National Stuttering National Stuttering Awareness WeekAwareness Week

Speech- Language Pathology DepartmentSpeech- Language Pathology Department

FMH Rose Hill RehabilitationFMH Rose Hill Rehabilitation

May 2010May 2010

What is What is StutteringStuttering??

Stuttering affects the fluency of Stuttering affects the fluency of speech. It is characterized by speech. It is characterized by disruptions with speech sounds and disruptions with speech sounds and words such as repetition, laryngeal words such as repetition, laryngeal blocks, and prolongations. blocks, and prolongations. (ASHA)(ASHA)

What are signs and symptoms What are signs and symptoms of stuttering?of stuttering?

Core (Primary) BehaviorsCore (Primary) Behaviors1.1. Laryngeal BlocksLaryngeal Blocks

2.2. RepetitionsRepetitions• SyllableSyllable

• WordWord• PhrasePhrase

3.3. ProlongationProlongation

Secondary BehaviorsSecondary Behaviors11.. Avoidance Avoidance

** CircumlocutionsCircumlocutions** Starters Starters** Not entering Not entering

feared feared contexts.contexts.

2.2. Escape/Disguise Escape/Disguise** Head nods/jerks Head nods/jerks** Eye blinks Eye blinks** hand/foot tapping hand/foot tapping

What age does stuttering What age does stuttering occur?occur?

2-4 years2-4 years

7-9 years7-9 years

11-13 years11-13 years

Stuttering in Two Perspectives:Stuttering in Two Perspectives:

A. PhysiologicalA. Physiological B. B. PsychologicalPsychological

(muscles, breathing, voice, speech) (emotions, feelings)(muscles, breathing, voice, speech) (emotions, feelings)

What causes stuttering?What causes stuttering?

Stuttering occurs Stuttering occurs when 1 out of the 3 when 1 out of the 3 subsystems is NOT subsystems is NOT functioning properly functioning properly for fluent speech. for fluent speech. These include:These include: RespirationRespiration PhonationPhonation Articulation Articulation

Respiration(The Lungs and Abdomen)

Articulation(Lips, Tongue, Jaw)

Phonation(The Larynx)

a. Physiology: Respirationa. Physiology: Respiration

The child, adolescent, The child, adolescent, and adult must take and adult must take in enough air using in enough air using the muscles of the the muscles of the abdomen and abdomen and thoracic cavities. thoracic cavities. When this does not When this does not happen, the patient happen, the patient will experience lack will experience lack of breathing of breathing CONTROLCONTROL. .

a. Physiology: Phonationa. Physiology: Phonation

The vocal folds of the The vocal folds of the larynx must move larynx must move in a “easy-flowing” in a “easy-flowing” motion to produce motion to produce proper proper controlcontrol and and comfortablecomfortable voicing. When this voicing. When this does not happen, does not happen, the vocal folds the vocal folds become closed, become closed, causing blocks. causing blocks.

a. Physiology: Articulationa. Physiology: Articulation

The tongue, jaw, and The tongue, jaw, and lips must feel lips must feel comfortable comfortable and under and under controlcontrol to produce to produce accurate speech. accurate speech. When this does not When this does not happen, all speech happen, all speech muscles become muscles become “tight” resulting in “tight” resulting in tension and blocks. tension and blocks.

b. Psychological: Negative b. Psychological: Negative EmotionsEmotions

When stuttering When stuttering occurs, the patient occurs, the patient may feel frustrated, may feel frustrated, guilty, guilty, embarrassed, and embarrassed, and most of all, most of all, negative about negative about him/herself, thus him/herself, thus resulting in lack of resulting in lack of confidence. confidence.

b. Psychological: Teasing and b. Psychological: Teasing and BullyingBullying

Preschool and school-Preschool and school-aged children may aged children may deal with other kids deal with other kids teasing and bullying teasing and bullying about their speech, about their speech, making them feel making them feel uncomfortable and uncomfortable and most of all, developing most of all, developing a low self-esteem of a low self-esteem of themselves. themselves.

b. Psychological: Avoidanceb. Psychological: Avoidance

Negative emotions associated with Negative emotions associated with stuttering include anxietystuttering include anxiety

Fear of entering certain speaking Fear of entering certain speaking situationssituations

Sense of humiliation in certain difficult Sense of humiliation in certain difficult speaking situationsspeaking situations

Avoidance may occur with certain Avoidance may occur with certain sounds, words, resulting in sounds, words, resulting in circumlocutioncircumlocution

What treatments are available What treatments are available for stuttering?for stuttering?

Patients will learn to use Patients will learn to use strategies to produce strategies to produce fluent speech such fluent speech such as:as:

1.1. Easy onsetEasy onset

2.2. Light Loose ContactLight Loose Contact

3.3. Fluency Shaping Fluency Shaping TechniqueTechnique

4.4. Monitoring rateMonitoring rate

Patients will learn to Patients will learn to “change” their “change” their lifestyle to increase lifestyle to increase their confidence and their confidence and comfort levels such comfort levels such as:as:

1.1. Using positive self Using positive self talktalk

2.2. Self-AdvertisingSelf-Advertising

3.3. MeditationMeditation

Being a HERO to oneself is a Being a HERO to oneself is a wonderful feelingwonderful feeling

Respiration

Phonation

Articulation

Confidence

ControlComfort

Are there organizations that Are there organizations that have more information on have more information on

stuttering?stuttering? American Speech-Language-Hearing American Speech-Language-Hearing

AssociationAssociation The American Institute for StutteringThe American Institute for Stuttering

National Stuttering AssociationNational Stuttering Association Stuttering Foundation of AmericaStuttering Foundation of America

International Stuttering AssociationInternational Stuttering Association Stuttering Home PageStuttering Home Page

ReferencesReferences

Rosenberry-McKibbin, C. and Hegde, M.N. (2000). Rosenberry-McKibbin, C. and Hegde, M.N. (2000). An Advance An Advance ReviewReview of Speech-Language Pathologyof Speech-Language Pathology..

American Speech-Language Hearing Association. (1997-2009). American Speech-Language Hearing Association. (1997-2009).

Miranda, R.E. (2007) Miranda, R.E. (2007) Standing Up and Speaking OutStanding Up and Speaking Out. ASHA . ASHA Leader, September 4 edition. Leader, September 4 edition.