Exam Three

SPA 461. Examination III. Fall Semester, 2003

Name: _______________________________Student Number: _____________

Put your name on ALL pages of the examination.

I pledge to work honestly, and to neither give help to others, nor attempt to receive help from others.

Signed: ________________________________________________________

Questions 1-30 are worth two points each. Questions 31-50 are worth one point each.

BONUS QUESTIONS

Define/Explain/show your understanding of the following:

1. GILCU
   
   
2. Secondary Features
   
   
3. PWS

Section I. Multiple Choice. Indicate the best of the possible answers on the basis of the information given.TWO POINTS EACH.

1. For the advanced stutterer, which of the following are key elements in stuttering modification therapy.
   1. teaching the stutter to modify the form of his stuttering
   2. teaching the stutterer to reduce fear of stuttering
   3. teaching the stutterer to reduce avoidance of stuttering
   4. two of the above
   5. all of the above
2. In the Identification Stage of therapy for the Advanced (Stage IV) stutterer, identification is directed toward:
   1. Core Features
   2. Secondary Features
   3. Associated Attitudes and Feelings
   4. A and B
   5. A, and B, and C
3. In the Identification Stage of therapy for the Borderline or Beginning stuttering child, parents are helped to identify:
   1. Behaviors
   2. Situations
   3. Attitudes and Feelings: expectancy and avoidance
   4. two of the above
   5. all of the above
4. Modification techniques should be taught to the client in the following order:
   1. Cancellation --> Pull-Out --> Preparatory Set
   2. Pull-Out --> Preparatory Set --> Cancellation
   3. Preparatory Set --> Cancellation --> Pull Out
   4. Cancellation --> Preparatory Set --> Pull Out
   5. Pull-Out --> Cancellation --> Preparatory Set
5. Mr. and Mrs. Smith are extremely proud of their child's precocious development and "brag" about him by having him recite things that he has learned: e.g., the 23rd Psalm and Pledge of Allegiance, etc. This is referred to as:
   1. Verbal Display
   2. Verbal Demand
   3. Verbal Time-Pressure
   4. Verbal Sharing
   5. Verbal Competition
6. The twins and brother in the video tape shown in class needed particular help with:
   1. verbal competition
   2. reducing avoidances
   3. reducing their speech rates
   4. increasing their articulation rates
   5. using FEBS to increase their fluency and modify the severity their stuttering
7. Which of the following long term therapy goals for the Advanced Stutterer Stage IV (Van Riper) would be REJECTED by Guitar, as well as your instructor?
   1. achieving spontaneous fluency
   2. achieving controlled fluency
   3. achieving acceptable stuttering
   4. achieving success by using avoidance to result in fluency
   5. achieving Success by the continued use of FEBS in stressful situations
8. Which of the following statements is FALSE?
   1. Cancellations represent a clinical form of punishment
   2. Pull outs, when properly performed, are positively reinforced
   3. Escape behaviors are maintained by intermittent negative reinforcement
   4. Behaviors that result in successful avoidance receive strong internal positive reinforcement
   5. Desensitization is designed to help reduce the client's frustration tolerance
9. Those who emphasize "Fluency Shaping" through the use of FEBS would give very little attention to teaching the stutterer to use ___________________ to achieve fluency:
   1. Slow rate
   2. Cancellations
   3. Easy/Gentle Onsets
   4. Soft/Light Contacts
10. For older children and adolescents in the intermediate stages of stuttering (Stage III) who are entering the more advanced phases of stuttering, the concept of cancellation can be presented as a process of ________
    1. Erase and Fix
    2. Stop and Start Over
    3. Don't let it happen again
    4. Slow Down
    5. All of the above
11. Which of the following would be the most appropriate show for a young child who is beginning to stutter to watch on television?
    1. Judge Judy
    2. Mr. Rogers
    3. Sesame Street
    4. Saturday Night Live
    5. None of the above because children who stutter should not watch television.
12. The authorities that we watched on video tape (Manning, Murphy, Guitar, Ramig) in class have all emphasized that the advanced stutterer must do all of the following EXCEPT:
    1. work hard to reduce the frequency of stuttering
    2. tackle difficult sounds, words and situations more directly
    3. get curious about better understanding the associated tensing and struggling behavior(s)
    4. do more and more things to talk easily and communicate effectively
    5. give up avoidances and face the moment of stuttering more openly and honestly
13. Which of the following is NOT necessary in order to perform a correct preparatory set?
    1. the etiology/cause of stuttering
    2. correct identification of anticipation
    3. appropriate speech monitoring
    4. the ability to assume correct articulatory positions
    5. the client must know all of the above to correctly use preparatory sets
14. The exteriorized stutterer will have disfluencies that are: (Repeat question)
    1. nonvocalized
    2. vocalized
    3. overt
    4. two of the above
    5. all of the above
15. Which of the following is NOT a good example of correctly performed pull-out?
    1. it has minimal tension
    2. it is gradual and easy
    3. it is totally forward moving
    4. it is rapid and abrupt
    5. all of the above are characteristic of a good pull out.

Section II. True-False. Indicate your choice regarding whether the following questions are true, or false.

16. For the advanced (Stage IV) stutter, the ideal goal of therapy should be normal, spontaneous fluency. But this occurs only rarely, so the most realistic goals include controlled fluency, controlled stuttering, or acceptably mild stuttering.
17. Desensitization for the advanced stutterer (Stage IV) should be directed to the actual core features of the stuttering behaviors themselves, rather than to the emotional correlates.
18. It is often wise for the clinician to accompany the client on outside assignments.
19. Desensitization should be directed not only to the stuttering, but also to adverse listener reactions.
20. Desensitization generally begins with situations that are most aversive and stressful, then gradually works backward to situations that are least aversive and stressful.
21. Voluntary stuttering can be useful in desensitization both to the actual stuttering behavior and to aversive listener reactions.
22. During cancellation, the client should immediately stop at the first sign of stuttering, then say the word as easily and fluently as possible.
23. Cancellations should be produced as fluently as possible in order to prove to the client that it is possible to speak normally.
24. Pull-outs should be produced slowly and deliberately.
25. According to Guitar, and your instructor, therapy for the advanced stutterer should help the person to use both stuttering modification skills, and fluency shaping skills.
26. For young children who are just beginning to stutter it is important to provide speech models that are unhurried, and contain correct but simple patterns of speech and language.
27. Children who stutter often have concurrent problems with articulation.
28. Children tend to learn to talk at their own particular rate of speech. This is why the rate of speaking of close relatives is relatively unimportant in the modeling of optimum speaking rate(s).
29. When trying to model a reduced speaking rate for young children, it is better to do so by pausing in between words, rather than stretching out the syllables within words.
30. Parents of young children who are beginning to stutter should reduce the number of questions they ask their children. 

CONTINUED– NEXT PAGE.

SECTION III. Short Answer explanations.

List five different (i.e., non-overlapping) things that can be done to improve the speaking environment for a child who is beginning to stutter

31. _________________________________________________________________________
32. _________________________________________________________________________
33. _________________________________________________________________________
34. _________________________________________________________________________
35. _________________________________________________________________________

Briefly explain/describe/give a clinical example to demonstrate your understanding of each of the following:

36. Turtle Talk (Three components)
    
    
37. Secondary Guilt
    
    
38. Secondary Gain
    
    
39. NSA
    
    
40. FEBS
    
    
41. Recoil
    
    
42. Voluntary Stuttering/ Advertising
    
    
43. Escape Behaviors
    
    
44. Stuttering SEVERITY
    
    
45. Internet Resources (pertaining to stuttering)
    
    
46. Speech Helpers
    
    
47. "Freezing" (as related to stuttering, not the Arctic Circle)
    
    
48. Safety Margin
    
    
49. Time-Pressure
    
    
50. Desensitization