Stuttering Foundations And Clinical Applications 2nd Edition By Ehud Yairi – Test Bank A+

Stuttering Foundations And Clinical Applications 2nd Edition By Ehud Yairi – Test Bank A+

Stuttering Foundations And Clinical Applications 2nd Edition By Ehud Yairi – Test Bank A+

Stuttering Foundations And Clinical Applications 2nd Edition By Ehud Yairi – Test Bank A+
  1. A clear, workable definition of stuttering is important for:
  2. determining treatment outcome
  3. differential diagnosis of stuttering
  4. measuring the effect of experimental conditions
  5. all of the above

  1. In addition to theoretical, research and clinical purposes, a clear, acceptable definition of stuttering is important for:
  2. economic reasons
  3. syntactic reasons
  4. anatomical reasons
  5. subjective reasons

  1. The term stuttering may refer to certain speech events or to the:
  2. linguistic parameters
  3. fluent parameters
  4. complex disorder
  5. normal disfluencies

  1. Definitions of stuttering can be based on the following orientation:
    1. listener-based perspectives
    2. psychopathogenic-based perspectives
    3. organic-based perspectives
    4. all of the above

  1. A definition of stuttering is not important in:
  2. selecting measures for what is quantified about stuttering
  3. estimating levels of alcohol consumption
  4. identifying research subjects who stutter
  5. deciding who receives treatment

  1. Stuttering-like-disfluencies (Yairi & Ambrose, 1999) do not include:
  2. repetitions of single syllable words
  3. repetitions of parts of words
  4. repetitions of phrases
  5. dysrhythmic phonations

  1. The “tip of the iceberg”(Sheehan, 1958) refers to the:
  2. overt (surface) features of stuttering
  3. covert (hidden) features of stuttering
  4. fluent segments of speech
  5. overt emotional reactions

  1. The term “disfluency” refers to:
  2. normal interruptions in speech
  3. abnormal interruptions in speech
  4. associated non-speech behaviors
  5. both a and b above

  1. Disfluency types most typical of stuttering:
  2. interjections, revisions, pauses
  3. whole word, phrase and multisyllable repetitions
  4. sound prolongations, sound and syllable repetitions
  5. both b and c above

  1. Van Riper suggested that stuttering is best defined as:
  2. a defect in the structure and function of the speech mechanism
  3. a forward flow of speech is interrupted and the speaker’s reaction to it
  4. a difficulty changing position of the tongue when moving from one sound to the next
  5. a momentary disruption of ongoing speech

  1. Stuttering has occurred when the speaker:
  2. holds out a speech sound while falling off a chair
  3. repeats a phrase again because the listener failed to understand
  4. repeats a word because a siren blared when it was said the first time
  5. none of the above

  1. An example of a covert aspect of stuttering:
  2. sound repetitions
  3. sense of a loss of control over speech
  4. disrhythmic phonations
  5. eye blinks

  1. Yaruss and & Quesal’s (2006) model of stuttering:
  2. defines stuttering as primarily an organic speech impairment
  3. defines stuttering as a psychologically- and environmentally-based disorder
  4. defines stuttering as a personal handicap regardless of its etiology
  5. does not define what stuttering is but represents what it involves

  1. Which of the following aspects of speech and language is most impaired in the disorder of stuttering.
  2. vocabulary
  3. pitch
  4. rate
  5. syntax

  1. Which disfluency type is not common to normally fluent speakers (i.e., not Other Disfluency)?
  2. sound repetitions
  3. phrase repetitions
  4. interjections
  5. revisions

True – False Questions

  1. The definition and clinical diagnosis of stuttering are not the same. However, arriving at a clinical diagnosis often involves use of specifications of, e.g., the frequency, of the parameters found in the definition of the disorder.

  1. One reason why definitions of stuttering differ is that some of them are based entirely, or partially, on hypotheses about the cause of the disorder instead of describing it.

  1. The inner, affective reactions of the person who stutters that are associated with stuttering events are known as the “core behaviors.”

  1. Research has indicated that fluent speech of stutterers may also be different from fluent speech of normally speaking individuals.

  1. Various surface interruptions that occur in ongoing speech are referred to as “disfluencies.”

Essay Questions

  1. List three situations or conditions where a definition of stuttering is important and has practical implications. After listing a situation, briefly (5-7 lines) explain/discuss. P. 3-4

  1. What is meant by “stuttering as an event”? What is meant by “stuttering as a disorder”?

Give examples of the features that might characterize a stuttering event and the features that may broadly characterize a stuttering disorder. P. 5; 9-16

  1. Your textbook stated that not all speech disfluencies are stuttering. What does this mean? What factors influence the distinction between just “speech disfluencies” and “stuttering”? P. 7-10
  2. List and discuss six dimensions of stuttering. P. 12-13

  1. What are the reasons that there is such a wide variation in the definitions of the same term “stuttering”? P. 14

  1. The authors of your textbook explained that the fluent speech of adults who stutter may not be free of the stuttering disorder. Why investigate fluent speech? What is one point of evidence characteristic of their fluent speech that may indicate that there is an underlying problem? P. 12

  1. What are the three dimensions of normally fluent speech production, and how does each dimension contribute to the flow of a spoken utterance? P.6

Chapter 2. Who and How Many Stutter?

Multiple Choice Questions

  1. Which of the following appears to be most influential on changes that occur over time

in the gender distribution in the stuttering population from 2:1 to approximately 4:1 male-to-female ratio:

  1. the percent of natural recovery among girls is larger than for boys
  2. boys are physically stronger than girls
  3. gender differences in various fine motor control
  4. gender differences in phonology and language skills

  1. Data on the occurrence of stuttering across the lifespan indicate that:
    1. whereas the incidence of stuttering increases with age, its prevalence remains constant
    2. the incidence of the disorder is about 1% while its prevalence is about 5% or higher
    3. the prevalence of the disorder is about 1% while its incidence is about 5% or higher
    4. the prevalence and the incidence are basically equal

  1. Which is not true about the incidence of stuttering in various groups?
  2. it may be somewhat lower in cultures reported to have little concern about speaking abilities
  3. it is higher than the average among some groups of mentally disabled persons
  4. it is lower than the average in the hearing-impaired population
  5. It is very low in the lowest social-economic strata (layer).

  1. Data on the prevalence of stuttering in African American and European American preschool children (Proctor 2008) showed that
  1. there was a greater prevalence of stuttering among European American children than African American children.
  2. there was a greater prevalence of stuttering among African American children than European American children.
  3. there was a greater prevalence of stuttering among African American girls than African American boys
  4. there was no difference in the prevalence of stuttering between African American children and European American children.

  1. The general tendency for the gender ratio (males to females) in the stuttering population indicates it:
  2. increases with age,
  3. increases and then decreases with age
  4. decreases and then increases with age
  5. remains constant throughout the age range

  1. The prevalence of stuttering in the population at large is:
  2. three to five percent
  3. two percent
  4. one percent
  5. six to eight percent

  1. Which factor is likely to have the most influence on stuttering prevalence data in a population of college students?
  2. gender
  3. cultural background
  4. I.Q. scores
  5. age.

  1. The findings (Dalston, 1982) that stuttering incidence is higher in children with orofacial abnormalities than in the general population serve to prove that:
  2. stuttering is an organically based disorder
  3. stuttering is a disorder of speech production
  4. stuttering is, in part, influenced by the acoustic (resonance) characteristics of speech
  5. none of the above answers is true because the incidence of stuttering in this group is lower than that in the general population.

  1. Research on the prevalence of stuttering in the hearing impaired school age population (Montgomery & Fitch, 1988), has shown that:
  2. the prevalence is about 1/20 of one percent with most of the cases exhibiting stuttering in their manual communication,
  3. the prevalence is about 1/20 of one percent with most of the cases exhibiting stuttering in their oral communication,
  4. the prevalence is about 1/20 of one percent with most of the cases exhibiting stuttering in both their manual and oral communication,
  5. the hearing impaired population does not exhibit stuttering.

  1. Most of the available data, especially from recent research, suggest that stuttering:
  2. is more prevalent among monolinguals than among bilingual speakers
  3. is as prevalent among monolinguals than among bilingual speakers.
  4. is more prevalent among bilinguals than among monolingual speakers
  5. never occurs in bilingual speakers.

  1. Which of the following age groups is expected to exhibit the lowest incidence of stuttering:
  1. 12 to 24 months
  2. 25 to 40 months
  3. 48 to 60 months
  4. 63 to 77 months

  1. Which of the geographical areas has, by far, the lowest incidence of stuttering:
  1. South America
  2. North Africa
  3. East Europe
  4. None of the above

  1. If a group of 100 individuals reveals a 20% lifetime incidence, they are most likely:
  1. adults enrolled in stuttering therapy
  2. all members of a single large family
  3. preschooler boys
  4. epileptic parents

True – False Questions

  1. The incidence of stuttering among deaf persons appears to be considerably higher than the incidence in the general population because they have greater difficulties monitoring and controlling their speech.

  1. In terms of exhibiting stuttering, dizygotic twins will be more similar than monozygotic twins.

  1. Data concerning the distribution of stuttering in families of people who stutter would seem to suggest that stuttering runs in families due to genetic factors.

  1. Stuttering can affect one or both languages in bilingual individuals.

  1. A child identified as a persistent stutterer is likely to have other persistent stutterers in his/her family.

  1. 21s century studies have tended to report higher stuttering incidence than was reported in the past, with central figures 8% or higher.

  1. The large difference between incidence and prevalence of stuttering is best explained as the result of differences in experimental procedures.

  1. Longitudinal investigations are best suited for prevalence studies whereas large single surveys are best suited for incidence studies of stuttering.

Essay Questions

  1. What is the significance and what are the implications of data regarding incidence and prevalence to research and theory of stuttering? Explain and discuss. P. 25-26

  1. What is the significance and implications of data regarding incidence and prevalence of stuttering to clinical practice considerations? Explain and discuss. P. 27

  1. List two major approaches to the study of the prevalence of stuttering. Explain each one. What are the weaknesses involved? P. 28-29

  1. What research methods can be used to study the life-time incidence of stuttering? What problems are involved? P. 29-30

  1. For many years, China has had a policy of only one child per family. Considering cultural factors, in what ways may this policy influence the incidence and prevalence of stuttering? [Not discussed in book. Question tests general understanding].

Chapter 3. When and How Does Stuttering Begin? How Does it Develop?

Multiple Choice Questions

  1. The onset of stuttering occurs most frequently in which of the following age ranges:
  1. 18 to 24 months
  2. 25 to 48 months
  3. 48 to 60 months
  4. above 65 months of age

  1. The statement that there is some overlap between stutterers and nonstutterers in the frequency of disfluencies in their speech means that:
    1. frequency of disfluencies is not a very good indicator of the presence of stuttering
    2. some people who stutter have fewer disfluencies than some normally fluent people
    3. all normally fluent people have fewer disfluencies than some people who stutter
    4. most people cannot readily be classified as stuttering or normally fluent

  1. Which of the following provides an example of double-unit word repetition?
  2. but-but
  3. but-but-but
  4. but I, but we
  5. but I, but we-we

  1. Within speech samples of the same length, which of the following is most likely to be identified as the speech of a person who stutterers? A sample containing
  2. six instances of single-syllable word repetition
  3. four instances of multisyllabic word repetition
  4. six instances of phrase repetition
  5. four instances of revision

  1. Research by Yairi and Ambrose (2005) found that the percentage of stuttering onsets occurring after age 4 years (48 months) is:
  2. 30-41%
  3. 20-30%
  4. 5-15%
  5. 1-2%

  1. Which of the following characteristics should be taken as an indicator of the first stage of

of stuttering according to the Bloodstein system:

  1. stuttering occurs in response to specific environmental cues
  2. stuttering occurs throughout the sentence, not in certain particular locations
  3. the dominant symptom is short, easy repetitions of syllables and short words
  4. there is a marked tendency for the stuttering to occur on content words (e.g.

adjectives and verbs)

  1. According to Van Riper’s developmental scheme of stuttering:
  2. the disorder develops in four distinct consecutive phases
  3. the disorder develops in one of four possible patterns (tracks)
  4. all four major dimensions of the disorder develop simultaneously but each in its own track
  5. only one of the four different dimensions of stuttering becomes pronounced during the developmental process

  1. According to recent research on the development of childhood stuttering, which is true in regard to differences between children who persist and who recover? Children who persist tend to:
  2. have earlier stuttering onsets
  3. initially exhibit greater number of disfluencies and more severe stuttering
  4. exhibit poorer motor skills
  5. have more relatives who also exhibited persistent stuttering

  1. Currently, the best predictor of natural recovery from stuttering in young children is:
  2. age at onset
  3. the type of family history of recovery
  4. good language and phonologic skills
  5. the initial stuttering is moderate in severity

  1. Ideas about how the onset of stuttering occurs have changed in that:
  2. we now think that it is all genetically controlled
  3. we used to think it began in a uniform fashion but now we have evidence that there is much variability in several aspects of onset
  4. we now know that, most typically, stuttering begins as a mild disorder
  5. our ideas about the onset of stuttering have not substantially changed.

  1. Which is NOT true regarding the onset of stuttering? It occurs

  1. before a child speaks in sentences
  2. when anatomical structures for speech are growing quickly
  3. when speech and language skills are expanding sharply
  4. after normally fluent speech has been present

  1. In most cases, stuttering onset is characterized by, or associated with
  2. mild stuttering
  3. strong emotional reaction
  4. moderate or severe stuttering
  5. moderate phonological deficiency

  1. Which of the following disfluencies is above the mean for preschool children who stutter:
  2. bu-but
  3. bu-bu-but
  4. I-I would la-like
  5. Mo-momy se-see th-this

  1. The overall trend in the development of stuttering is:
  2. downward
  3. upward
  4. downward then upward
  5. flat

  1. Natural recovery from stuttering occurs subsequent to:
  2. mild stuttering
  3. episodic, slow easy repetitions
  4. clinical intervention
  5. no clinical intervention

True – False Questions

  1. Shorter intervals between repetition units in speech of children who stutter, make their repetitions faster than those of normally fluent children.

  1. Onset of stuttering is rare after age 9 years.

  1. Interjections are the most frequent feature of early stuttered speech.

  1. Van Riper’s Track II children who stutter with poor articulation represented the majority of cases.

  1. Some secondary behaviors appear to be integral features of stuttering, and not necessarily “secondary.”

  1. Scientific studies of stuttering onset are difficult because of the confusion between language difficulties and stuttering.

  1. Symptoms such as blocks and facial contortions are never present at or near stuttering onset.

  1. Stuttering before 18 months of age is not really stuttering

  1. A preschool child presenting only 7 SLD per 100 syllables is still within the limit of normal disfluency.

  1. 10. The difference between the incidence of stuttering and its prevalence supports a substantial factor of natural recovery.

Essay Questions

  1. Present and discuss (only) two arguments regarding the importance of scientific information about the onset of stuttering. 51-52
  2. List three methods have been used, to study the onset of stuttering? What problems are involved in each? 52-54
  3. What are the implications of the fact that most cases of stuttering begin between 24 and 42 months of age? P. 56-57
  4. Discuss the male-to-female ratio. What differences are seen with age? How is the gender ratio affected by male and female differences in stuttering onset and natural recovery?
  5. What changes have taken place in relation to the traditional concepts regarding the development of stuttering? 74-79
  6. What kinds of evidence have been used to document natural recovery? Why does the age of the children at the beginning of a study make a difference? 76-79
  7. What explanations can be used to account for the recovery that is labeled “natural recovery”? P 84

Chapter 4. Where Does Stuttering End? What Are Its Advanced Characteristics?

Multiple Choice Questions

  1. Which of the following is not regarded as a secondary, or accessory characteristic of stuttering?
    1. head jerk
    2. eye blink
    3. lip tremor
    4. tense pause

  1. Which of the following provides an example of double-unit word repetition?
  2. I-I
  3. I-I-I
  4. but I, but I
  5. but I, but we-we

  1. Variations in which vocal parameter(s) are associated with stuttering more than the others:
  2. sentence inflection
  3. timing of phonation
  4. the degree of nasality
  5. whispering

  1. Stuttering decreases most with an increase in:
  2. a. audience size
  3. b. the meaningfulness of the message
  4. c. arm swinging activity
  5. d. speaking rate

  1. Which of the following is not classified as a stuttering-like disfluency?
  1. disrhythmic phonation
  2. single syllable word repetition
  3. revisions
  4. part word repetition

  1. Which term means the same as secondary behaviors of stuttering:
    1. physical concomitants
    2. stuttering-like disfluency
    3. concomitant disorders
    4. advanced stuttering

  1. The mean duration of all disfluency types for preschool children is about:
  2. 0.4 seconds
  3. 1.1 seconds
  4. 2.5 seconds
  5. 4.3 seconds

  1. The “consistency effect” refers to the fact that moments of stuttering:
  2. a. tend to occur consistently in relation to certain speech situations such as oral recitation in class
  3. b. tend to occur on the same words in repeated readings
  4. c. occur in inconsistent locations for adults and on consistent locations for children
  5. d. have the same consistent form or pattern related to disfluency types

  1. The stuttering “adaptation effect” refers to:
  2. a. the fact that listeners tend to not notice stuttering after they become used to it
  3. b. a decrease in the frequency or severity of stuttering with successive readings of the same material
  4. c. the gradual adaptation or adjustment of the stutterer to the fact that he or she stutters and to the experiences that go with being a stutterer
  5. d. the tendency for each stutterer to eventually settle on certain stuttering characteristics

  1. In which of the following situations would you expect a stutterer to stutter most?
  2. a. talking to peers in a regular voice
  3. b. singing
  4. c. talking in monotone
  5. d. talking in rhythm

  1. In advanced stages, the intensity of stuttering events is affected by:
  2. time pressure

b communication demands

  1. concern about social approval
  2. all of the above
  3. e. none of the above

  1. An experiment to test whether stuttering frequency is altered by the interval (in seconds) between presentation of a word and the signal to the stutterer to say that word, would have implications for:
  2. the presence of anticipation
  3. the consistency effect
  4. the effect of time pressure
  5. none of the above

  1. Which of the following is not one of Brown’s four main factors that increases the chance for a word to be stuttered?
  2. position of word in sentence
  3. frequency of word in language
  4. length of word (number of syllables)
  5. initial sound: consonant/vowel classification

  1. In which of the following situations would you expect a stutterer to stutter most?
  2. swearing
  3. singing
  4. whispering
  5. explaining

  1. In regards to stuttering, the term “core behaviors” refers to:
  2. repetition and prolongation
  3. interjection and revision
  4. deep anxiety about speaking
  5. central processing of motor speech.

  1. The mean overall speaking rate in reading for adults who stutter is closest to:
  2. 170 words per minute and faster than that of normal speakers
  3. 123 words per minute and slower than that of normal speakers
  4. 150 words per minute and equal to that of normal speakers
  5. 180 words per minute and equal to that of normal speakers

  1. Regarding typical locations of stuttering, research has shown all the following features are related to an increased probability of stuttering, except for:
  1. stress and prosody
  2. phonological complexity
  3. propositionality (amount of meaning)
  4. position within a sentence or utterance

  1. Which of the following is not a true statement about the relationship between stuttering and intellectual abilities:
    1. the average intelligence levels of PWS are not clinically different from that of NFP
    2. parents’ intellectual abilities strongly influence the incidence of stuttering in their children
    3. stuttering is common in some sub-groups of children whose intelligence is below average
    4. stuttering is found even in individuals of superior intelligence level

  1. There are minimal differences between people who stutter and normally fluent speakers in the frequency of this disfluency type:
    1. prolongations of sounds
    2. monosyllabic whole-word repetitions
    3. interjections
    4. part-word repetitions

  1. Secondary, or accessory, characteristics (symptoms) of stuttering are:
    1. physical tensions, movement of body parts, and/or other behaviors during moments of stuttering
    2. extended repetitions and elongations of sounds
    3. symptoms seen only during the later, secondary, stages of the development of stuttering
    4. only associated with the inward feelings of the person who stutters

  1. An adult is most apt to stutter when:
    1. releasing a shout of “Happy New Year!”
    2. answering the phone
    3. mimicking the boss with a co-worker
    4. swearing at the other driver

  1. The frequency of these disfluencies correlates the highest with listeners’ perceptions of stuttering severity:
  2. multisyllabic word repetitions
  3. interjections
  4. phrase repetitions
  5. part-word and single-syllable word repetitions

True – False Questions

  1. One of the most accurate observations related to advanced stuttering is that it is reduced or absent in conditions of low anxiety about stuttering.

  1. Stuttering in adults is more likely to occur on words beginning with consonants than with vowels.

  1. The person who stutters experiences the emotion of anxiety most typically after he or she has stuttered as compared to before the stutter event.
  2. Stuttering is more likely to occur on unstressed than stressed syllables within words.

  1. Hypnotic suggestion has never been observed to induce a reduction in stuttering.

  1. In choral reading, the person who stutters must attempt to speak at a delay after someone else.

  1. Tense pauses begin with a complete or almost complete blockage of airflow through the glottis.
  2. Stuttering frequency and disfluency frequency measure the exact same events.
  3. The disfluency that occurs when a speaker says “re-re-refrigerator” is a multisyllabic word repetition.
  4. Broken words are considered to be a form of disrhythmic phonation.

Essay Questions

  1. The terms “stuttering” and “disfluency” should not be equated. Explain the differences. What factors may influence the differences? 90-91
  2. List and describe at least 6 specific disfluency types. What are the major disfluency classes under which the specific types can be classified? What are the strengths and weaknesses of currently available disfluency classification systems? P. 91-95
  3. Describe the emotional and cognitive dimensions of the stuttering disorder that develop as stuttering persists from preschool to school age. P. 102-105
  4. Compare and contrast the features of advanced stuttering and early stuttering. [No specific pages]
  5. What is meant by stuttering loci? How is the knowledge of such loci useful in the context of clinical assessment and treatment? P. 109-111
  6. Name and describe at least 3 ameliorating conditions of stuttering. Compare and contrast the level and nature of their effects on stuttering. P. 110-113

Chapter 5. Why Do People Stutter? Evaluating Theories and Models

Multiple Choice Questions

  1. When a theory explains only a few, but not all of the phenomena associated with stuttering, it lacks this criterion to be strong or credible:
  2. prediction
  3. testability
  4. simplicity
  5. exhaustiveness

  1. In contrast with a theory that offers an explanation, a model offers a:
    1. definition
    2. representation
    3. speculation
    4. validation

  1. When a theory uses the smallest number of variables to explain the greatest number of factual phenomena, it is described as:
  2. parsimonious
  3. flexible
  4. valid
  5. consistent

  1. The idea that a stuttering theory should be multifactorial means:
  2. that multiple contributing variables are included
  3. it explains the most facts
  4. it includes multiple subtypes of stuttering
  5. that many observations of stuttering served as evidence

  1. The problem with concluding that the cause of stuttering has been found by research revealing a particular characteristic in adults who stutter that was not present in non-stuttering controls is that:
  2. the characteristic could be typical of groups with other communication disorders not tested as controls
  3. the characteristic could emerge at a later age, but not be present in children at stuttering onset
  4. the characteristic and the stuttering might both have been caused by another variable
  5. all of the above

  1. When a theory explains all the facts revealed about a phenomenon, it is described as:
  2. parsimonious
  3. exhaustive
  4. exclusive
  5. elegant

  1. When the essence of a theory can be proved or disproved, it is described as:
  2. predictive
  3. flexible
  4. valid
  5. testable

  1. When a theory is elegant, it is particularly:
  2. succinct
  3. predictive
  4. flexible
  5. testable

  1. Which of the following has NOT been a challenge to testing theories of stuttering:
  2. variable and inconsistent occurrence of stutter events
  3. how difficult it is to observe its onset
  4. the amount of research of stuttering that has been conducted
  5. ethical problems of testing variables that may induce stuttering

  1. The high likelihood that multiple etiological factors contribute to stuttering has led to the proposal that:
  2. the stuttering disorder should be viewed as a “pathognomonic monolith”
  3. the stuttering disorder may consist of subtypes
  4. the stuttering disorder should be modeled with sequential rather than hierarchical components
  5. the stuttering disorder will most likely never be explained

  1. Which is not a good example of a precipitating factor for stuttering?
    1. a genetic defect
    2. a burst in vocabulary growth
    3. the transition of moving into a new house
    4. a new sibling being born into the family

  1. A factor that may perpetuate a stuttering disorder:
    1. genetics
    2. being teased by peers after stuttering moments
    3. periods of silence imposed every time a person stutters
    4. tapping while speaking

  1. The best example of a predisposing factor for stuttering:
    1. social reactions
    2. genetics
    3. low academic performance
    4. potty training

  1. Being male is best described as which type of factor for stuttering?
    1. protective factor
    2. precipitating factor
    3. perpetuating factor
    4. risk factor

  1. The best example of a protective factor from developing a stuttering disorder:
    1. a male gender
    2. a few years of virtually chronic stuttering post-onset
    3. a family history of persistence
    4. a family history of natural recovery

True – False Questions

  1. When two variables are correlated, a causal relationship can be inferred.
  2. Demosthenes was considered to be the “Father of Medicine.”
  3. The literature reveals a plethora of theoretical notions about the nature and cause of stuttering.
  4. A theory and a model can handle the explanation of a phenomenon slightly differently.
  5. Systems of classification usually take the form of taxonomies with a hierarchy of divisions and subdivisions.
  6. A “risk” factor is another term that means the same thing as “protective” factor.
  7. Scholars appreciate that the cause of stuttering can best be explained within a multifactorial framework.
  8. The idea that stuttering is caused by tickling is an example of a testable theory.
  9. Cluttering can be considered as a stuttering subtype.
  10. Research supports the idea that stuttering is not a unique disorder, but represents merely a greater quantity and intensity of events that are common to the same continuum with normal speech disfluency.

Essay questions

  1. What is a theory? What is a model? What are their purposes and significance? 109-110
  2. What makes for a strong theory? P. 115-116
  3. What difficulties are encountered in testing theories of stuttering? 117-118
  4. Discuss reasons why there have been such a wide range of explanations of stuttering. 120-123
  5. Discuss the issue of stuttering subtypes. Are there currently stuttering subtypes? What are the advantages of having subtype classification? P. 119-121

Chapter 6. Is Stuttering Psychological? Theories and Investigations

Multiple Choice Questions

  1. Johnson’s diagnosogenic theory states that:
    1. the parents’ reactions to the child’s normal disfluencies create stuttering
    2. the parents’ reactions to the child’s initial mild stuttering creates a real stuttering
    3. the parents’ reactions to stuttering in their own parents also create stuttering in their child
    4. the parents’ genetic make-up creates stuttering

  1. Reports have shown that what used to be considered “no stuttering” Native American groups do, in fact, exhibit the problem of stuttering and even have several words to label it it. These findings:
    1. indicate that culture has absolutely no effect on stuttering
    2. clearly prove that stuttering was introduced into these groups only recently
    3. support the idea that stuttering is universal
    4. proves that once there is a word for it, stuttering will occur in members of the group

  1. The Demands-Capacities Model explains stuttering as a product of:
  2. a delayed repair of sound errors arising from the phonological system
  3. parents’ negative reactions to normal childhood disfluency
  4. an utterance spoken with conditions beyond the speaker’s ability to maintain fluency
  5. hemispheric competition for the lead dominance in speech functions

  1. Compared with psychiatric patients, adults who stutter have been found to:
    1. have a similar personality disturbance
    2. have no personality disturbance
    3. have a more severe personality disturbance
    4. have a different form of personality disturbance

  1. In the Two-Factor theory of stuttering (Brutten and Shoemaker, 1967), the primary factor of core stuttering is acquired through:
    1. genetic predisposition
    2. inefficient phonological encoding
    3. operant conditioning
    4. classical conditioning

  1. In general, research on personality characteristics of stutterers would seem to indicate that:
  2. stutterers exhibit certain unique personality characteristics although these are not neurotic in nature
  3. b. stutterers are more similar to nonstutterers than they are different from them
  4. stutterers do not exhibit certain unique personality characteristics but they do manifest various neurotic symptoms
  5. d. stutterers appear to have no more problems relating to others than do nonstutterers.

  1. The two-factor theory of stuttering (combining classical and instrumental learning) implies that:
  2. primary stuttering emerges through instrumental learning and then develops into

secondary stuttering through classical learning

  1. fluency breaks resulting from strong emotional reactions are gradually shaped

into complicated stuttering through classical as well as instrumental learning

  1. emotional reactions resulting in fluency breaks are generalized to various stimuli

through classical learning while secondary stuttering characteristics (body tensions,

etc.) are shaped through instrumental learning

  1. while fluency breaks are shaped through instrumental learning, secondary characteristics are generalized through classical learning

  1. The theory that explains stuttering as a behavior learned through reduction in the anxiety drive, suggests that stuttering is reinforced because anxiety is reduced:
  2. immediately following stuttering blocks but prior to experiencing their unpleasant consequences
  3. b. after the experience of unpleasant consequences which follow stuttering blocks
  4. c. immediately prior to the occurrence of stuttering block
  5. both immediately prior to, and immediately following, stuttering blocks regardless of

the order of other events or consequences

  1. Johnson’s diagnosogenic theory on the onset of stuttering is based on the assumption that the problem began as a result of this parental action:
  2. a. positive reinforcement of normal disfluency
  3. b. negative reaction toward primary stuttering
  4. c. positive reinforcement of primary stuttering
  5. negative reaction toward normal disfluencies

  1. When the monitoring component of the central speech planning system identifies a speech error about to occur, the result is a disfluent event. This scenario best matches the:
  2. Two Factor Theory
  3. Multifactorial Theory
  4. The Covert Repair Hypothesis
  5. Diagnosogenic Theory
  6. Psychoanalytic Theory

  1. According to the Demands & Capacities model, stuttering will occur when:
  2. abnormally high self-imposed demands exceed the child’s normal capacities,
  3. normal environmental demands exceed the child’s inferior cognitive, linguistics, and motor capacities
  4. abnormally high demands, mainly for fluency, are imposed on the child, regardless of capacities
  5. abnormally high demands, for either fluency, motoric performance, cognitive or emotional reaction, are imposed on the child
  6. all of the above.

  1. Which of the following states that fluency breaks down when environmental and/or self-imposed pressures exceed the speaker’s cognitive, linguistic, motoric and/or emotional abilities for responding:?
  2. Covert Repair Hypothesis,
  3. Diagnosogenic Theory,
  4. Demands and Capacities Model,
  5. Multifactorial Model.

  1. Which of the following is not considered by Johnson et al. (1959) to be a major variable supporting his Diagnosogenic theory?
  2. The listener’s (parental) sensitivity, and overanxious reaction, to a child’s disfluency,
  3. The amount of time pressure involved in the conversation,
  4. The overlap in the degree of disfluency between stuttering and nonstuttering controls,
  5. The child’s unfavorable reactions to his own disfluency, mirroring the parents’ disappointment.

  1. Which pair of terms best fits the components in the dual diathesis-stressor model of stuttering?
  2. physiological and psychological factors
  3. capacities and demands
  4. linguistic skills and emotional regulation
  5. motor skills and cognitive abilities

  1. Which theory explains stuttering as an asynchrony between the arrival of syllable frames and segmental fillers?
  2. Two Factor Theory
  3. Semantogenic Theory
  4. The Covert Repair Hypothesis
  5. Demands-Capacities Model
  6. Neuropsycholinguistic Theory

True – False Questions

  1. A review of the research on personality of people who stutter would seem to indicate that no particular stuttering character structure has been identified.

  1. One of the weaknesses of stuttering theories that explain the disorder as psychogenic in nature is that major stuttering symptomatology, such as negative emotional reaction (anxiety), may not be present during early stages of the disorder.

  1. From a theoretical point of view, the consistency effects in stuttering suggests that other factors besides negative emotion contributes to stuttering.

  1. Temperament research has revealed tendencies toward greater sensitivity, reactivity, and lower adaptability in children who stutter

  1. As a group, more than half of those who stutter exhibit a moderate, though consistent, trend of having a compulsive personality trait.
  1. Signs of mild social maladjustment such as social withdrawal in adults who stutter, still within the normal range, are quite frequent and appear to be the result, not the cause of, stuttering.
  2. The anticipatory struggle theory of stuttering is based on the assumption that stuttering results from the stutterer’s fear of anticipated stuttering.
  3. According to psychoanalytic theories, stuttering should be treated through gradual shaping

of its symptoms (stuttering) to thereby resolve the deep emotional conflicts.

  1. Projective tests, such as Rorschach and TAT, were shown to differentiate between

people who stutter and normally fluent speakers.

  1. The Covert Repair Hypothesis (CRH) suggests that unconscious motives are expressed

in overt stuttering.

Essay Questions

  1. Several theories have presented stuttering as a psychoemotional disorder. Discuss the general features of these theories. What are the basic assumptions? What dynamics have been suggested that result in stuttering? What research support has been reported? P. 133-142
  2. Outline and discuss the diagnosogenic theory of stuttering? What research evidence has been reported in support of, and in refuting the theory? P. 143-146
  3. Discuss the conflict theory of stuttering. What is the main theme of the theory? What are the several possible conflicts involved? P. 148-149
  4. From a learning orientation, discuss the proposition that stuttering is an operant behavior. What does it mean? Accordingly, what dynamics might be involved that eventually result in stuttering? In what ways does the two-factor theory of stuttering deviate from the pure operant concept? P. 149-153
  5. Briefly (a few sentences) state and explain the clinical implications to stuttering of the (a) psychoemotional theories, (b) the diagnosogenic theory, (c) conflict theory, and (d) the operant theories. P. 133-153
  6. Explain the difference between a psycholinguistic theory of stuttering and the concept of a language or phonological disorder. Provide a detailed example of psycholinguistic theory of stuttering. P 153-159

Chapter 7. Is Stuttering Biological? Theories and Investigations

Multiple Choice Questions

  1. Which of the following does not reflect recent findings concerning the link between stuttering and genetics:
  2. genetic factors influence the severity of stuttering
  3. genetic factors influence natural recovery from stuttering
  4. there is an interaction between genetic and environmental factors in stuttering
  5. genetic factors influence persistent stuttering

  1. The findings that concordance for stuttering among monozygotic twins occurs only in approximately 70% of twin pairs:
  2. invalidate the notion of genetic inheritance of stuttering
  3. support a theory of interaction between genetic and environmental factors
  4. provide a conclusive proof for a genetic basis of stuttering
  5. rule out the role of environment

  1. Pedigrees are used to study:
  2. familial patterns of inheritance of a trait or disorder
  3. which family member is affected by a trait or disorder
  4. family data across several generations
  5. all of the above

  1. The proportion of young children who stutter who have a family history of stuttering among either their immediate or extended family has been reported as:
    1. 43%
    2. 71%
    3. 10%
    4. 1%

  1. In motor learning terms, repeating the same word over intentionally multiple times is an example of:
    1. distributed practice
    2. negative practice
    3. massed practice
    4. prolonged practice

  1. Which of the following provides information on the function of the larynx in people who stutter:
  2. data on the effects of loud noise on stuttering
  3. data on phonological and language characteristics of stutterers
  4. data on cognitive deficiencies in stutterers
  5. data pertaining to the handedness of stutterers

  1. The cerebral dominance theory of stuttering implies that in PWS:
  2. the slow peripheral speech musculature cannot make a timely response to an abnormal overflow of neural signals from the left cerebral hemisphere which is usually dominant for speech; the lagging musculature results in stuttering blocks
  3. normal cerebral dominance has transferred from the left to the right hemisphere;

neural signals from the right hemisphere, which is not specialized for speech

processing, are slightly disorganized resulting in stuttering blocks

  1. cerebral dominance is greatly reduced or lacking. Consequently, neural signals from the two hemispheres reach the bilateral speech musculature in an asynchronous manner resulting in stuttering blocks
  2. cerebral dominance alternates randomly between the left and right hemisphere; this

erratic brain function generates conflicting neural signals to the speech musculature

resulting in stuttering blocks

  1. The cerebral dominance theory of stuttering suggests that in people who stutter:
  2. the Right cerebral hemisphere has assumed partial dominance for speech
  3. the Left Cerebral hemisphere has assumed complete dominance for speech
  4. the dominance for speech has been transferred from the hemispheric brain cortex to subcortical brain structures
  5. the two cerebral hemispheres compete for speech dominance

  1. Recent studies on brain functioning in PWS indicate that they differ from normals in that:
  2. they clearly lack any cerebral dominance
  3. they tend to show a reverse cerebral dominance
  4. they tend to show left hemisphere dominance for processing both linguistic and

nonlinguistic information

  1. they tend to show increased activity of the right hemisphere for processing both linguistic and nonlinguistic information

  1. Biological genetic research has:
  1. identified several genes that directly cause stuttering through their function of regulating muscle tonus
  2. identified several genes that directly cause stuttering through their function of regulating emotionality
  3. identified specific genes that appear to be associated with stuttering
  4. no specific genes have been identified in relation to stuttering, only several chromosome where they might be located

  1. Speech-motor studies of people who stutter have revealed that:
  2. PWS generally have slower reaction times than those who are NFP
  3. PWS generally have inferior motor skills in comparison to NFP
  4. the movement patterns of articulators in PWS and NFP are generally similar
  5. the speech system of PWS can tolerate a wide range of movement
  6. PWS are faster in achieving peak velocity during fluent speech

  1. Individuals who stutter feature a number of brain structural aberrations. Past research has reported aberrations that affect:
  2. gray matter volume
  3. white matter volume
  4. gyri variations
  5. white matter intergrity
  6. two of the above
  7. all of the above

  1. Current research has shown that people who stutter can be readily identified by:
  2. voice onset time characteristics
  3. brain dominance for language
  4. abnormal EMG activity in muscles of articulation
  5. respiratory patterns
  6. all of the above
  7. none of the above (a-e)

  1. Aggregation studies concerning the genetics of stuttering have shown that the inheritance of stuttering:
  2. fits well with a single major locus model (one or several main genes being responsible)
  3. is more through affected mothers than affected fathers
  4. is equally accounted for by both genetics and environmental factors
  5. fits best with polygenic model (many genes but no environmental factors).

  1. DAF stands for:
  2. Decreasing activated fluency
  3. Delayed auditory feedback
  4. Decreasing auditory feedback
  5. Degree anticipated fluency

  1. The fact that “masking” noise results in a decrease in stuttering while simultaneously increasing the stutterer’s vocal level would seem to primarily support a strong:
  2. timing component
  3. psychological component
  4. learned component
  5. motor component

  1. To be most effective, Cherry & Sayers (1956) found that the application of noise to the treatment of stuttering must:
  2. be bone conducted
  3. be low frequency and bone conducted
  4. be high frequency
  5. be high frequency and bone conducted

  1. With some differences among physiological brain studies, the findings indicate that, compared with normally fluent speakers, PWS demonstrate:
  2. greater activity in the right hemisphere cortex (gray matter)
  3. lower level alpha-type waves in both hemispheres
  4. lower level beta-type waves in both hemisphere
  5. lower level of both alpha and beta type waves in the right hemisphere

  1. Unlike early studies of motor aspects of stuttering, current research reported by Anne Smith concluded:
    1. stuttering is “caused” by excessive muscle activation levels
    2. stuttering is not “caused” by excessive muscle activation levels
    3. tests of the respiration function of PWS have revealed lower than normal oxygen exchange levels that result in a slight hypertension limited to the muscles of respiration
    4. the higher tension in the respiratory musculature of PWS results in insufficient air available for smooth speech production

True – False Questions

  1. In terms of exhibiting stuttering, dizygotic twins will be more similar than monozygotic twins.

  1. Data concerning the distribution of stuttering in families of people who stutter suggest that stuttering runs in families due to genetic factors.

  1. A child identified as a persistent stutterer is likely to have other persistent stutterers in his/her family.

  1. For people who stutter, there has been evidence of abnormal activity in their speech movements during perceptually fluent speech.

  1. Voice onset time (VOT) and laryngeal reaction time (LRT) are essentially the same measure.

  1. Speech motor studies have reported that PWS tend to have abnormally large tongue that interferes with its proper positioning for speech production causing disfluencies as the person struggles to move on.

  1. Speech motor studies have reported that PWS tend to have tongues that is too weak, incapable of reaching far enough in the oral cavity.

  1. Several investigations reported a much higher concordance for stuttering in monozygotic than in dizygotic twins.

  1. If stuttering were purely genetic, then all twin pairs with one stutterer would have concordance.

  1. Contrary to findings concerning adults who stutter, brain imaging with children did not show any brain matter differences between those exhibiting persistence in, and those who recovered from, stuttering.

Essay Questions

  1. Early research concerning the genetics of stuttering employed the family incidence method. Describe and explain the method. What were the general findings of the many studies conducted in this area? What are the method’s faults? 167-168
  2. One approach to the investigation of the genetics of stuttering is twin studies. Describe/explain the method and the rationale behind it. What have been the general findings? 168-169
  3. The relatively early Cerebral Dominance theory implicated brain function as the cause of stuttering. Describe/explain the theory. In what ways do recent research findings indeed implicate the possible role of both brain structure and function in stuttering? 174-182
  4. Discuss research advances and recent findings concerning brain structure and function in stuttering. P. 176-182
  5. What are the indications for stuttering-audition links? 182-185
  6. Discuss theories of motor disfunction in stuttering. What type of research evidence has been reported? 185-196
  7. What are the different clinical implications to stuttering of its auditory links, motor links, and genetic links? [No specific pages]

Chapter 8. Assessment of Adults and School-Age Children

Multiple Choice Questions

  1. Inconsistent identification of stuttering (judging the same disfluent events as “stuttering” and “normal” in the same speech sample of same speaker at two different times) may be explained as related to:

a the influence of listeners’ psychological set at a particular time when a judgment is made

  1. the fact that all types of disfluencies are present in normal and stuttered speech
  2. the speaker’s gender or age
  3. all of the above

  1. The two longest, most frequent types of speech samples collected with adolescents or adults who stutter are:
  2. imitation of sentences and automatic speech sequences
  3. word lists and phrase lists
  4. phone call and public speaking sample
  5. oral reading and spontaneous speech samples

  1. What dimension is measured with the instrument known as the SSI-4?
    1. attitudes toward stuttering
    2. severity of stuttering
    3. levels of difficulty across speaking situations
    4. speaking rate

  1. Which assessment instrument includes a rating of attitudes toward speaking?
  2. SSI
  3. OASES
  4. SSR
  5. CELF

  1. Another term for “physical concomitants” of stuttering:
  2. primary behaviors
    1. cluttering
    2. secondary characteristics
    3. other communication domains

  1. A speech sample of a person who stutters contained 5 instances of stuttering measured in duration as: 2.25 sec., 0.25 sec. 1.00 sec., 0.5 sec, and 1.00 sec. The clinician must make a general evaluation of the stuttering severity using only these data. Based on what is known about the average duration of moment of stuttering, the stuttering events contained in this sample will be considered to be:
  2. a. way below average
  3. just about average
  4. c. moderately above average
  5. d. way above average

  1. The Scale of Communication Attitudes (S-Scale) is used to evaluate:
  2. the emotional adjustment of adults who stutter
  3. the ability of adult who stutterer to communicate negative emotions
  4. the emotional reactions of adults who stutter to specific situations
  5. the interpersonal communication skills of adult who stutter

  1. The Scale of Communication Attitudes is scored by:
  2. the total number of “correct” items (those corresponding to a certain standard key)
  3. the number of “true” answers minus the number of “false” answers
  4. the number of “true” answers
  5. none of the above

  1. Which of the following formulas should be used to calculate the number of disfluencies

per 100 words (N= Number of words in sample; D= number of disfluencies in sample;

/ = divide; x = multiply):

  1. (N/D) x 100
  2. (N/100) x D
  3. (D/N) x 100
  4. 100/ (D x N)

  1. For purposes of calculating the extent of disfluencies, the sentence “I la-la-like to-to um

go ho-ho-home” contains:

  1. two instances of disfluencies and eight repetition units
  2. three instances of disfluencies and eight repetition units
  3. four instances of disfluencies and five repetition units
  4. three instances of disfluencies and five repetition units

  1. Which of the following measures is included in the Stuttering Severity Instrument:
  2. mean number of head and facial movements
  3. overall speaking rate
  4. extent of disfluencies in term of repetition units
  5. none of the above is included

  1. The overall score on the Stuttering Severity Instrument is evaluated in terms of:
  2. specific percentile ranking
  3. standard scores
  4. relative weight of the different components
  5. a range of percent distribution

  1. In determining the overall speaking rate of a person who stutters you have transcribed the client’s speech sample as follows: “To-today is-is Thursda-day and-and I la-la-like t-t-t-to go-go home.” This sentence took exactly 15 seconds to utter. Based on this information, your calculations will show that the client’s:
  2. speaking rate is 36 words per minute
  3. speaking rate is 84 syllable per minute
  4. articulation rate is 56 syllables per minute
  5. all of the above

  1. Questioning the adult who stutters about the history of his/her treatment may provide useful information in relation to:
  1. the reason for the person’s persistent stuttering
  2. the inability of the person to respond positively to treatment
  3. determining the future treatment
  4. estimating the person’s chances for further failure in therapy

  1. The contribution of the task score for emotional reactions to the total score of the SSI is


  1. 10%
  2. 15%
  3. 30%
  4. none of the above

  1. The statement “I like asking questions in a variety of small group discussions” is most likely taken from which type of assessment instrument:
  2. a locus of control behavior scale
  3. a perception of stuttering severity inventory
  4. a stutterer’s self-rating of reactions to speech situations
  5. a scale of communication attitudes

  1. Due to the variability of stuttering across situations, what is the minimal number of separate speech samples needed for reliable assessment of stuttering?
  2. two 500-word samples
  3. three 750-word samples
  4. three 75-word samples
  5. one 600-word sample

  1. The best representative speech sample for adults who stutter is elicited from:
  2. conversation
  3. reading from a newspaper
  4. reading from a prose
  5. monologue

  1. In selecting the context/type of a speech sample to be obtained from a person who stutters, which among the following factors is the most important to consider :
  2. the need to compare the client’s disfluency with published reference data
  3. the time elapsed from the last recording of the client’s speech sample
  4. the length of the sample to be recorded
  5. the physical surrounding of the recording place

  1. An initial evaluation of stuttering in adults should also routinely include evaluation of voice parameters, such as:
  2. general motor skills
  3. voice reaction time
  4. voice quality and pitch variations
  5. Expressive and receptive language

True – False Questions

  1. Speaking rate is often assessed in evaluating the speech of people who stutter. Generally, there is an inverse correlation between speaking rate and the perceived severity of stuttering.

  1. The frequency of stuttering is an important parameter for assessment during evaluation of the status of the disorder. Generally, there is an inverse correlation between the frequency of stuttering and perceived severity of stuttering.

  1. One argument for using a large speech sample size is because certain disfluency types occur at a much lower frequency than other disfluencies, especially in mild to moderate stuttering. Hence, larger samples provide better chances to record several examples of these.

  1. Naturalness ratings are not sufficiently reliable for use in clinical assessment of stuttering.

  1. Articulatory rate refers to the overall time required for production of a given speech sample minus the phonation time between phrases.

  1. Mild stuttering severity is typically characterized only by an excessive frequency of other, non-SLD type, disfluencies.

  1. If the speaker displayed 20 disfluencies during 400 words, then the frequency is 5 per 100 words

  1. A speech sample containing 10 stuttered syllables per 100 syllables is regarded as mild stuttering.

Essay Questions

  1. What are the objectives of the initial evaluation of adults and school age children who stutter? P. 202-208

  1. Is there a practical value to case history information for the treatment of stuttering? State and defend your reason whether you reply in the positive or the negative. 203

  1. What issues are encountered in relation to the length and number of speech samples used for evaluating the disfluent speech of a person who stutters? What are the considerations as to where/when the speech sample or samples are obtained? 208-210

  1. List and explain 5 specific speech-related measures and ratings you would obtain in the initial evaluation of stuttering. Note: do not consider each disfluency type as a separate measure. 211-225

  1. What kinds of methods/instruments have been employed to assess what aspects of emotional reactions associated with stuttering? P 226-231

  1. Suggest and explain three conditions/variables that may be affecting the client’s speech.

  1. Not all of the data collected in the case history of an adult who stutters may eventually prove In your opinion, does information pertaining to onset of stuttering may be useful? Whether you answer is positive or negative, explain. Same question about information concerning the usefulness of speech therapy in sixth grade. Same about family history of stuttering. Limit each answer to 5 lines.

  1. Explain the purpose of the following question in an initial interview with a young adult who stutters: “How would you describe your speech and your stuttering?”

Chapter 9. Assessment of Preschool-Age Children

Multiple Choice Questions

  1. According to research, the best predictor of spontaneous recovery from stuttering in young children is:
  2. mild stuttering severity at onset
  3. family history of recovery
  4. older age (5 to 6 years)at stuttering onset
  5. fewer disfluency types at onset

  1. Parents can be led to narrow the date range of the time of onset by recalling stuttering:
    1. when the child was engaged in daily routine activities
    2. at times when the child was upset
    3. at times of major events such as birthdays and holidays
    4. when the child was saying specific words

  1. In the utterance “bu-bu-but”, the number of units of syllable repetition is:
  2. one
  3. two
  4. three
  5. not evident

  1. A child had 10 disfluencies in 100-monosyllabic words speech sample. A year later, the same child produced a 100-bisyllabic word speech sample that contained 10 disfluencies. The changes that occurred can be described as follow:
  2. the percent of disfluencies per 100 syllable remained the same
  3. the percent of disfluency per 100 syllables doubled
  4. the percent of disfluencies per 100 syllables was increased by 50%
  5. the percent of disfluencies per 100 syllables was decreased by 50%
  6. none of the above.

  1. Based on data concerning the development of early childhood stuttering, which of the following factors should have the least influence on your decision to recommend speech therapy for a preschool age child at the early stage of the disorder:
  2. the initial severity of stuttering
  3. the child’s gender
  4. the type of familial history of stuttering
  5. the time elapsed from the onset of the disorder

  1. Which of the following factors should have the most influence in predicting persistent or naturally recovered stuttering in a 3-year child who has just begun stuttering?
  2. the child’s gender
  3. the dominant type of disfluency
  4. the time elapsed from the onset of the disorder
  5. the initial stuttering severity

  1. Which of the measures listed below has been shown in recent research on developmental paths of early childhood stuttering as a primary predictor of persistent stuttering:
  2. motor skills
  3. expressive and receptive language skills
  4. phonological skills
  5. none of the above

  1. One measure that can be used in differentiating early stuttering from normal disfluency is the number of repetition units per instance of repetition. The mean number of repetition units expected of a preschool age child who stutters at the early stage of stuttering is:
  2. 0.90
  3. 1.70
  4. 2.50
  5. 3.20

  1. In regards to the previous question, the average repetition units per instance of repetition for a normally fluent child is:
  2. 0.70
  3. 1.10
  4. 1.70
  5. 2.20

  1. Among the various measures of repetition units, the best discriminator between a normally fluent child and a child who stutters is:
  2. the frequency of multiple, “long” repetitions, three units or more per 100 syllables
  3. mean number of repetition units per repetition instance
  4. proportional distribution of repetition units
  5. all of the above are basically equal in their discriminative power

  1. If a child has a family history of persistent stuttering, the child’s chance of matching this pattern is:
  2. 65%
  3. 47%
  4. 25%
  5. 15%

  1. According to present clinical opinions, with some support from recent data, after a few months post-onset which of the following should be taken as the best sign of danger for persistent stuttering:
  2. two clusters of two or more disfluencies per 100 syllables
  3. seven Stuttering-Like Disfluencies (SLD) per 100 syllables
  4. a relatively high proportion of sound prolongations (15-25%) in the total of SLD in the speech sample
    1. a mean of 2.5 repetition units per disfluency

  1. Which of the following common forms of advice to parents of preschool children has NOT received experimental support as effective in reducing stuttering:
  2. ignore the child’s stuttering
  3. more sleep for the child (early bed time)
  4. use short, simple sentences when talking to the child
  5. all of the above have not received support
  6. all of the above did receive research support

  1. In the initial parent interview concerning a preschool child who stutters, the question “When exactly did stuttering begin ?” has the most direct implications to:
    1. emotional etiology
    2. language impact
    3. possible need for intervention
    4. the type of disfluencies

  1. In the initial parent interview concerning a preschool child who stutters, the question

“Was the onset of stuttering sudden or gradual?” is pertinent because:

  1. sudden onset tends to be associated with organic etiology
  2. gradual onset tends to be associated with psychological etiology
  3. gradual onset tends to be associated with more severe stuttering
  4. sudden onset tends to be linked to maternal history of stuttering
  5. none of the above

True – False Questions

  1. Based on recent longitudinal data on the development of stuttering in preschool age children, it would be justified to advise parents of a two and a half year-old child who began stuttering four months prior to the evaluation that his/her chances for recovery are approximately 75%.

  1. Based on the information described in the previous question, it would be justified to advise the parents that they should expect the stuttering to worsen throughout the first year of the disorder. Improvement in young beginning stutterers, if it occurs, typically takes place during the second year of the disorder or later.
  2. A speech sample of a preschool-age child containing only four instances of syllable or word repetitions per 100 syllables, each of which is of two or more repetition units, most likely was recorded from a child who stutters.

  1. A 30-month year old male is first seen 3 months after stuttering onset. He exhibits rather severe stuttering in terms of SLD frequency (15 per 100 syllables), moderate tension, and few secondary characteristics. No apparent emotional reactions. There is no known familial history of stuttering. Phonology and language appear normal for age. In this case, there is no reason to view the child, at this point in time, as being at high risk for persistence and he may be placed under close monitoring for several months.

  1. A 30-month year old male is first seen 3 months after stuttering onset. He exhibits rather severe stuttering in terms of frequency SLD (15 per 100 syllables), moderate tension, and few secondary characteristics. Three months later, there are no signs of aggravation such as changing symptomatology. Parents report improvement. Analysis of several speech samples yields 11 SLD per 100 syllables. Immediate therapy should be recommended because the child still exhibits a significant amount of stuttering.

  1. A 30-month old female is first seen three months after onset. She exhibits moderate to severe stuttering in terms of frequency (e.g., 13 SLD per 100 syllables). Her uncle exhibits mild stuttering and her older cousin has been stuttering for six years at a moderate level of severity. Three months later, the parents report some improvement but still rate the stuttering as moderate. Analyses of speech samples reveal 11 SLD per 100 syllables. In spite of the improvement, immediate intervention should be considered.

  1. The initial evaluation of a young child who stutters should be restricted to comprehensive testing of the his/her disfluent speech, secondary characteristics, emotional reactions, and parents’ report.

Essay Questions

  1. In the initial evaluation of a preschool age child, why are the following information items obtained: (a) accurate time of stuttering onset, (b) characteristics of speech and other behaviors (which ones?) of stuttering at onset, (c) accurate family history of stuttering? Elaborate on each of the above. 247-256

  1. The distinction between normal disfluency and stuttering might become blurred in some cases, especially when the suspected stuttering is mild. What disfluent speech characteristics have been suggested for the classification of a child as exhibiting mild stuttering? 338; 244-245; 265-266

  1. A 30-month old boy has been stuttering for a period of 3 months. List and discuss four primary risk factors for him to develop persistent stuttering. p 267-274

  1. The child’s awareness of his/her own stuttering has been viewed as an important factor in the development of stuttering after its onset. It is also as a factor that may influence the type of intervention. What sources and means can be used in attempting to evaluate a preschool-aged child’s awareness of stuttering and his/her emotional reaction to it? 258-259

  1. Discuss the initial counseling of parents whose child has just begun stuttering. Specifically, what can parents do to deal with the problem? List and briefly discuss 6 items of advice to parents. P. 276-279

Chapter 10. Stuttering Therapy Overview: Issues and Directions

Multiple Choice Questions

  1. Yairi & Seery propose that a theory-therapy link is advantageous because it
  2. ensures treatment will be successful
  3. provides a logical basis for sensible treatment alternatives when progress fails
  4. is more favorable to clients than treatment based on a pragmatic approach
  5. leads to treatment practices that are consistently similar across clients

  1. The “Fluency reinforcement” approach fits best within this broad category of treatment aims:
  2. focus on improved adjustment
  3. focus on reduced stuttering
  4. focus on increased deliberate fluency
  5. focus on increased natural fluency

  1. If the speaker self-monitors the gestures of speech to maintain a smooth flow, she or he is using:
  2. naturally fluent speech
  3. fluent stuttering
  4. deliberately fluent speech
  5. improved cognitive adjustment

  1. A treatment objective: “The client will perform target fluency strategies with 90% accuracy” lacks in:
    1. what level of achievement is expected
    2. what conditions of performance are expected
    3. who is expected to perform this objective
    4. what the speaker must perform

  1. Clinical research to examine treatment effects within an individual is called:
    1. single-subject studies
    2. group studies
    3. long-term studies
    4. clinical trials

  1. When research addresses only whether significant change has occurred as a result of therapy, it is referred to as a:
  1. clinical outcomes study
  2. clinical efficacy study
  3. clinical longitudinal study
  4. clinical control study

  1. Deliberately fluent speech is:
  1. actually not normal in spite of the fact that it is fluent
  2. comfortable and normal in spite of the fact that it is deliberate
  3. louder and/ or faster than normal
  4. produced with the aid of an instrument

  1. Which of the following is a therapeutic method for stuttering aimed at achieving naturally fluent speech:
  1. fluency shaping
  2. modifying stuttering moments
  3. promoting calmness and relaxation
  4. pharmaceutical treatment

  1. Which of the following does NOT represent a weakness in the following therapy objective set up by a clinician: “John will perform his fluency targets with 95% accuracy”? The objective is sufficient in only one component, by providing information about the:
  1. conditions where this goal is to be achieved
  2. the nature of the targets
  3. the measurement criterion
  4. speaking context

  1. Relapse management for stuttering may involve any of the following except:
  1. how to approach, understand, and solve related problems
  2. handling stuttering moments with greater resilience
  3. increasing speaking time with listeners who are perceived to be more patient
  4. modifying self-talk to strengthen self-esteem

  1. Which consideration usually warrants the greatest weight in guiding therapy outcomes?
  1. how many stuttering moments the speaker has
  2. how much speaking time is spent in fluency
  3. how frequently listeners perceive the speaker as fluent
  4. how effective the speaker is as a communicator

  1. Despite the lack of a complete cure of stuttering, indications are that speech therapy can
  1. eliminate emotional conflicts in people who stutter
  2. increase natural fluency in nearly all people who stutter
  3. alter the brain activity of people who stutter
  4. effect gains in speech control that rarely result in relapse

  1. Those who are expected to spend the largest percentage of time talking during fluency therapy sessions:
  2. conversational partners of people who stutter
  3. the clients who stutter
  4. the clinicians providing therapeutic guidance
  5. none of the above; the aim is an equal balance of talking time among participants

  1. One of the major problems with theories of stuttering over the years:
  2. they were narrowly focused in perspective and limited in scope
  3. they prescribed specific procedures for how to handle therapy that failed
  4. they were largely comprehensive and encompassed a multiple set of dimensions
  5. they were tied too closely to clinical observations of what worked in therapy

  1. The clinician quality of being authentic and genuine is also referred to:
  2. person-centered
  3. empathy
  4. unconditional positive regard
  5. self-congruence

True – False Questions

  1. In stuttering therapy the approaches of Increased Fluency and Decreased Stutter Events are basically very different.

  1. Preschool-aged children who exhibited natural recovery from stuttering demonstrate what is meant by naturally fluent speech.
  2. An evidence-based approach to intervention relies on empirical research showing that the treatment is applicable with all clients who stutter.

  1. Single subject research designs by nature do not involve control conditions.

  1. Improved cognitive-emotional adjustment is one of the three potential major goals of stuttering treatment.

  1. Clinical efficacy research is concerned exclusively with clinical outcomes.

  1. Not being physicians, speech-language clinicians have no need to follow the Hippocratic oath to “do no harm.”

  1. Adult clients need to learn how to serve as their own therapist.

Essay Questions

  1. What, if at all, is the importance of therapy guided by theory? What argument can be made for stuttering therapy which is not linked to theory? 283-286
  2. Chapter 10 presented 12 treatment approaches to stuttering. These were divided into three classes based on their focus. What are these classes and their different foci? List one example of a treatment approach for each. Could you suggest different classification? If yes, state and justify. 288-291
  3. What issues are involved in evidence-based clinical practice? Compare the “research-first” with the “clinician’s judgment first” point of views. 295-298
  4. Distinguish between clinical outcomes research and clinical efficacy research. Describe the features and discuss the strength and weaknesses of the two main methods used in clinical efficacy research: group studies and single-subject studies. 301-304
  5. Chapter 10 in your text lists several examples of questions concerning ethics involved in clinical practice. Following are five of these questions. Briefly, in a few sentences, elaborate on each:
    1. Is it sound practice to base diagnosis primarily on the judgment of a person who states that s/he stutters?
    2. Should I use only strict evidence-based therapies?
    3. Is it ethical to tell a client that the goal for therapy is the achievement of normal


  1. Is it ethical to instruct a client to stutter on purpose in the clinic or at home as part of the therapy?
  2. Is it ethical to instruct a client to stutter on purpose talking to strangers in the street,

store clerks, etc.? P.304-307

Chapter 11. Therapy for Adults: Focus on Emotional Reactions

Multiple Choice Questions

  1. Which intervention is the best example of a desensitization activity?

a the practice of stuttering openly without tension

  1. the practice of a slow, easy manner of speaking
  2. the practice of stopping after a stuttered word and reduce tension
  3. all of the above

  1. The main reason why systematic desensitization is used in stuttering therapy is to:
    1. remove operant reinforcement of stuttering
    2. weaken resistance to therapy
    3. reduce emotional sensitivity about being a stutterer
    4. counteract anxiety about stutter events

  1. The practice of progressive relaxation has been used in conjunction with this therapeutic program:
    1. rational emotive therapy
    2. systematic desensitization
    3. negative practice
    4. assertiveness training

  1. The main aim of “desensitization in vivo” is to:
    1. lessen negative emotional responses in real life speaking situations
    2. confront stuttering by discussing it openly
    3. induce physical relaxation following contrastive vivo-type muscular contractions
    4. challenge irrational assumptions and negative thoughts

  1. The use of voluntary stuttering could be considered a type of:
    1. relaxation
    2. voluntary auto-suggestion
    3. negative practice
    4. negative self-talk

  1. In stuttering therapy, the immediate purpose of the clinical procedure referred to as “desensitization in vivo” is to:
  2. increase fluency in spite of the anxiety
  3. reduce anxiety in spite of the stuttering
  4. reduce stuttering in spite of the anxiety
  5. reduce anticipation in spite of the anxiety

  1. When negative practice is used in stuttering therapy the client is to:
  2. practice reducing his own negative emotionality
  3. practice handling negative listener reactions
  4. practice voluntary stuttering
  5. practice stuttering in negative situations

  1. The therapeutic technique of “systematic desensitization” utilizes the client’s imagination to practice:
  2. being in speaking situations while reducing anxiety
  3. modification of stuttering in a relaxed manner
  4. speaking fluently with reduced anxiety
  5. eliminating anxiety regardless of speech

  1. In stuttering therapy, the concept of “relaxation” is focused mainly on the reduction of:
  2. negative attitudes
  3. trait anxiety
  4. physical tension
  5. sleeplessness

  1. The principle of hierarchy as used in desensitization procedures in stuttering therapy is designed to:
  2. gradually increase the stimulus value of the anxiety producing situations
  3. gradually decrease the stimulus value of the anxiety producing situations
  4. gradually increase the habitual response strength to the anxiety producing situations
  5. gradually contrast the old response with a new response to the anxiety provoking situations

  1. The main objective of desensitization is to:
  2. decrease visceral (emotional) arousal in order to facilitate motor performance
  3. maintain the same level of motor performance in spite of increasing emotional reactions
  4. decrease physical tensions associated with stuttering which intensify the stutter’s visceral arousal
  5. decrease the anticipation of stuttering thereby control the triggers for stuttering

  1. Which of the following therapeutic procedures would you practice by using the principle of disinhibition:
  2. punishment of stuttering
  3. negative practice
  4. modifying stuttering
  5. disassociation

  1. When employing a hierarchy for desensitization in stuttering therapy, the goal is to repeat

the experience at each level over and over again until the attendant emotionality is:

  1. reinforced
  2. decreased
  3. stabilizes
  4. becomes automatic

  1. A prediction that influences its own outcome is a:
  2. self-fulfilling prophecy
  3. free association
  4. authoritative suggestion
  5. psychodrama

  1. Which is not a physiological dimension associated with anxiety and tension?
  2. heart rate
  3. excitement
  4. muscle tone
  5. sweat

True – False questions

  1. According to psychoanalytic theories, stuttering should be treated through gradual shaping of its symptoms (stuttering) to resolve the deep emotional conflicts.

  1. In an anxiety hierarchy, the list of stimulus situations is presented with the most disturbing item is placed at the bottom of the list.

  1. The rationale behind Sheehan’s advice to stuttering clients to stutter “openly and honestly” is that the “open” stuttering results in better controlled stuttering

  1. By using voluntary stuttering for desensitization the client learns that he can dissociate disfluency from habitual emotional reactions.

  1. In stuttering therapy, the principle of “negative practice” is employed when the stutterer displays negative emotions while working on identification and analysis of stuttering.

  1. From a cultural perspective, where Western civilization is predominant, age 22 is a common milestone for considering a person as an adult for the kind of stuttering treatment prescribed.

  1. One reason for guarded prognosis for the outcome of therapy with adults who stutter is the large factor, about 75%, of natural recovery among preschool age children who stutter. It is reasonable to assume that adults who stutter are afflicted with a more robust form of the disorder.

  1. In current therapy for adults who stutter, the rationale for decreasing emotionality associated with stuttering rests on the idea that stuttering is caused by some emotional difficulties in early childhood.

  1. Classical Freudian psychoanalysis is aimed at the root problem, not the symptoms. Its ultimate objective is to elevate the unconscious to the conscious level. Hence, when applied to stuttering, no attempts are made to directly modify speech.

  1. Unlike psycho-analysis, with the Rational-Emotive Therapy (RET), a patient does not merely note and express thoughts but actively takes charge of them.

Essay Questions

  1. Is there a room for relaxation activities in stuttering therapy? Discuss your position. If positive, what procedures might be used? P. 315-318

  1. What is systematic desensitization? What are its objectives in regards to stuttering? List and describe three specific procedures. P. 319-320

  1. Construct an example of a stage by stage program of systematic desensitization for responding to telephone calls by a person who stutters. [No page number]

  1. What is desensitization in vivo? What are its objectives in regards to stuttering? What are its advantages? P. 321-326

  1. Explain the concept/procedure of negative practice and its application in stuttering therapy. P. 323-325

Chapter 12. Therapy for Adults: Focus on Stuttering and Fluency

Multiple Choice Questions

  1. The fluency-facilitating speaking strategy that clients may practice is referred to as:
  1. phrase repetition
  2. phrase revision
  3. phrasing
  4. paraphrasing

  1. Which of the following is not a fluency-facilitating speaking strategy:
  1. short duration vowels
  2. easy voice onsets
  3. light articulatory contacts
  4. connect between words

  1. Another name for the cancellation technique is:
  1. pre-block modification
  2. post-block modification
  3. in-block modification
  4. out-block modification

  1. Identification techniques are essentially intended to:
  1. slow the client’s overall speaking rate through self-monitoring
  2. address emotions before, during, and after the occurrence of stuttering
  3. raise the client’s awareness of the features of stuttered speech that need correction
  4. describe listeners’ overt and nearly concealed reactions

  1. The treatment approach focused on changing the client’s whole manner of talking is:
  1. stuttering modification
  2. fluent stuttering
  3. language of responsibility
  4. fluency shaping

  1. 6. In the traditional stuttering therapy, one rationale for pausing after instances of stuttering, when the “cancellation” modification technique is used, is to:
  2. a. prevent stuttering on the next word
  3. b. weaken stuttering on the next word
  4. c. increase tolerance to brief moments of silence
  5. d. analyze the recent instance of stuttering

  1. In the traditional stuttering therapy one rationale behind the common procedure of post-block modification (cancellations) is to:
  2. prevent stuttering on the next word
  3. weaken stuttering on the last word
  4. increase tolerance to brief moments of silence
  5. avoid anticipated stuttering
  6. none of the above.

  1. When a person who stutters talks about “my stuttering” it reveals:
  2. symbolic language
  3. animistic language
  4. concrete language
  5. abstract language

  1. When doing post-block modification, the speaker often wants to shorten the stuttering block by stopping in the middle of the word. What is the best rationale for instructing them to finish the word rather than stopping in the middle?
  2. increased frustration can be triggered
  3. avoidance of stuttering is counter-productive
  4. listeners may not recognize the word
  5. it reduces the negative reinforcement value of the subsequent pause

  1. In stuttering therapy the procedure of “in block” modification is designed to:
  2. a. generate moments of fluency
  3. b. change the pattern of stuttering
  4. c. sustain moments of fluency
  5. d. prevent the occurrence of anticipated moments of stuttering

  1. The procedure for an in-block modification technique involves:
  2. easing up the tension to finish the moments of stuttering
  3. substituting one form of stuttering with a different form
  4. sustaining fluency after moments of stuttering
  5. preventing the occurrence of stuttering before the next word
  6. inserting fluency to “pull out” of the spoken phrase.

  1. In stuttering therapy, the purpose of a preparatory set is to:
  2. replicate the moments of stuttering
  3. remove stuttering to achieve natural fluency
  4. sustain fluency after moments of stuttering
  5. stress syllables in time to a regular, even rhythm
  6. none of the above.

  1. Post-block modification can be accomplished by changing speech movement in this way:
  2. elongating a word
  3. bouncing (easy repetition)
  4. pantomime before speaking aloud
  5. all of the above

  1. One of the main problems which may arise when the pre-block modification technique is used in stuttering therapy is:
  2. the client is capable of only short-term (one or two words), not long-term (two or three sentences), anticipation of stuttering
  3. the client’s anticipation of stuttering is too accurate
  4. anticipation of stuttering blocks which do not materialize
  5. the occurrence of stuttering blocks which was not anticipated

  1. 15. In stuttering therapy, delayed auditory feedback (DAF) is particularly useful in:
  2. a. controlling the length of the intervals between spoken words
  3. b. reducing the fast rate of repetitions
  4. c. inducing better coordination between phonation and articulation
  5. d. controlling the phase disparity between the two ears in terms of auditory feedback.
  6. none of the above

  1. Using the therapeutic approach of fluency enhancing, the clinician’s aim is to:
  2. gradually establish fluency using an exaggerated speaking pattern
  3. immediately establish complete fluency using an exaggerated speaking pattern
  4. gradually establish fluency by reinforcing fluent words in increasing number,
  5. immediately establish fluency by eliminating all anticipated stuttering

  1. Which of the following is not included in Perkins’ (1990) sequence of techniques for establishing fluency:
  2. motoric skill
  3. rate skill
  4. blending skill
  5. rhythmic skill

  1. Based on several reports concerning the use of rhythmic speech in stuttering therapy, a reasonable program should include a range of metronomic rate between:

  1. 40 and 80 beats per minute
  2. 50 and 260 ” ” ” ,
  3. 40 and 170 ” ” “
  4. 60 and 120 ” ” “

  1. Which of the following alterations are imposed on the stutterer’s speech pattern by the therapy technique of rate control using DAF or other techniques designed to achieve “stretched speech”:
  2. longer intervals between words or syllables
  3. shorter voice onset time
  4. longer pauses between phrases and sentences
  5. increasing vowel duration
  6. none of the above

  1. Experimentation with the application of noise or metronomic rhythm to stuttering therapy has indicated that:
  2. the two methods yield substantial long‑term cure or near-cure (stuttering on 1% or less of syllables) during unaided speech in 75% of the clients
  3. the two methods yield only short‑term, though substantial, results in the majority of the clients
  4. the two methods yield only minor improvement, either short or long term in about 75% of the clients
  5. none of the above is a reasonable/accurate conclusion on the basis of present data

  1. Which of the following techniques is not employed in the Establishment Phase of Bruce Ryan`s operant conditioning therapy program for stuttering?

  1. practicing easy voice onset
  2. establishing awareness of stuttering
  3. practicing easy stuttering
  4. increasing length of fluent speech

True – False Questions

  1. The main focus of the “traditional approach” to stuttering therapy (e.g., Van Riper’s) is the complete elimination of stuttering by means of post-block and in-block modification techniques.

  1. The stage of identification in stuttering therapy is designed to increase the stutterer’s awareness of his/her stuttering.

  1. Positive reinforcement of stuttering is probably the most effective operant conditioning technique in stuttering therapy.

  1. Using the rate control method of stuttering treatment, the immediate goal is to achieve

complete fluency during the first session using exaggerated pattern of speaking.

  1. Experiments with EMG as biofeedback in the treatment of stuttering have shown that a short program over only 10 consecutive days can yield relatively lasting positive effects.

  1. The Kassel Stuttering Therapy (KST) program utilizes an altered auditory feedback technique for the treatment of stuttering in adults.

  1. The Modifying Phonation Intervals (MPI) is a computer-assisted fluency program aimed at aiding clients in achieving stutter-free and natural-sounding speech.

  1. Integrated approaches to stuttering therapy is the term for a group of programs that utilize modern integrated electrical circuits to stimulate the motor cortex with the objective of normalizing brainwaves deemed to be associated with stuttering.

  1. DAF can easily be integrated with behavioral stuttering therapy.

Essay Questions

  1. Taking the general therapeutic approach of stuttering management, describe the various steps involved in the procedure known as identification. P. 342-346
  2. Taking the general therapeutic approach of stuttering management, describe the various steps involved in the procedure known as modification. P. 346-350
  3. What are the basic principles and basic procedures in fluency shaping stuttering therapy? P. 350-362
  4. What types of fluency inducing instruments have been applied in stuttering therapy? Discuss pros and cons. P 362-370
  5. Several therapeutic programs for stuttering have been developed based on operant behavior principles. What are these principles? Discuss applications, for example, Ryan’s GILCU program. P 357-362
  6. What are integrated approaches in stuttering therapy? Provide an example. Discuss. P. 370-373

Chapter 13. Therapy for School-Age Children

Multiple Choice Questions

  1. The GILCU program of stuttering intervention is based mainly on principles of:
    1. physical relaxation
    2. authoritative suggestion
    3. cognitive restructuring
    4. operant conditioning

  1. Intervention for school-age children who stutter:
    1. should involve parents as an important component
    2. should involve parents only as a minor component
    3. should involve only parents, not the children
    4. should not involve the parents at all

  1. A child who stutters may often respond to teachers’ questions with “I don’t know” because of being:
    1. less likely to understand the question
    2. less likely to know the answer
    3. afraid of stuttering in front of the class
    4. emotionally and socially immature

  1. The school-aged child who stutters:
  2. is highly aware of the stuttering
  3. is surrounded by peers who typically are not highly aware of the stuttering
  4. exhibits only limited range of rather mild, not complex, emotional reactions in spite of his/her awareness
  5. exhibits an overall stuttering disorder characterized mainly by speech difficulties, without significant emotional and social aspects

  1. Many clinicians have observed that it is difficult for school age children to eliminate stuttering, or even make appreciable progress. The best explanation for this phenomenon is that:
  1. current therapies have been adopted from those designed for adults; they are not adequate for the specific conditions of stuttering in school age children, especially their slow to develop fine motor skills
  2. the nature of the school environment, such as uncooperative teachers and peers’ negative reactions
  3. children who did not exhibit natural recovery at an earlier period represent a more resistant type of stuttering
  4. the important element of parental involvement in the therapy, so essential in the treatment of stuttering in preschool children, is either missing or rather weak in the routine therapy provided in the schools

  1. Which would be the most appropriate for working with a 3rd-grader who stutters:
  2. in-block modification of stuttering
  3. stuttering on purpose to strangers (in vivo desensitization)
  4. rate control starting at 30-word per minute
  5. systematic desensitization

  1. Comparing the overall nature of stuttering treatment between school-age children and adults:
  2. both the objectives and the procedures are entirely different
  3. both the objectives and the procedures are essentially the same
  4. the objectives are different, but the procedures are the same
  5. the objectives are the same, but the procedures are different

  1. The 2004 reauthorization of IDEA criteria for children who stutter:
  2. made no changes in eligibility for services
  3. narrowed eligibility so that services were less accessible
  4. expanded eligibility that increased accessibility to services
  5. redefined eligibility to have an entirely different basis for services

  1. School teachers who have children who stutter in the classroom should:
  2. talk with the child about whether and how to adjust the mode of class participation
  3. be sure the child who stutters will take his or her speaking turn last
  4. just treat the child exactly like other children in terms of class participation
  5. excuse the child who stutters from any participation of speaking in class

  1. School-age children who have received therapy since preschool age often:
  2. are ready for more adult treatment procedures
  3. need less parental involvement in their therapy
  4. already know how to execute most speaking strategies
  5. lack motivation to continue therapy

  1. One of the best controlled studies concerning the results of stuttering therapy for school-aged children who stutter and conducted by Craig, et al. (1996) was discussed in your textbook. It compared three methods: intensive smooth speech, intensive electromyography (EMG), and home-based smooth speech. A control group of no therapy was also employed. The investigators found that:
  2. by the end of the therapy program all treatment groups improved by approximately 20% in terms of reduction in the frequency of stuttering
  3. by the end of the therapy program all treatment groups improved by approximately 50% in terms of reduction in the frequency of stuttering
  4. by the end of the therapy program all treatment groups improved by 85% to 90% in terms of reduction in the frequency of stuttering
  5. the control group also improved by about 25%
  6. none of the above is a correct description of the findings.

  1. When a school-age child’s stuttering is relatively mild in frequency and severity…

  1. the child is usually less afraid to talk in group situations
  2. the child will make more progress in therapy
  3. the child tends to perform better in school subjects
  4. the child may still be quite terrified of stuttering

  1. One of the best ways to reduce the pain of stuttering with school-age children is by:
  2. suggesting ways that they can avoid talking in social situations
  3. explaining at great length why stuttering is not so bad
  4. helping them have fun playing with voluntary stuttering
  5. playing table games in the therapy session

  1. The technique that is not used as a fluency-facilitating speaking skill:
  2. pull-outs
  3. slow-stretched spoken phrases
  4. gentle voice initiations
  5. light articulatory contacts

  1. The therapy approach that mainly trains the parents to deliver the procedures:
  2. Lidcombe Program
  3. Fluency Rules Program
  4. GILCU Program
  5. Stuttering Modificaton Program

True False Questions

  1. It is impossible for the average-aged 5th grader who stutters to already have a 9-year long stuttering history.
  2. It is possible for the average aged 2nd grader who stutters to already have a 4-year long stuttering history.
    • Considering their age and what is known about natural recovery, school-aged children, in general, have passed most of the chances for natural recovery.
  3. Many school-aged children who stutter tend to academically perform above norms. This trend is due to their motivation to compensate for the stuttering handicap.
  4. All factors considered, it is better for teachers not to be involved in a school-age child’s stuttering therapy.

  1. Role play can be used to help a child practice assertive responses to teasing.
  2. Stuttering is just a bad habit that by speaking fluently often enough a child should be able to change.
  3. Studies have shown that practicing conversational turn-taking with peers substantially reduces stuttering in school-age children.

Essay Questions

  1. What are the particular stuttering, emotional, and cognitive characteristics of school-age children that should be considered in regard to therapy? In what ways do they differ from those of preschool-age children who stutter? 377-379

  1. Discuss home and school environment as pertained to the school-aged child who stutter: what issues are involved regarding parents, teachers, and peers? 381, 387-393

  1. What are the potential roles of parents and teachers in the clinical management of school-age children who stutter in various clinical programs? P 390-393

  1. What information about stuttering should teachers be made to be aware of? What are the main points of advice teachers should be given? 392-393

  1. How would you modify and apply stuttering desensitization techniques when working with a 9-year old child who stutter? Are there differences in the objectives and rationales compared to working with adults? 395-397

  1. Outline an assertive training program for an 11-year old boy who stutter who is helpless in dealing with peers’ teasing. What are the essential elements? 397-399

  1. How would you modify and apply stuttering management techniques when working with a 9-year old child who stutters? Are there differences in the objectives and rationales compared to working with adults? 399-402

  1. Describe and explain the important challenge of balancing smooth speech goals with emotional acceptance of stuttering. P 384

Chapter 14. Therapy for Preschool-Age Children

Multiple Choice Questions

  1. An adult using an environmental modification with a child who stutters is most apt to:
  2. say to the child: “Let’s use our turtle talking.”
  3. ask the child: “Was that bumpy speech?”
  4. instruct the child: “Say it like I do.”
  5. wait a second before speaking and model a slow, relaxed approach

  1. Arguably the most out-dated approach to clinical management of early childhood stuttering is:
  2. direct therapy
  3. parent education
  4. Lidcombe program
  5. Extended Length of Utterance

  1. Van Riper’s main focus of therapy for preschool children was the:
    1. prevention of future development of negative emotionality and the avoidance of talking
    2. development of speech motor control through correction of deficient speech movements
    3. reduction of stuttering behavior by the modification of its consequences
    4. facilitation of fluency through slow rate

  1. Speech therapy with young children should be:
  2. conducted with minimal instruction or explanation
  3. focused on decreased stuttering, even if the child talks less often
  4. aimed to change the child’s cognitive and language skills
  5. rich with speech modeling and plenty of child talking time

  1. Speech is more likely to be fluent in:
  2. unstructured free play
  3. structured speaking activities
  4. small group interactions
  5. sentences of more than 6 words

  1. The best description of direct therapy according toYairi & Seery is when:
  2. only the child interacts with the clinician
  3. the child participates in any form of therapy that is speech or non-speech oriented
  4. the child receives only speech modification therapy
  5. none of the above

  1. Which one of the following is not a major class of therapy applied with preschool children?
  2. modifying speech motor patterns
  3. reinforcement of fluency via operant conditioning
  4. altering parent-child interaction
  5. cognitive restructuring, such as rational-emotive therapy

  1. Pindzola’s (1987) Stuttering Intervention Program is mainly based in which of these theories?
    1. demands and capacities model
    2. covert repair hypothesis,
    3. diagnosogenic theory
    4. conflict theory

  1. The main reason for including parents in early childhood intervention is:
  2. the reactions of the immediate family are the primary cause of stuttering
  3. the immediate family typically constitutes an overwhelming portion of the child’s world
  4. modeling of fluent speech by the immediate family improves the child’s fluency by approximately 25%
  5. the parents of stuttering children tend to have authoritarian and domineering parenting


  1. The Extended Length of Utterance (ELU) intervention program is based on principles of:
  2. improving the child’s linguistic skills
  3. enhancing the child’s comprehension of utterances
  4. positive reinforcement of fluent utterances practiced
  5. none of the above

  1. The Parent Child Interaction program is focused on manipulation of the child’s:
  2. emotional reactions
  3. length of utterances
  4. speaking environment
  5. self-evaluation of stuttered speech

  1. When the adult says to a child: “That was bumpy, wasn’t it?” they are most likely engaged in:
  2. indirect therapy
  3. speech motor training
  4. psychotherapeutic play
  5. Lidcombe program

  1. The following productions would be drilled in a Speech Motor Training approach:
  2. “baseball – hotdog – birdcage”
  3. “park – parking – parking lot”
  4. “vami – vami – vami ”
  5. “chuh- chuh- chuh- chicken”

  1. In the Extended Length of Utterance (ELU) program, the client performs:
  2. drill of non-words composed of progressively longer and more complex CV structures
  3. fluent utterances progressing from monosyllabic words up to 5-min. conversations
  4. slow-stretched speech during free play/conversation activities
  5. self-corrections to acknowledge parental feedback

  1. The best example of a comprehensive and integrated program of early intervention for stuttering:
  2. Parent-Child Interaction program
  3. Easy Speaking Voice program
  4. Lidcombe program
  5. Helsingborg-Hospital model

True – False Questions

  1. The recent trend toward more direct therapy for stuttering represents a bold and revolutionary approach to early childhood intervention.

  1. It is common for young children under 5 years who stutter to be teased by their peers.

  1. The Illinois program of early childhood intervention is based primarily on the method slow speaking rate.

  1. Most of the stuttering programs for young children include a progression of practice from shorter (e.g., monosyllabic words) to longer (e.g., conversation) speech segments.

  1. The Lidcombe program of early stuttering intervention seeks to train parents in the methods of reinforcement or non-reinforcement of certain portions of the child speech.

  1. Drama therapy is aimed at preparing the child who stutters for stage performances.

  1. The current trend in early stuttering treatment is a focus on parent counseling that avoids bringing the child into the clinical setting for therapy.

  1. In the treatment program offered by Gregory and Hill, preventive parent counseling and prescriptive parent counseling involve virtually the same approach.

Essay Questions

  1. State and discuss the issues involved in which preschool children who stutter should receive therapy, when, and what type of therapy. 421-423
  2. What is indirect therapy as contrasted with direct therapy? Why has the indirect approach been employed for the treatment of early childhood stuttering? What kinds of programs have been, or can be, used? 416-420
  3. Briefly present and discuss the Extended Length of Utterance program (ELU). What are the advantages? Are there and weaknesses? If yes, explain. 431-432
  4. Briefly describe the Lidcombe treatment program for preschool children who stutter. What are the advantages? Are there weakness? If yes, list and explain. 431-432
  5. Several current programs focus on altering parent-child interaction, such as the Parent- Child Interaction program (Kelman & Nicholas) and the Parent-Child Groups program (Conture). Describe the basic features and procedure involved in this type of program. What are the advantages? Are there disadvantages? If yes, explain. 434-438
  6. Should SLPs intervene with every preschool child who is stuttering, or should they only intervene if there is a high risk for persistence? Be sure to explain the rationale behind your position. [No specific pages]

Chapter 15. Other Fluency Disorders; Cultural and Bilingual Issues

Multiple Choice Questions

  1. The least common location for stuttering moments in speech contexts:
  2. clause-initial position
  3. word-initial position
  4. word-medial position
  5. word-final position

  1. Children with specific language impairment (SLI) produce a preponderance of:
    1. sound prolongations
    2. monosyllabic whole-word repetitions
    3. maze revisions
    4. syllable repetitions

  1. Rapid, sporadic, unorganized, and sometimes unintelligible speech is associated most often with:
  2. stuttering
  3. cluttering
  4. psychogenic stuttering
  5. neurogenic stuttering

  1. Neurogenic stuttering is diagnosed based on:
  2. frequency and types of stuttering
  3. evidence of a neurological disorder or disease
  4. familial history of neurological disorders
  5. locations of core and accessory disfluencies
  1. Psychogenic stuttering mainly differs from developmental stuttering by this feature:
  2. multiple units of syllable repetition
  3. bursts of rapid speech
  4. adult age of onset after excessive emotional stress
  5. types of secondary behaviors

  1. Language learning disabilities are typically characterized by:
  1. disfluency frequency comparable to that of mild stuttering
  2. faster articulatory rates
  3. more frequent word-finding problems and circumlocutions
  4. slurred articulation and speech sound transpositions

  1. Cluttering and developmental stuttering in school-age children are best differentiated by:
  1. age of onset
  2. disfluency on automatic speech tasks
  3. locations of core and accessory disfluencies
  4. self-monitoring awareness of speech disfluency

  1. Which disorder begins during early childhood?
  1. neurogenic stuttering
  2. developmental stuttering
  3. psychogenic stuttering
  4. malingered stuttering

  1. Which fluency disorder is usually characterized by the most “islands of fluency”?
  1. neurogenic stuttering
  2. psychogenic stuttering
  3. developmental stuttering
  4. cluttering

  1. Which disorder is least responsive to fluency-inducing conditions such as singing, whispering, etc.?
  1. neurogenic stuttering
  2. psychogenic stuttering
  3. developmental stuttering
  4. cluttering

  1. Which of the following speech behaviors is commonly associated with neurogenic stuttering?
  2. secondary physical characteristics
  3. the adaptation effect
  4. anxiety about speech
  5. all of the above
  6. none of the above

  1. Which of the following factors most clearly differentiates between stuttering and cluttering?
  2. sentence constructions
  3. fear of specific words
  4. accessory (Other) disfluencies
  5. speaking rate
  6. all of the above
  7. none of the above (a through d)

  1. Which of the following is not typical of cluttering?
  2. interjections
  3. speech hesitation
  4. sound prolongations
  5. syllable repetitions

  1. Pausing to inhale in the middle of words is most characteristic of:
  2. fluency disorders (unspecified)
  3. developmental stuttering
  4. psychogenic stuttering
  5. cluttering

  1. The most common reason for malingered stuttering is:
  2. financial, legal or vocational gains
  3. desired emotional attention
  4. second language learning
  5. covert fluency disorders

True – False Questions

  1. When stuttering begins in adulthood, it appears to be the results of a sudden language development growth.

  1. Indifference (apathy) about stuttering is a typical emotion of someone with neurogenic stuttering.

  1. If you tell a person who clutters to pay more attention to his speech, he will probably become even more disfluent.

  1. Psychogenic stuttering is usually a form of conversion reaction.

  1. Unlike stuttering, most cases of the disorder called “cluttering” begin in adulthood.

  1. Typically (or “Many cases of”) neurogenic stuttering begins in early childhood as one aspect of general neurological problems.

  1. Because patients exhibiting neurogenic stuttering are very tense, a good starting point for therapy is deep relaxation activities.

  1. Developmental stuttering is not classified as an acquired fluency disorder.

Essay Questions

  1. Language disorders may occur concomitantly with stuttering. What are the treatment implications? What treatment options are should be considered? What are the advantages and weaknesses? 451-454
  2. What are the main characteristics of cluttering? Is cluttering a disorder of fluency? Of Language? Articulation? Something else? Explain/discuss. 455-461
  3. What are the characteristics that distinguished neurogenic from developmental stuttering? What treatment approaches seem to be useful for this condition? 462-465
  4. What are the characteristics that distinguish psychogenic stuttering? What are the intervention options? 465-468
  5. Are bilingualism and cultural/ethnic factors in stuttering? If yes, in what ways? Are there clinical implications for diagnosis and treatment? 468-473

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