Unit 1 Fluency, Disfluency, and Stuttering


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Unit 1 Fluency, Disfluency, and Stuttering

  1. 1. CDIS 730: Unit 1 Fluency, Disfluency, and Stuttering
  2. 2. Agenda <ul><li>Discuss how fluency is defined </li></ul><ul><li>Fluency as a continuous variable </li></ul><ul><li>Types of stuttering </li></ul><ul><ul><li>More typical versus less typical disfluencies </li></ul></ul><ul><ul><li>Core versus secondary behaviors </li></ul></ul><ul><li>The “iceberg analogy” of stuttering </li></ul><ul><li>Practice identifying types of stuttering </li></ul>
  3. 3. The five dimensions of fluent speech <ul><li>Continuity or smoothness </li></ul><ul><li>Rate of speech </li></ul><ul><li>Rhythmic structure of speech </li></ul><ul><li>Information load </li></ul><ul><li>Physical and mental effort </li></ul>
  4. 4. Continuity <ul><li>Listeners perceive speech as being more fluent than it really is. </li></ul><ul><li>The average duration of continuous utterances without pausing is not very large. </li></ul><ul><li>The frequency of pauses increases as the speech act becomes more complex. </li></ul>
  5. 5. Rate of speech <ul><li>A measurement of speed, such as syllables per minute (SPM), or words per minute (WPM). </li></ul><ul><li>People naturally talk as fast as they can. </li></ul><ul><li>Coarticulation helps us to talk with about 250-360 SPM (between approximately 160-230 WPM) without excess effort. </li></ul><ul><li>The rate of speech is not constant. SPM or WPM measures do not necessarily provide much information for clinicians and researchers. </li></ul>
  6. 6. Rhythmic structure of speech <ul><li>Speech rhythm consists of: </li></ul><ul><ul><li>Segmental: the grouping of consonants and vowels (sound segments) into syllables. The time it takes to utter the individual segments in a syllable. </li></ul></ul><ul><ul><li>Suprasegmental: the grouping of syllables and linguistic stresses into phrases; the time extending over phrases. </li></ul></ul>
  7. 7. Information load <ul><li>Vowels are longer in words that convey more information. </li></ul><ul><li>Syntactic structure is one of the main causes for changes in information load. </li></ul><ul><li>The beginning of a sentence or a clause contains a high amount of information. </li></ul><ul><li>Consonant duration varies with information load and is affected by phonetic environment and positioning in the word. </li></ul>
  8. 8. Information load (cont.) <ul><li>Speech rate changes at word, clause, and sentence boundaries </li></ul><ul><li>We adjust speech to maintain a more or less constant rate of information flow: </li></ul><ul><ul><li>Slow down when information load is high at syntactic boundaries </li></ul></ul><ul><ul><li>Speed up when information load is low </li></ul></ul>
  9. 9. Effort <ul><li>Fluent speech appears to be effortless: </li></ul><ul><ul><li>Mentally requires little thought, and the speaker concentrates on the content rather than the process of the utterance </li></ul></ul><ul><ul><li>Physically requires little muscular exertion </li></ul></ul><ul><li>According to Starkweather (1987), effort may be the primary dimension of fluency with the timing variables being secondary. </li></ul>
  10. 10. Key fluency concepts <ul><li>Fluency is a multidimensional behavior </li></ul><ul><li>Fluency is not dichotomous with stuttering </li></ul><ul><li>It is on a continuum: </li></ul><ul><li>FLUENCY  DISFLUENCY  STUTTERED SPEECH </li></ul><ul><li>When smooth flowing streams of sounds are produced in an effortless, timely manner, the speaker is judged to be fluent. </li></ul>
  11. 11. Speech disfluencies <ul><li>May occur in all speakers, whether PWS or people who don’t stutter (PWDS) </li></ul><ul><li>Depending on severity, frequency, and other variables, disfluencies may be more or less typical of fluent speakers </li></ul><ul><li>There are many ways to classify disfluencies, but there are few real differences between the labels used by various researchers. </li></ul>
  12. 12. Broad types of disfluencies <ul><li>Interjections </li></ul><ul><li>Whole word repetitions </li></ul><ul><li>Phrase repetitions </li></ul><ul><li>Revisions </li></ul><ul><li>Incomplete phrases </li></ul><ul><li>Part-word repetitions </li></ul><ul><li>Prolonged sounds </li></ul><ul><li>Broken words (or blocks) </li></ul>
  13. 13. MORE TYPICAL DISFLUENCIES Also known as “between word” or “normal” disfluencies
  14. 14. Interjections <ul><li>Also known as “fillers” </li></ul><ul><li>Consist of “um,” “uh,” “like,” “you know” or any other meaningless word or phrase that is inserted before or in the middle of an utterance </li></ul><ul><li>For PWDS and PWS, may be habitual, an indicator of uncertainty, or a sign that the speaker needs more time to complete his or her thoughts </li></ul><ul><li>For PWS, may also be a sign of avoidance or fear and may be a way to postpone a moment of stuttering </li></ul>
  15. 15. Whole word repetitions <ul><li>One of more repetitions of the same word. </li></ul><ul><li>E.g., “Can we go go to the bookstore after class?” </li></ul><ul><li>Occur naturally for both PWS and PWDS </li></ul><ul><li>When only one easy repetition is present, the listener probably perceives the speaker as fluent. </li></ul><ul><li>Exception: monosyllabic whole word repetitions, e.g., I-I-I-I want the ball” are less typical and may be more representative of stuttering. </li></ul>
  16. 16. Phrase repetitions <ul><li>Similar to whole word repetitions in that they occur for both PWDS and PWS </li></ul><ul><li>E.g., “If you want, if you want I can take notes for you while you’re gone.” </li></ul><ul><li>Again, sounds pretty natural to listeners. </li></ul>
  17. 17. Revisions <ul><li>Typically occur at the word or phrase level. </li></ul><ul><li>E.g., “Kelly and me—Kelly and I can meet you at 7:00. </li></ul><ul><li>Is generally due to some issue with content or grammar of one’s speech—the speaker realizes he or she has made an error and corrects him or herself accordingly. </li></ul>
  18. 18. LESS TYPICAL DISFLUENCIES Also known as “within word” or “less typical” disfluencies
  19. 19. Monosyllabic one word repetitions <ul><li>In general, repetitions of whole words are considered more typical disfluencies. </li></ul><ul><li>Monosyllabic words are essentially just a single sound, and so their repetition is less typical for PWDS. </li></ul><ul><li>Young children, including those who will have stuttering issues, often have these repetitions, e.g., “It was a-a-a-a- bear!” </li></ul>
  20. 20. Part-word repetitions <ul><li>Repetitions of sounds/syllables </li></ul><ul><li>E.g., “C-c-can I get a r-ride later?” </li></ul><ul><li>The stuttering will be perceived as more severe depending on the tenseness of the speaker, the number of repetitions, and the rate of the repetitions. </li></ul><ul><li>Occur more frequently on consonants </li></ul>
  21. 21. Prolongations <ul><li>Are audible extensions of a sound. </li></ul><ul><li>E.g., “S---ara is my best friend.” </li></ul><ul><li>Do not typically occur with much regularity in the speech of PWDS </li></ul><ul><li>Are most common on fricative sounds, e.g., /f/, /s/, “sh” </li></ul>
  22. 22. Blocks <ul><li>Are tense, silent prolongations of a sound. </li></ul><ul><li>E.g., “I a----sked you to take out the trash.” </li></ul><ul><li>May also be called “a tense pause” or “inaudible prolongation” </li></ul><ul><li>Are the most severe in terms of the types of stuttered or less typical disfluencies. </li></ul>
  23. 23. Also note <ul><li>Unlike PWDS, PWS may have a lot of tension in their speech mechanism which is apparent to listeners. </li></ul><ul><li>PWS may experience a great deal of fear in every day speaking situations, as compared to PWDS, who may experience only occasional speech anxiety. </li></ul><ul><li>Fear of public speaking can lead everyone to want to avoid speaking, but PWS may have a general fear of speaking which may cause them to avoid many speaking/social situations. </li></ul>
  24. 24. A representation of more typical to less typical disfluencies
  25. 25. Pseudostuttering Practice! <ul><li>You will rotate partners over the course of the next 15 minutes. </li></ul><ul><li>I will call out the type of disfluency, and you and your partner will have a brief conversation in which you both incorporate that type of disfluency into your speech. </li></ul><ul><li>Give it your all! </li></ul>
  26. 26. Core Stuttering <ul><li>Applies to the most basic characteristics of stuttering: </li></ul><ul><ul><li>A disruption in fluency of verbal expression </li></ul></ul><ul><ul><li>Characterized by involuntary, audible, or silent repetitions or prolongations of sounds, syllables, and words </li></ul></ul><ul><ul><li>These disruptions occur frequently or are marked in character </li></ul></ul><ul><ul><li>The disruptions are not readily controllable </li></ul></ul>
  27. 27. Secondary Stuttering <ul><li>May or may not co-occur with core behaviors </li></ul><ul><li>Are often nonverbal </li></ul><ul><li>Includes escape behaviors that have been learned over time to try to resume fluent speech when “stuck” </li></ul><ul><li>Include postponement/avoidance behaviors in response to anticipated stuttering </li></ul><ul><ul><li>Word substitutions, circumlocution, withdrawal </li></ul></ul>
  28. 28. The stuttering cycle <ul><li>Very mild or almost unnoticeable stuttering can result in a small emotional reaction </li></ul><ul><li>The emotional reaction can cause the stuttering to become more frequent or more severe, with an according escalation in negative emotions. </li></ul><ul><li>PWS are unique, so this cycle won’t fit everyone, but there are commonalities among the experiences of PWS. </li></ul>
  29. 29. Stuttering and accompanying emotions
  30. 31. The Iceberg Analogy <ul><li>Developed by Joseph Sheehan </li></ul><ul><li>The core behaviors of stuttering are the most noticed. What is “beneath the surface” may never be apparent to listeners. </li></ul><ul><li>Because emotional reactions of PWS to their stuttering can impact stuttering severity, therapists must be prepared to address both overt and more covert aspects of stuttering. </li></ul>