J. Scott Yaruss
August 31 — Introduction to Stuttering
What is the role of the SLP in treating people who stutter?
What skills should SLPs possess if they are to successfully treat stuttering?
How can SLPs help their clients achieve their goals in treatment?
Which of these skills come from outside the field of speech-language pathology?
What does it take to be a good stuttering clinician?
Why is it important for the SLP to become comfortable with stuttering?
How should we go about doing this?
What is the role of support groups in treating people who stutter?
What are the major support groups for people who stutter in the U.S.?
Should clients participate in both support groups and treatment?
What is the role of the SLP in helping people who stutter make contact with support groups?
September 7 — Defining fluency, fluency disorders, and stuttering
What are common definitions for terms used to described speech fluency?
What is fluency? disfluency? dysfluency? nonfluency? stuttering?
Why are there so many different terms for interruptions in speech?
What are the types of disfluencies people produce?
Why are some disfluencies characterized as normal and others characterized as stuttered?
What is the difference between stuttering events and the stuttering disorder?
Who produces disfluencies?
What is a person who stutters? What is a stutterer?
What is the difference between a person who stutters and a person who does not stutter?
What is the prevalence of stuttering in the population?
What is the gender ratio of stuttering in children? In adults?
What about other fluency disorders?
What is cluttering? neurogenic stuttering? psychogenic stuttering?
How does developmental stuttering differ from cluttering? neurogenic stuttering?
psychogenic stuttering?
What are the primary symptoms of developmental stuttering? cluttering? neurogenic stuttering?
psychogenic stuttering?
Sept. 14 — The Etiology of Stuttering
What are some "historical" theories (1800s/early 1900s) that we no longer believe to be true?
Why are there so many different theories about the cause of stuttering?
What is one of the primary factors that leads to changes in beliefs about the cause of stuttering?
What is the theory of cerebral dominance or hemispheric conflict?
When was it first proposed? What evidence was originally offered in support of this theory?
How does it relate to our current understanding of the etiology of stuttering?
What role does learning theory play in the onset and development of stuttering?
What is classical conditioning? What is operant conditioning?
What role does conditioning play in the production of disfluencies and the development of stuttering?
What is instrumental avoidance? What is an approach-avoidance conflict?
What is anticipatory struggle?
What is the diagnosogenic theory?
What evidence was used in support of this theory?
Why is this theory no longer believed to accurately describe the "cause" of stuttering?
Bonus: What was the outcome of the recent media flap reporting the 1939 "Monster" study?
What is the role of speech-motor control in the development of stuttering?
What is the role of the larynx in the production of disfluencies?
What is the theory of temporal discoordination?
Bonus: What evidence is there that speech motor factors affect the development of stuttering?
What do researchers and clinicians currently believe to be the cause of stuttering?
What is an interactionist theory? What is a multifactorial theory?
What is the demands and capacities model? What does it tell us about stuttering?
Bonus: What is the Neuropsycholinguistic Model?
Bonus: What is the Covert Repair Hypothesis?
Sept. 21 — Factors affecting speech fluency
Factors that affect speech fluency:
What linguistic factors contribute to the production of disfluencies on specific words?
What linguistic factors contribute to the production of disfluencies on specific utterances?
What paralinguistic factors contribute to the production of disfluencies
What situational factors contribute to the production of disfluencies?
Overall, how predictable is stuttering?
Factors that ameliorate speech fluency:
What are some of the factors that increase the likelihood that a person will speak fluently
in a given situation?
What does speech sound like in these situations?
Why are these factors believed to affect people’s fluency?
What do these factors mean for the treatment of stuttering?
The development of stuttering in children:
What are some prominent theories about the development of stuttering?
What is the Alpha-Delta Hypothesis?
What is the Stuttering Continuum?
What are Van Riper’s tracks of stuttering development?
What are the characteristics of sudden onset of stuttering in children?
What do these different developmental pathways mean for the diagnostic process?
What risk factors contribute to children’s development of stuttering?
Do each of these factors play a role for every child who stutters?
How do your determine which factors are present in a given child?
Sept. 28: Evaluating stuttering I: General considerations
NOTE: We will begin the session with the in-class discussion for experience assignment #1
What is the purpose of the diagnostic evaluation…
…for preschoolers? …for school-age children? …for adolescents? …for adults?
What is the difference between measuring stuttering events and the stuttering disorder?
What are the basic measures of stuttering events?
What are the basic measures of the stuttering disorder?
What are two basic measures of stuttering severity?
What aspects of stuttering behaviors are included in these measures?
What are some strengths an weaknesses of stuttering severity measures?
What is the International Classification of Impairments, Disabilities, and Handicaps?
How does the ICIDH differ from the ICD?
How can the ICIDH be used to describe the stuttering disorder?
How should we define impairment, disability, and handicap for describing stuttering?
Where do stuttering events fall in the ICIDH?
How does the ICIDH relate to the process of evaluating stuttering in adults?
Bonus Question: How do the changes in the new ICIDH-2 (also called the ICF) relate to the disorder of stuttering
Oct. 5: Evaluating Stuttering II: Measurement
NOTE: The majority of the class this week will be spent practicing techniques for measuring stuttering
What are the relevant measures to consider when counting stuttering events? Why?
How do these measures differentiate people who stutter from people who do not stutter?
What are the basic decisions that need to be made when measuring stuttering events?
What is the difference between counting words vs. syllables?
What is the difference between counting disfluencies vs. stuttering?
What is the difference between real-time and off-line measurement?
Why is it important to examine stuttering events in a variety of different speaking situations?
Oct. 12: Treating adults who stutter I: Fluency modification
What are the overall goals of treatment for adults who stutter?
What are the basic approaches to stuttering treatment for adults who stutter?
General Information about "Fluency Modification"
What is fluency modification?
What are some other terms that have been used to describe this type of treatment?
What are the basic principles upon which this approach is based?
What is the goal of this approach to treatment?
How do you determine whether this approach is appropriate for a specific client?
What are the basic treatment procedures?
What data are there to indicate the efficacy of this approach?
What are the potential pitfalls of this approach to stuttering and how should you deal with them?
Oct. 19: Treating adults who stutter II: Stuttering modification
General Information about Stuttering Modification:
What is stuttering modification?
What are some other terms that have been used to describe this type of treatment?
What are the basic principles upon which this approach is based?
What is the goal of this approach to treatment?
How do you determine whether this approach is appropriate for a specific client?
What are the basic treatment procedures?
What data are there to indicate the efficacy of this approach?
What are the potential pitfalls of this approach to stuttering and how should you deal with them?
Individualized Treatment Plans:
What factors might lead an adult client to come to therapy?
What kinds of issues might you need to address in therapy for adults who stutter that are not directly related to stuttering?
How do we combine the "speech modification" and "stuttering modification" treatment approaches for individual clients?
Generalization, Transfer, and Maintenance
How do we help clients transfer their speaking skills (fluency and stuttering modifications) to other settings and maintain them over the term?
How do we prepare clients to deal with relapse?
How do you develop the skills needed to help adults who stutter?
Oct. 26 Evaluating Stuttering III: Preschool Diagnostics
What are the components of a complete diagnostic evaluation for a preschool child?
Why are each of these components included?
How do these components relate to the risk factors for developing stuttering?
What components should you focus on if you only have a short time to evaluate the child?
What are the primary questions you should ask parents during an interview and why should all of these questions be asked?
What does it mean to say that a child "needs" treatment?
How do you determine which children need treatment?
How do you know if you made the "right" decision?
What is the controversy about recommending treatment for preschoolers who stuttering?
What is the ultimate goal of treatment for preschool children who stutter?
Nov 2: Treating Preschool Children Who Stutter I: Indirect Treatment
What is the primary goal of indirect treatment for preschool children who stutter?
What are the primary strategies used to achieve this goal in indirect treatment?
How do these treatment strategies relate to current and historical theories about childhood stuttering?
What specific aspects of the environment do we try to modify in indirect treatment? Why?
How do you help families use these strategies?
What evidence is there that these strategies are effective?
How do you help parents deal with the guilt they may feel regarding their child’s stuttering?
Why do parents feel this guilt?
What do you do if this guilt seems to be getting in the way of the child’s success in treatment?
How do you help parents help their children develop healthy attitudes toward stuttering?
How do you know if it’s appropriate to talk to a child about his or her speech?
Nov 9: Treating Preschool Children Who Stutter II: Direct Treatment
What is the primary goal of direct treatment for preschool children who stutter?
What is the difference between direct and indirect therapy?
How do you determine which approach to use with a given child?
What are the pros and cons of direct and indirect therapy approaches?
What is the Lidcombe Program for treating childhood stuttering?
On what theoretical principles is this approach based?
What evidence is there in support of this approach?
How do you administer this type treatment?
How does this approach relate to the "diagnosogenic theory" of stuttering?
What is the purpose of teaching children to speak more slowly and easily?
On what theoretical principles is this approach based?
What evidence is there in support of this approach?
How do you administer this type of treatment?
How do we determine whether or not treatment is working?
What does it mean if a preschooler has significant physical tension during stuttering?
How do we help preschoolers reduce physical tension?
What does it mean if a preschooler has significant negative speech attitudes?
How do we help preschoolers improve speech attitudes?
Nov. 30 Treating school-age children who stutter
What are the goals and procedures of the diagnostic evaluation for school-age children who stutter?
What are the goals of treatment for school-age children who stutter?
What are the basic procedures for treating school-age children who stutter?
How are these techniques related to the treatment for adults who stutter?
What modifications do you need to make to your treatment because of the children’s age?
What modifications do you need to make to your treatment if you are working in the schools?
What are some potential roadblocks to treating school-age children who stutter in the school setting and how do you overcome these roadblocks?
What do you do if a child is not motivated to participate in treatment?
What do you do if a child is fluent in the therapy room but not in the classroom?
What do you do if your child is grouped with other children who do not stutter?
How do you help school-age children improve their attitudes toward stuttering
How do you help school-age children deal with teasing?
What do you do if the child is reacting inappropriately to teasing?
What do you do if the child has strongly negative emotional reactions to teasing?
How do you work with the family when you’re in a school setting?
What should you do if you don’t have any access to the family during treatment?
What should you do if the family has different goals for treatment than you or the child?
Dec. 7 Group Presentations / Wrap-Up
What questions do you still have about stuttering?
What specific resources should you use for learning more information about stuttering?
