Exam Four

SPA 461. Final Examination. Fall, 2003

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The Turtle Wins by a Hare.

BONUS QUESTIONS:

1. What is the name of the NSA Newsletter?
   
   
2. What is the full name of the SFA
   
   
3. What are three DIFFERENT ways that a person can engage in Advertising.
   
   

Section I. TRUE/FALSE. One Point Each.

1. A major end-product of therapy for the adult Stage IV (advanced) stutterer is to achieve speech which is free of tension, struggle and avoidance.
2. The concept of cancellation can be applied to both words and situations.
3. For the Stage I (Borderline) stutterer, the major goal of therapy is the direct positive reinforcement (reward) of easy stuttering.
4. The basic rationale for the preparatory set (Prep-Set) is that since the stutterer anticipates and scans ahead anyway, he should do so in the best way possible.
5. Before the client is ready to work on "cancellations" he must already have succeeded with pull-outs.
6. Many children who stutter are afraid to "make mistakes in the process of talking."
7. According to Hood a major goal of therapy for the Stage IV (Advanced) adult is not fluency for the sake of fluency, but rather, the ability to cope with your talking behaviors.
8. A good cancellation, even when produced correctly, is not produced normally. This is why the use of cancellations is a means to reach a goal, rather than a final goal in and of itself.
9. The adult stutterer must learn to devise his tasks of learning and unlearning in such a way that he can objectively evaluate his performance.
10. A good preparatory set will allow the production of a word which is acoustically acceptable, but which is still not produced normally.
11. According to Sheehan, Van Riper and Hood, the advanced stutterer (Stage IV) may not necessarily have a choice as to whether he stutterers, but he does have a choice as to how he stutters.
12. According to Douglass and Quarrington, the major internal goal for the nonvocalized secondary stutterer is to avoid stuttering out loud, and the major goal of the interiorized stutterer is not to stutter at all.
13. The clinician should reward avoidance behaviors only when they are followed by fluency.
14. Avoidance behaviors are generally harder to work with than escape behaviors.
15. Prolongations and fixations may be either vocalized or non-vocalized.
16. Negative reinforcement results in an increase in the frequency of occurrence of a response.
17. Clinicians who attempt to shape the client's fluency give less attention to reducing fears and frustrations than is the case for clinicians who attempt to modify the form and severity of the stuttering.
18. Your instructor feels it is unwise for parents to observe their own children in therapy. This is because parents tend to be resentful of the fluency which the clinician elicits, pressure the child to be as fluent at home as in the clinic, and are unable to relate to the child in the same way as the clinician.
19. The stage III-IV (intermediate-advanced) stutterer must be helped to understand and appreciate the dilemma of the listener who reacts negatively to stuttered speech.
20. "Hard Talking" results from factors which interfere either from an emotional level, and/or, from a motor level.
21. In stead of saying "I'll see you Wednesday" the client says "I'll see you tomorrow." This is an example of the kind of circumlocution that occurs in Stage IV of Advanced Stuttering.
22. According to Hood, the major long term goal for the Stage IV (Advanced) stutterer is to reduce the frequency of stuttering.
23. The adult stutterer should be directly told that he has a long, hard, tough job ahead of him.
24. Clinicians who teach stuttering modification seek primarily to reduce the severity of stuttering. Fluency shaping clinicians seek to teach fluency enhancing skills that will result in fluency.
25. According to the laws of learning theory, any behavior that reduces anxiety gets strongly reinforced.
26. Whereas classical conditioning helps to explain emotional learning, operant conditioning helps to explain behavioral learning.
27. Clinicians who believe in fluency shaping approaches to treatment give little attention to Identification and Desensitization.
28. It would be easier to use exaggerated AVM on the phrase "they were washing windows" then it would be on the phrase "Sue thinks she is funny."
29. "Advertising" is a major component in therapy geared toward fluency shaping.
30. According to Hood, it is essential that the Stage I and Stage II (borderline-beginning) stutterer understand the nature and rationale for his therapy.
31. According to Hood, it is essential that the Stage III and Stage IV (intermediate-advanced) stutterer understand the nature and rationale for his therapy.
32. Direct confrontation of the stuttering symptoms should not be done until the stutterer reaches stage IV.
33. The elimination of avoidance behaviors should not be done in ways that create more anxiety than the stutterer can tolerate.
34. Knowledge of Predisposing causes are more important then knowledge of Maintaining causes in terms of the clinical management of stuttering
35. Struggle behaviors such as head jerks are maintained by intermittent punishment.
36. In Sheehan's conflict theory of stuttering, the tendency to avoid is stronger than the tendency to approach.

SECTION II. Multiple Choice. One point each.

37. Which of the following is NOT true of a good preparatory set?
    1. It teaches the stutterer to come closer to the stuttering moment in a more appropriate way.
    2. It demonstrates that the client knows what to do with his speech mechanism.
    3. It involves appropriate compensatory behaviors for coping with an anticipated moment of stuttering.
    4. It teaches an acceptable form of behavioral avoidance.
    5. It replaces avoidance with approach.
38. Which of the following is NOT a good rationale for the use of cancellations in Stage III and Stage IV?
    1. the period immediately following the completion of a stuttered word is a good time for learning.
    2. reconfrontation of the moment of stuttering is behaviorally essential.
    3. reconfrontation of the moment of stuttering is emotionally essential.
    4. during the cancellation, the speaker learns that he can be fluent.
    5. all of the above are good rationales for the use of cancellations.
39. Which of the following sequences of therapy is most logical for the teaching the client to modify moments of stuttering?
    1. pull-out, prep-set, cancellation b. cancellation, pull-out, prep-set c. cancellation, prep-set, pull-out
    2. prep-set, pull-out, cancellation e. pull-out, cancellation, prep-set
40. From the viewpoint of learning theory, cancellations:
    1. interfere with the self-reinforcing properties of escape behaviors
    2. result in fluency
    3. increase avoidance
    4. prove the importance of repressing/hiding the symptoms of stuttering
    5. help the client better control his fluency
41. Which of the following is NOT a good basis of stuttering therapy?
    1. stuttering is intermittent
    2. stuttering is both "emotionally awful" and "behaviorally lawful"
    3. therapy is viewed as selective reinforcement and extinction
    4. successful interiorization of stuttering is a sign of successful therapy.
    5. all of the above are good bases of therapy.
42. Which of the following does NOT apply to the concept of cancellations?
    1. coming to a complete halt after a moment of stuttering
    2. being fluent the second time the word is spoken
    3. punishment of escape behavior
    4. two of the above
    5. all of the above
43. The concept of "erase and fix" which can be used with the child is essentially the same as the concept of ___________ which can be used with the adult:
    1. cancellation
    2. light articulatory contact
    3. pull-out
    4. preparatory set
    5. stop and start over again
44. Prior to therapy, which of the following is generally NOT true of the adult (Stage IV) stutterer?
    1. they show fear and expectancy
    2. they show fear, expectancy and avoidance
    3. they demonstrate much avoidance
    4. they are well able to identify the overt and covert components
45. The shaping of normally fluent speech would include all of the following EXCEPT:
    1. establishing normal sounding prosody
    2. establishing normal breath flow
    3. establishing normal sounding preparatory sets and pull-outs
    4. establishing normal rate
    5. establishing normal sounding melody
46. The authorities that have been emphasized in class feel that the stutterer must do all of the following EXCEPT:
    1. repress the stuttering by hiding the abnormality
    2. give up avoidances and face the moment of stuttering more openly and honestly
    3. tackle feared words and sounds more openly
    4. be willing to do some voluntary stuttering
    5. employ tactile, kinesthetic and proprioceptive monitoring
47. According to your instructor, therapy for the child who stutters is least effective when it is:
    1. aimed at hiding the disorder
    2. aimed toward appropriate parental counseling
    3. aimed toward speech-motor modifications of talking
    4. geared toward preventing the development of fear, expectancy and avoidance
    5. aimed at environmental manipulation of communicative stress.
48. Voluntary stuttering can be helpful for accomplishing which of the following:
    1. interiorizing b. desensitizing c. providing a safety margin
    2. two of the above e. all of the above
49. In pull-outs the stutterer does all of the following EXCEPT:
    1. lets the block run its course as it does in cancellation
    2. makes a deliberate effort to change the form of stuttering before the moment of release
    3. modifies his speech in the direction of "more fluent stuttering"
    4. Increases the approach gradient (Sheehan)
    5. reduces the struggle and tremor
50. According to Brutten and Shoemaker, fluency failures are sporadic because they are:
    1. penalized
    2. unlearned
    3. acute
    4. operant
    5. associated with learned emotion
51. Cancellations represents a clinical form of
    1. punishment
    2. negative reinforcement
    3. non-reinforcement
    4. contingent negative emotion
    5. antecedent negative emotion
52. A stutter often feels is stuttering is "painful" to others. Sheehan refers to this as:
    1. primary guilt
    2. secondary guilt
    3. secondary gain
    4. repressed shame and guilt
    5. double approach-avoidance conflict
53. The gradual reduction in the frequency of stuttering after successive oral readings of the same paragraph is referred to as
    1. consistency effect
    2. adjacency effect
    3. adaptation effect
    4. recovery effect
54. Reinforcement can be to increase the ___________ of a behavior
    1. magnitude
    2. frequency
    3. intensity
    4. two of these
    5. all of these
55. According to Quarrington and Douglass, an exteriorized secondary stutterer will have disfluencies which are:
    1. Vocalized
    2. Nonvocalized
    3. Overt
    4. A and C
    5. A and B and C
56. The statement that "stuttering begins not in the child's mouth but in the listener's ear" would most represent:
    1. Sheehan
    2. Guitar
    3. Johnson
    4. Brutten
    5. Van Riper
57. Which of the following would NOT contribute to severity?
    1. duration
    2. frequency
    3. effort-struggle
    4. self concept
    5. all of the above do contribute to severity
58. Johnson has defined stuttering as follow: "Stuttering is what a person does trying not to stutter again." This definition includes all of the following except:
    1. avoidance
    2. anticipation
    3. escape
    4. apprehension
    5. all of the above
59. A child says "I am ssssssix years old." This is an example of:
    1. vocalized-audible
    2. non-vocalized-audible
    3. vocalized-inaudible
    4. non-vocalized-inaudible
    5. more than one of the above
60. Which of the following involves an audible, nonvocalized part-word repetition?
    1. sssseven
    2. rrrradio
    3. p-p-port
    4. b-b-bunt
    5. j-j-jump
61. Interrupter devices are:
    1. attempts to overcome blocking
    2. forms of attempted escape
    3. advanced forms of avoidance
    4. a and b
    5. a and b and c
62. According to Van Riper, Stuttering is chronic in:
    1. Stages I and II
    2. Stages III and IV
    3. Stages I and II and III
    4. Stage IV
    5. Stages I and II and III and IV
63. The gradual learning of new behavior is best explained by:
    1. reward
    2. positive reinforcement
    3. successive approximation
    4. intermittent reinforcement
    5. punishment
64. Upon termination of therapy, the Stage IV stutterer should be able to do all the following EXCEPT:
    1. use relapse as motivation for further self therapy
    2. maintain internal motivation
    3. accept some avoidance as a residual of the former problem
    4. resist potential fluency disruptors
    5. remain tolerant of normal nonfluency
65. Which of the following is NOT a characteristic of a good pull-out?
    1. it has minimal tension
    2. it is gradual and easy
    3. it is totally forward moving
    4. it is produced with normal fluency
    5. all of the above are characteristic of a good pull-out
66. Which of the following goals/procedures would most likely be used by clinicians who engage in "fluency shaping" for an adult client who is in the advanced stages of stuttering:
    1. reducing the frequency of stuttering to less than 1 stuttered word per minute
    2. developing the ability to discuss stuttering openly and objectively
    3. learning to stutter openly, honestly and easily
    4. two of the above
    5. three of the above
67. For these questions, match the letter of the concept in the right hand column with the name of the person associated with it as listed in the left hand column.
    1. Joseph Sheehan
    2. Brutten and Shoemaker
    3. Douglass and Quarrington
    4. Dean Williams

    1. Conflict
    2. Descriptive Language
    3. Normal Nonfluency
    4. Negative Emotion

Section II. Short answer explanations. Define, describe, explain or otherwise show your understanding of the following terms and concepts, as they relate to stuttering: (5 points each.)

1. Episodic -versus- chronic stuttering
   
   
2. Threats and Promises -versus- contingent punishments and rewards
   
   
3. Speech rate -versus - articulation rate
   
   
4. Audible-nonvocalized sound prolongation
   
   
5. Stutter-Like Disfluencies: SLD
   
   
6. For this one, give a term of your own, and explain it.