Which one of the following is the most evident sign of the intermediate stutterer?

a.  Tense prolongations

b.  Monosyllabic whole-word repetitions

c.  Tense part-word repetitions

d.  Blocks

d.  Blocks

True/False.

Four major characteristics of the intermediate stutterer are Fear, Avoidance, Struggle, and Shame.

TRUE

approach

1) an intermediate stutterer is starting to fear stuttering, whereas beginning stutterers are usually only frustrated, surprised, or annoyed by it;

2) the intermediate stutterer reacts to his fear of stuttering by appearing to avoid it, something beginning stutterers don’t do with any regularity.

True/False.

A realistic fluency goal for many intermediate stutterers is:acceptable stuttering; that is, fluency mixed with mild or very mild stuttering.

TRUE

Explain a “stuttering friendly” environment.

It is an environment in that increases the child’s comfort using the techniques learned in treatment.

True/False.

According to Carl Dell, an intermediate stutterer should be dismissed from therapy once they are completely fluent and are able to transfer their fluency to their natural environment.

FALSE- Dismissal occurs when the stutterer is confident that they can control their remaining stuttering and before they are completely fluent

List 2 ways a classroom teacher can help an intermediate stutterer in the classroom setting:

Oral Participation- The teacher and child can get together and discuss ways in which the child can participate in the most comfortable manner. For example, the child might like to get called upon first to prevent the build up of anxiety.

Teasing- The teacher is responsible for dealing with teasing in the classroom. They should eliminate the teasing and educate the students.

Carl Dell’s direct treatment of an intermediate stutterer begins by teaching the child three ways of saying words. What are the three ways?

1. Regular (fluent)
2. Hard stuttering (typical stutter)
3. Easy stuttering (Effortless prolongations or repetitions)

Bruce Ryan’s treatment of an intermediate stutterer using delayed auditory feedback follows three phases. Which one is NOT one of the phases?

a. Exploration

b. Maintenance

c. Establishment

d. Transfer

a. Exploration

True/False.

During the home hierarchy of Ryan’s transfer phase, the child begins with either parent carrying out the transfer procedures, whether or not they attended the previous therapy sessions.

FALSE- The home hierarchy starts with the parent that practiced the transfer procedure in the therapy room with the SLP.

June Campbell and Hugo Gregory teach the intermediate stutterer to use a fluency-enhancing skill they describe as an, “easy, relaxed approach with smooth movements” (ERA-SM) which involve a slower rate of speech and smooth transitions from sound to sound and word to word. These changes occur in:

a. Beginning of words, phrases, and  entire sentences

b. Beginning of words

c. Beginning of words and phrases

d. None of the Above

c. Beginning of words and phrases

d. A & C only

True/False.

Spontaneous fluency is a realistic goal for an advanced stutterer.

FALSE

True/False.

Counterconditioning occurs when feared words and situations are experienced over and over again in the presence of positive feelings.

TRUE

Describe the “freezing” technique

Freezing is a technique where a client stutters and the clinician signals them to hold on to that stutter until signaled to come out of it. The client is encouraged to maintain eye contact and remain calm. As their tolerance increases, the length of time the client is asked to hold the stutter is increased. Eventually the client will hold on to the stutter until the tension and struggle have disappeared and they can end the stutter easily and slowly.

______________ occurs when words and situations that elicit low levels of fear are experienced over and over, in the absence of feared consequences, until the client’s fears are extinguished.

Deconditioning

Which is not a part of treatment for an advanced stutterer?

a. Decreasing fear and avoidance and increasing approach behaviors

b. Counseling parents or caregivers

c. Teaching controlled fluency and transferring it into anticipated stuttering

d. Increasing motivation to change

e. Teaching coping strategies to deal with residual stuttering

b. Counseling parents or caregivers

• Intensive and non-intensive treatment
• Medication
• Assistive devices

True/False.

The responsibility for stutters to manage their own speech is not gradually transferred to them over the course of treatment.

FALSE

Motivation to change; Fear and avoidance

For many clients, continued work is needed on ________________(increasing/decreasing) approach behaviors and ___________________(increasing/decreasing) avoidance behaviors.

Increasing; Decreasing

What are some reasons you could give clients as to why voluntary stuttering may be helpful?

• Reduces tension and avoidance
• Decreases fear
• Facilitates the use of controlled fluency

1. Flexible rate
2. Easy onsets
3. Light contacts
4. Proprioception

In ______________________, stuttering remains constant or increases while speaking under fluency-inducing conditions; whereas in ______________________, stuttering does not reduce in fluency inducing conditions.

Psychogenic stuttering; Neurogenic stuttering

What is the typical onset of Neurogenic stuttering and Psychogenic stuttering? Give an example for each. 

• Neurogenic stuttering usually occurs after childhood following a neurological event, such as a stroke or head trauma.
• Psychogenic stuttering is a late onset disorder that occurs after a prolonged period of stress or a traumatic event, such a divorce or death.

Psychogenic stuttering is characterized by which of the following:

a. Injury to the nervous system

b. Absence of neurological factors

c. Dramatic decline with trial therapy

d. Reduction in severity when speaking under fluency inducing conditions

b. Absence of neurological factors

True/False.

Clutters become more fluent, as well as slower and more intelligible, when they make an effort to control their disorder.

TRUE

The steps used in Trial Therapy for Psychogenic Stuttering are:

a. Have the client stay in a moment of stuttering.

b. Have the client touch places on face or throat where there is tension

c. Coach the client to slowly finish the stuttered word

d. Guide the client to follow these steps while reading aloud or conversing.

e. All of the above

f.  None of the above

e. All of the above

-Etiology: Both are neurological

-Onset: Both during preschool years

-Speech Characteristics:

• Developmental stuttering- single syllable, whole word, and part word repetitions, prolongations, and blocks.
• Cluttering - rapid bursts of speech

-Treatment:

• Developmental stutters benefit from stuttering therapy
• clutters benefit from self regulating speech rate and fluency.

True/False.

Neurogenic stuttering occurs after a neurological event, therefore stuttering is never observed after presenting a neurological problem.

FALSE

-Stroke

-head trauma

-tumor

When treating neurogenic stuttering clients, every effort needs to be made to rule out:

a. memory,

b. language formulation

c. emotional distress tests

d. all of the above

d. all of the above

True/False.

Neurogenic stuttering clients may feel frustrated but not fearful or anxious about stuttering.

TRUE

Evidence data from psychogenic stuttering and neurogenic stuttering have reported treatment success. List two different techniques used to treat each disorder.

• Psychogenic stuttering techniques: Fluency shaping, tension reduction
• Neurogenic stuttering techniques: Pacing, masking

True/False.

Psychogenic stuttering treatment includes fluency shaping, masking, and pacing among other techniques which have been significantlyeffective for stutterer clients participating in individual and group treatment programs

FALSE