Stuttering Wendell Johnson Fluency & Disfluency Fluency: The effortless flow of speech. Flow includes pauses, intonation, stress, rhythm, and rate. Fluency & Disfluency Disfluency: A disruption in the effortless flow of speech. We all produce disfluencies. Two common disorders of fluency are Stuttering and Cluttering. Stuttering (or Stammering in UK) A Definition: Occurs when the forward flow of speech is abnormally interrupted by repetitions or prolongations of a sound or syllable, articulatory postures, or by avoidance and struggle behaviours (Van Riper) Stuttering involves both overt (observable) and covert (nonobservable) behaviours. Famous People Who 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') Cameron Daddo, actor (Australia's youngest TV Game Show Host at 21) Gareth Gates, singer in the UK ('Record of the Year' 2002) Noel Gallagher, guitarist from the rock band Oasis 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 Satirization of Stuttering Stuttering: Some Characteristics • Approximately 3% of Preschoolers stutter • Approximately 1% of school-age and adults stutter • Stuttering occurs more often in boys (3:1 to 5:1) • A higher occurrence of stuttering occurs in twins • More stuttering occurs in children who are bilingual • Some situations raise or lower moments of stuttering Stuttering Behaviours Primary Stuttering Behaviours: • Interjections • Sound/Syllable Repetition • Word Repetition • Phrase Repetition • Audible Sound Prolongation • Inaudible Sound Prolongation (Block) • Revision • Combination of any of the above Stuttering Behaviours Secondary Behaviours • Bodily Movements: – facial grimaces – head movements – loss of eye contact • Psychosocial Behaviours: – – – – – Fear Frustration Embarrassment Anger word avoidance Draw a picture of what it feels like to stutter: Pre-Teen 8-yo 9-yo Source: Minn State Univ Draw a Picture of What it feels like to stutter: Teenager 18-yo 15-yo Draw a picture of what it feels like to stutter: Teenager 15-yo Components of Stuttering Behaviour Overt Covert Theories of Stuttering The actual cause of stuttering remains unknown to this day, in spite of being the most researched disorder in our profession. Some of the classic theories regarding the cause of stuttering are: • Cerebral Dominance Theory • Neurotic Theory • Conditioning Theory • Diagnosogenic Theory • Constitutional Theory Cerebral Dominance Theory View developed in the 1920’s that stuttering resulted from either a lack of brain dominance or competing hemispheres in regard to the production of speech. Neurosis Theory View developed in the 1950’s that stuttering occurs in people because of a deep-seeded unconscious wish to do so. Developed out of the fields of psychiatry and psychoanalysis. Conditioning Theory View developed in the 1950s that is based on principles of learning, specifically the notions of “punishment” and “reinforcement. Stuttering results from a conflict of opposing drives. A drive to speak (approach) and a drive to refrain from speaking (avoidance). Types of Conflict: Approach ↔Approach Avoidance ↔ Avoidance Approach ↔ Avoidance Diagnosogenic Theory Very popular theory between 1940-1970. Based on the notion that stuttering occurs as a result of an over-reaction or misdiagnosis by adults. Stuttering develops as a child’s reactions to the parent’s reaction of his/her speech. “Stuttering begins not in the child’s mouth by in the parent’s ear” (W Johnson). Constitutional Theory Consists of a number of various theories that have developed between 1980-present. The essence of these theories is that the child is predisposed to stutter. There is a deficit or breakdown in the body that causes stuttering. Examples of these theories are: Genetic Theory: stuttering is found to run in families. Physiological Theory: stuttering results from impaired respiration, phonation, and/or articulation. Development of Stuttering • The onset of stuttering is between the ages of 2-5 years, with an average of 3-years. • When stuttering first occurs it is episodic (waxes & wanes). • 50% of children are free of stuttering by age 4. • 75% of children are free of stuttering by age 6. • By 12-years of age, if no stuttering is observed, the child is risk-free. Low & High Risk Disfluencies Low Risk Disfluencies: • Interjections • Revisions • Phrase Repetitions • Whole Word Repetitions High Risk Disfluencies: • Sound/Syllable Repetitions • Any Prolongation (audible, inaudible) Other High Risk Behaviours: • Bodily Movements • PsychoSocial Behaviours Warning signs leading to stuttering in young children (Van Riper) 5 Myths about Stuttering Myth 1: People who stutter (PWS)are not smart Reality: There is no link whatsoever between stuttering and intelligence. Myth 2: Nervousness causes stuttering. Reality: Nervousness does not cause stuttering. Nor should we assume PWS are prone to be nervous, fearful, anxious, or shy. They have the same full range of personality traits as those who do not stutter. Myth 3: Stress causes stuttering. Reality: Stress is not the cause, but it certainly can aggravate stuttering. Source: ASHA Myths - continued Myth 4: Stuttering can be “caught” through imitation or by hearing another person stutter. Reality: You can’t “catch” stuttering. The exact cause is unknown but recent research indicates that family history (genetics), neuromuscular development, and the child’s environment, all play a role in the onset of stuttering. Myth 5: It helps to tell a person to “take a deep breath before talking,” or “think about what you want to say first.” Reality: This advice only makes a person more selfconscious, making the stuttering worse. More helpful responses include listening patiently and modeling slow and clear speech yourself.