psychological theories of sttg sm.ppt

1. Ms S. Pathak
Clinical Lecturer

2.  One first school of thought, all PWS
exhibit signs of psychological
maladjustment.
 Fortunately, there is little empirical
support for this position.
 Another school of thought, view
stuttering as a speech mechanism
disturbance that has the potential to be
emotionally handicapping. (abnormal risk
for psychological maladjustment).

3.  The fact that the source of stuttering
remains obscure and that the outlines of
the problem are often ill-defined
 and apparently shifting contributes
indirectly, but substantially, to the belief
that stuttering is basically ‘psychological’?
 All psychological interpretations of
stuttering believe that EMOTION – of a
“negative” character –plays a central role.

4.  It is easy to appreciate how emotion has attained
prominence in explanations of stuttering:
 Many PWS report that their stuttering varies
according to circumstances and is related to how
they feel-,,
apprehensive/secure.
threatened/
confident
tense/relaxed

5.  Stuttering is seen as a neurosis (Silverman, 1996)
 What is a neurosis?
 a neurotic behaviour usually presents 3 major
characteristics..,
 Unpleasant feelings
 Inability to understand/accept the feelings
 Patterns of behaviour that symbolize and
maintain them.

6.  According to the Repressed Need Hypothesis,
individuals who stutter do so as a result of a
repressed, neurotic, unconscious conflict.
Stuttering has been described as an integrated,
purposeful activity that a person performs
because he unconsciously wishes to.

7.  Stuttering has been viewed as a covert
expression of hostile or aggressive impulses
that the person fears to express openly.
 Stuttering may represent the unconscious
desire to suppress speech – the stoppages in
the stutter’s speech result from a conflict
between all of the conscious pressures and
needs that force him to speak and his
conscious wish to be silent.

8. LEARNING THEORIES and STUTTERING
 AMMAN (1970) first stated that stuttering was a
bad habit.
 ARNOTT (1928) BELIVED THAT STUTTERING
RESULTED FROM A LEARNED “SPASM OF THE
GLOTTIS”.
 According to Blood stein (1997), stuttering is a
learned behaviour”.

9.  Modern concepts of stuttering as Learned
Behaviour:
 learning plays some part in determining the
patterns of behaviour shown by advanced PWS.
 The different varieties of stuttering reactions,
the changes that occur as the disorder develops
as well as the role of situational and verbal cues
in its precipitation all testify to the influence of
learning.
 However there is much disagreement about the
exact role that learning plays-how is the original
stuttering learned, shaped and maintained and
whether it can be unlearned?

10.  THE ANTICIPATORY STRUGGLE HYPOTHESIS:
 This hypothesis states that the PWS interferes in
some manner with the way he is talking because
of his belief in the difficulty of speech .
 tendency to have difficulty whenever he expects
to stutter and to speak fluently when not
“thinking” about his speech (that is the
anticipation of stuttering lead to stuttering).

11.  Failure of automaticity:
 Stuttering is said to result from the attempt to
exercise conscious control over the automatic
processes of speech.
 According to WEST, the stutterer tends to create
difficulty for himself by voluntarily producing
individual speech movements rather than by
initiating “automatic serial responses”.

12.  Anticipatory Avoidance (proposed by JOHNSON):
 stuttering begins as a child’s effort to avoid
normal disfluencies.
 In older childhood and adulthood, stuttering is
nothing more than the speaker’s attempt to avoid
stuttering.
 Faced with a “difficult” word, he makes an effort
not to stutter on it.
 But the very effort that he makes is the stuttering.
 And having stuttered, he confirmed the belief that
the word was difficult and so is the more likely to
try avoid stuttering on the same word the next
time.

13.  APPROACH – AVOIDANCE CONFLICT
(DEVELOPED BY SHEEHAN , 1953):
 Stuttering may be represented as the resultant
of a conflict between opposing wishes to speak
and to keep silent.

14.  This approach-avoidance conflict, according to
Sheehan , shown up on various levels:
 1). The word level
 2). The situational level
 3).The level of emotional expression
 4). The level of interpersonal relationships
 5). The ego protective conflicts that result in the
oscillations and fixations of speech

15.  1).The word level ( saying sounds or words
which have been feared or are hard to
pronounce or carry unpleasant meanings.
 2).The situational level (where communicative
situations are such that the speaker both desires
to enter them and to avoid them).
 3).The level of emotional expression (in which
opposing desires to express hate and love etc
are involved).

16.  4). The level of interpersonal relationships (e.g.
wanting to impress the boss and fearing he
may reject you).
 5).The ego protective conflicts that result in
the oscillations and fixations of speech
 The more of these conflicts that are involved in
any moment of stuttering, the harder and
longer one stutters.

17. Theory applies to precipitating and
maintaining factors. It is not a theory of
etiology.
 Levels of Conflict
◦ approach-approach
◦ avoidance-avoidance
◦ approach-avoidance
◦ double approach-avoidance

18. • Conflict occurs when a person experiences
demands or desires that are incompatible with
each other.
• In approach-approach conflict one is attracted
to two equally desirable goals.
• In avoidance-avoidance conflict we must
choose between two equally undesirable
demands.
• In approach-avoidance conflict we have one
goal that has positive and negative aspects.
• And in double approach-avoidance conflict we
experience two or more goals, both of which
have positive and negative aspects.

20.  Preparatory set (Van Riper ):
 In advance on the attempt of a word perceived
as difficult or feared, the PWS tends to ..,
 Place him in a characteristic muscular and
psychological “set” which determines the form
of the subsequent stuttering block.
 This set has essentially three identifiable
features:

21. 1) First he establishes an abnormal focus of tension
in his speech organs.
2) Second he prepares himself to say the first sound
of the difficult word as affixed articulatory
posture rather than as a normal movement
blending with the rest of the word.
3) Third he may adopt this unnatural posture of his
speech organs appreciably before he initiates
voice or airflow, resulting in a silent
“preformation” of the sound.

22.  TENSION:
 whenever we are faced with the threat of failure
in the performance of a complex activity
demanding accuracy or skill we are likely to
make use of abnormal muscular tension.
 In stuttering , the underlying tension produces
prolongations and hard attacks.

23.  Fragmentation: we are also apt to produce a
portion of the act separately and sometimes
repeatedly before we complete it.
 The repetitions of stuttering may be interpreted
as a fragmentation of speech units.

24.  Bloodstein, 1961, 1993, 1995
 Sttg as a learned behavior
 Increase in normal disfluencies due to
increase in tension and fragmentation
 Esp part word repn increase and the pattern
becomes chronic.

25.  SHAMES and SHERRICK (1963): disfluency of
any kind, normal or abnormal, can be
considered an operant because it can be
increased or decreased, or shaped into varied
forms by differential reinforcement.

26.  Two-factor theories in stuttering
 Brutten and Shoemaker (1967)
 combined both the operant and classical kinds
of conditioning.
 initial fluency breaks occurred as a result of
classically conditioned negative emotion being
associated with the act of speaking.
 Via classical conditioning, the learned negative
emotion disrupts the cognitive and motoric
production of speech.
 The automatic nervous system responds to
this negative emotion.
 The development of secondary behaviors that
follow are the result of respondent or operant
conditioning.

27.  Respondent Learning Theory: Classical
Conditioning
 Here the core behavior of stuttering is attributed
to the disruptive effects of negative emotion on
the sequencing of speech.
 strong emotions such as the expectation of
imminent unpleasantness, punishment, or
frustration are disintegrative, and they produce
breakdown not only in the formulation of
messages but also in their motoric expression.


28.  In the stutterer, any stimulus previously
associated with the emotions that originally
produced such breakdown would tend to create
fear and also to disrupt speech.
 In this view stuttering is learned in the same
way that dogs learn to stop eating and to jump
spasmodically when a tone is presented which
was previously paired with an electric shock.
 Hence, stuttering has been classically
conditioned.

29. Operant conditioning forms an association
between a behavior and a consequence.
(It is also called response-stimulus or RS
conditioning because it forms an association
between the animal's response [behavior] and the
stimulus that follows [consequence]).
 Positive reinforcement.

30.  Punishment
 Negative reinforcement.( secondaries) a
behaviour followed by termination of
unpleasant situation.

32.  THE DEMAND AND CAPACITIES MODEL: Gottwald
& Stark weather, 1995
 proposes that stuttering occurs when demands
for fluency are greater than the child’s capacity
to produce it.

33.  The DC model proposes four developmental
factors or capacities related to fluency:
 speech motor control
 language development
 social
 emotional functioning
 cognitive development

34.  Demands: within the child/ in the external
environment, or both
 time pressure, innate and environment
pressure to use more complex language, high
levels of excitement and anxiety , and
parental demands for increased cognitive
functioning.
Internal/External
demands
Child capacities

35.  The central points of the model summarized as
follows:
 capacities

motor
linguistic
Socio-
emotional
Cognitive

36.  Simultaneously, demands from the
communicative environment (motor, linguistic,
socioemotional, cognitive) increases because
individuals in the children’s environment and the
children themselves come to demand or expect
more mature behavior.

37. demand
capacities
Stark weather and Givens- Ackerman (1997, p.67) state
thang as the child’s capacities for producing fluent speech
are ahead of the demands for fluency that the child’s
environment presents, the child will speak
fluently.

38. However, when the demands become too great or
the capacities have not developed fast enough,
he or she will not be able to speak fluently.
Because demands vary according to a number of
factors.
Hubbell, 1981...., According to him, the
stuttering will occur when the child’s capacity is
insufficient, irrespective of the level of demand.

39. capacities
 “insufficient” “sufficient”
levels tat could make it
difficult
for a given child to meet
the
demands placed on him
levels that would not
reduce a given child’s
abilities to meet those
demands

40.  stuttering occur no matter what demands are
made by the environment. That is, the causal
factors of stuttering are within the child

 DEMAND
 Appropriate inappropriate
 Sufficient
 Capacity

 Insufficient
Fluency Fluency
Stuttering Stuttering

41. stuttering will occur when demands is
inappropriate ,irrespective of the child’s
constitution. That is, the causal factors of
stuttering are within the environment
DEMAND
 Appropriate inappropriate

 Sufficient
 Capacity

 Insufficient
Fluency Stuttering
Fluency Stuttering

42.  stuttering will occur only when the demand for
fluent speech is at a level higher than what the
child’s capacity
 Low demand high

high
capacity
low
Fluency Fluency
Fluency Stuttering

43.  Smith and Kelly (1997)
 Stuttering “... as an emergent, dynamic
disorder” and proposes “… that stuttering refers
to processes that change in time, rather than to
compartmentalized, static events”.
 Multifactorial and interactional in nature and
based on the principles of nonlinearity and
dynamism (Smith and Kelly, 1997).
 No single factors can be identified as “the cause
of stuttering”.

44.  The intrinsic factors such as genetic, organism,
emotional, cognitive and linguistic themselves
interact with one another while they also are
interacting with environmental factors.
 It appears From the DC model that stuttering
results when the interacting factors affect the
operations of the speech motor system.

45.  Johnson in 1942
 Stuttering began “not in the child’s mouth but in
the parent’s ear”.
 disorder is usually caused by a parent’s diagnosis
of normal disfluency in the child’s speech as
stuttering.
 According to Johnson’s theory, it was not
excessive hesitancy that usually caused a child to
develop anticipatory reactions of struggle or
avoidance, but abnormal parental reactions to
this hesitancy.

46.  Stuttering is a definite disorder which was
found to occur, not before being diagnosed,
but after being diagnosed (Johnson, 1944).
 Having been evaluated as a stutterer, in
Johnson’s view, the child was indeed likely to
begin speaking differently in response to …,
 parental anxieties, pressures, criticism, and
correction

47.  Johnson’s theory is somewhat of an extension
of the concepts of primary and secondary
stuttering developed by Bluemen (1932).
 Bluemen described primary stuttering as
unconscious repetitions made without effort
or struggle that would eventually cease if the
child attention were not drawn to them.
 however, the child was made aware of the
repetitions and make anxious about them,
then secondary stuttering, or fully developed
stuttering, would result.

48.  Proposed by Bloodstein (1958): “stuttering is
caused by communicative failure as perceived
by the child”.
 This view point states that what is first
identified as stuttering usually begins from
certain types of normal dysfluency
 and is brought about largely by provocation
of continued communicative failure in the
presence of communicative pressure.

49.  Retarded language development articulatory
errors, reading difficulty, cluttering, difficulties
of phonation or practically any other kind of
verbal ineptness or obstacle to communication
 may render child more or less chronically
subject to the threat of speech failure to the
degree that his attempt to speech may become
more tense and fragmented than those of the
average child who experiences such difficulties
in mild and intermittent form.

50.  Such threat of failure is worsened by high
parental standards of speech or other speech
pressures such as competition with siblings
more advanced in speech development,
excessive praise for good speech or
identification with an adult having a reputation
for superior speech.

51.  There may be some personality triads of the
child himself (ex: the tendency to be
unusually sensitive, fearful, dependent,
perfectionist, easily frustrated or too anxious
for approval).
 That renders him more vulnerable to the
provocation and pressure that may lead
anticipatory behaviour.


52. 
 One might expect that stutterers with a long
history of communicative failure would show
lower levels of aspiration if only to protect
themselves from further failures.

53. 
 Stuttering has been described as ‘the learned
phobias of speaking’.
 ASAMIANI and KOZOKOV (1974) state that
almost all of the adult stutterers they
examined has developed logophobias
whether their disorders were accompanied by
brain damage or not.

54.  The stutterer “experiences strange difficulties
in the performance of an automatic skill
(speaking) which previously he had been able
to carry out with the greatest ease.
 These difficulties may arise from many
different stress factors (interpersonal
conflicts, difficulties in verbal formulation and
recall, physical and emotional traumatic
experience, fear of listener’s reactions and
many others.

55.  As a person experiences life, he develops a
system of personal constructs that allow
him to anticipate further events.
 These constructs become the person’s
reality.
 Change, especially as result of therapy,
requires a person to develop alternative
constructs – a difficult process since it
means letting go of accepted and safe views
to attempt new ways of thinking and acting.

56.  According to the Theory of Personal
constructs,
 Anxiety is defined with reference to the
inadequacy of an individual’s personal
constructs in a given situation.
 ‘Cognitive Anxiety’ has been defined by
VINEY & Westbrook as “awareness that one’s
construct systems are inadequate to allow full
and meaningful construing (and therefore
prediction) of events with which the person is
constructed.

57. 
 FRANSELLA (1972) proposed that persons
who stutter fail to meaningfully integrate
experiences of fluent speech but instead,
develop construct systems based on the
experience of stuttering.

58.  For persons who stutter, the fluent speaker
role tends to lack any meaningful predictive
quality, whereas the stutterer role tends to be
more “meaningful” so that it facilitates
accurate prediction of internal and external
reactions to, and consequences of, speaking.
 Fransella concluded that a person continues
to stutter because it is in this way that life is
most meaningful to him.