Fluency

= = Fluency disorders are speech disorders that are characterized by a disruption of the fluency, smoothness or rhythmic flow of oral language.
 * __ Fluency Disorders __**  **Standards: III-B, III-C, III-E, III-F, and IV-B **

[|The Basics] [|The Stuttering Foundation of America] [|National Stuttering Association]

__Types__ __Cluttering__ __Neurogenic Stuttering__ __Stuttering of Early Onset__ __Core Behaviors__ __Secondary Behaviors__ __Feelings and Attitudes__ __Theories__ __Assessment__ __Treatment__
 * 1) Cluttering
 * 2) Neurogenic Stuttering
 * 3) Stuttering of Early Onset
 * A fluency disorder characterized by a rapid and irregular rate, imprecise articulation, and disorganization. The individual is usually unaware of his/her dysfluencies. Treatment of cluttering usually focuses on increasing awareness and decreasing rate of speech.
 * A fluency disorder characterized by a late onset of neuropathic origin, such as, stroke, head trauma, extrapyramidal diseases, tumor, dementia, and long use of prescription drugs. Dysfluencies include repetitions, prolongations, and blocks.
 * A fluency disorder characterized by repetitions, prolongations, blocks, and an early onset.
 * Repetitions: may be repeating a whole phrase, word, syllable or sound
 * Prolongations: the lengthening of a speech sound
 * Blocks: the stoppage of air flow that occurs when someone is trying to speak, it may occur at the lips, tongue or larynx
 * Classical conditioning: establishes and maintains core behaviors
 * Escape Behaviors: behaviors the individual engages in to try and escape the moment of stuttering
 * Avoidance Behaviors: behaviors the individual develops to try and avoid moments of stuttering
 * Operant conditioning: establishes and maintains secondary behaviors
 * Pervasive feelings and attitudes that develop from emotional reactions to moments of dysfluency.
 * Covert repair hypothesis: we think about what we want to say and formulate it, then repair it just before speaking, this theory is base on the idea stutterers do not repair their speech
 * Anticipatory struggle hypothesis/Bloodstein: children experience frustration with typical dysfluencies, with repeated difficult children start expecting to experience difficulty, anticipating difficulty increases tension and increased tension increases dysfluencies
 * SSI (Stuttering Severity Instrument): measures frequency, duration and physical concomitants of stuttering
 * Reducing rate of speech by using a pacing board
 * Delayed Auditory Feedback: [|Info about DAF]
 * Fluency shaping therapy: goals are either spontaneous fluency or controlled fluency, does not address secondary behaviors or feelings and attitudes
 * Cognitive restructuring/Emerick: targets feelings and attitudes, adjust the way a person feels about their stuttering, does not target core behaviors
 * Stuttering modification: goals could be spontaneous fluency, controlled fluency or acceptable stuttering, stutterer learns to modify stutter, addresses feelings and attitudes
 * Van Riper’s approach: modify moment of stuttering, reduce avoidance behaviors, 4 steps = identification, desensitization, modification, stabilization; slow rate, freezing, cancellations, pull outs, preparatory sets

//References// Cupples, B. (2007). Lecture presented in Stuttering-SPSI 454. Eastern Michigan University. Hegde, M.N. (2008). //Hegde's Pocketguide to Communication Disorders//. New York: Delmar Learning. Kehoe, T. (2006). //Delayed Auditory Feedback.// Retrieved April 6, 2009, from Casa Futura Technologies Web site: [] National Institute of Deafness and Other Communication Disorders. (2008). //Stuttering.// Retrieved April 6, 2009, from National Institute of Health Web site: [] National Stuttering Association. (2009). //Home.// Retrieved April 6, 2009, from The National Stuttering Association Web site: http://www.nsastutter.org/ Nicolosi, L., Harryman, E., & Kresheck, J. (2004). Terminology of Communication Disorders. Maryland: Lippincott Williams &Wilkins. Roseberry-McKibbin, C., Hegde, M. (2006). An Advanced Review of Speech-Language Pathology. Texas: Pro-Ed. The Stuttering Foundation. (2009). //Home.// Retrieved April 6, 2009, from The Stuttering Foundation of America Web site: []