatory,
apprehensive, and hypertonic AVOIDANCE reaction (Johnson et al., 1959)
- Stuttering is not the same thing as dysfluency; Dx is made based on
consistent avoidance of speaking situations
- Stuttering begins when a child learns to avoid speech, speaking situations,
and certain audiences (listeners or CPs)
- Consists of: 1) anticipating trouble in speaking situations, 2) becoming
apprehensive about the prospect of speaking, 3) experiencing tension, and
4) avoiding the situation
,- Avoidance results from parental disapproval/punishment of normal
nonfluencies in typical speech
- Stuttering can also be defined as what a person does to avoid stuttering
(e.g., avoid speech situations in order to avoid negative consequences of
normal nonfluencies)
- Finally, it can also be defined as a social role conflict (Sheehan, 1970); the
PWS cannot play their social roles normally
- E.g., PWS may speak more fluently when talking to pets or kids, or when
acting; difficulties arise when they have to speak with their boss or
strangers. Thus, trouble playing different social roles
-Defining stuttering w/ unspecified behaviours - -- Some definitions of
stuttering don't specify behaviours (speech or nonspeech); instead refer to
stuttering molar or global terms
- Central notion to these definitions is an expert judgment; an expert's
judgment that stuttering has occurred is the definition of stuttering (i.e.,
stuttering is what the expert says it is)
- Stuttering may be defined as a MOMENT (moment of stuttering observed by
an expert during some time duration); note, this does not specify WHAT the
behaviour was
- Stuttering may also be seen as an EVENT, as recognized by an expert
- While the terms MOMENT and EVENT are used, they don't help us measure
the beahviours objectively
-Definitions of stuttering limited to certain types of dysfluencies - -- Many
types of dysfluencies exist, and this is one reason why stuttering has so
many definitions and varied diagnostic criteria
- Certain definitions include only certain dysfluencies; from their POV, some
dysfliencies are clinically significant, others are part of normal speech
- Classic definitions include only part-word repetitions and speech-sound
prolongations
- Dysfluencies like word repetitions, interjections, and pauses are considered
normal from this POV
-Van Riper: "Stuttering occurs when the forward flow of speech is
interrupted by a motorically disrupted sound, syllable, or word or by the
speaker's reaction thereto" - -- This definition restricts stuttering to sound,
syllable, or word repetitions or sound prolongations
- Emphasizes speaker reactions, which many other definitions do not.
Reactions are typically negative
-Definition of stuttering based on psychopathology (neurosis) - -- View held
by psychoanalysts and some psychologists (those who adopt Freudian POV)
- Stuttering is d/t some psychopathology or a neurotic reaction (i.e.,
exhibiting neurosis)
- Neurosis = drastic/irrational reactions; anxiety, phobias, frustrations
, - Psychological reactions like anxiety, frustration in self-expression, and
apprehension about speaking situations/specific words are self-reported by
many adults who stutter
- Freudian psychoanalysts: fixation at an earlier stage of psychosexual
development (i.e., oral or anal), frustration later in life, regression to the
fixated stage of development, and subsequent symptom formation (i.e.,
conversion of fixation to relatively socially acceptable behaviours) explains
stutttering
- Not all psychologists who believe that stuttering is a form of neurosis
believe in Freud's fixation-regression-symptom formation model; some just
believe stuttering = a formed of learned neurotic reaction
- Few SLPs believe that stuttering is d/t psychopathology
- However, psychological reactions of PWS are considered significant and
worth assessing
-Definition of stuttering based on all types of dysfluencies - -- Many experts
describe stuttering in terms of FREQUENCY and DURATION of dysfluencies
- Include all types of dysfluencies in their definition
- Accordingly, all forms of dysfluencies disrupt fluency and create a fluency
disorder, IF their frequency or duration is excessive
- Thus, stuttering = production of any or all forms of dysfluencies of
excessive frequency, excessive duration or both
-Definitions of stuttering based on etiology - -- Most definitions of stuttering
explain WHAT stuttering is; few include hypothesized causes
- One view holds that stuttering is a fluency failure resulting from classically
conditioned negative emotion; normal dysfluencies are d/t operant
conditioning
- Classical conditioning (i.e., Pavlovian) -> stimulus leads to
involuntary/automatic response
- Operant conditioning (i.e., Skinnerian) -> stimulus leads to a behaviour
which is either reinforced or punished; learned behaviour
- Only part-word repetitions and sound prolongations count here; other
dysfluencies are operantly conditioned speech disruptions
- Thus, from this pov: Strong negative emotional reactions are the stimuli
that disrupt fluent speech and lead to part-word repetitions and speech-
sound prolongations; other dysfluencies are d/t operant conditioning
-Cerebral Dominance Theory of Stuttering - -- Unlike fluent peers, PWS have
not developed unilateral (i.e., left-sided) cerebral dominance; often
ambidextrous
- People stutter d/t lack of unilateral cerebral dominance
- Few people subscribe to this theory. However, how language is processed
in the brains of PWS is an area of interest
-Repetitions - -Saying the same element of speech more than once
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