Final Exam

NAME __________________________________

SPA 561.  Final Examination
Spring, 2003

This examination is designed to last no longer than 100 minutes.  Exams should be returned promptly at the end of this time period. --   or earlier if you don't need this much time.

Write your essay answers on separate sheets of paper.

BUDGET YOUR TIME CAREFULLY:      Spend "one minute per point."

SECTION I.  Short Answer Essays  (40 point total)  (Spend about 40 minutes on each question.)

Listed below are three questions.  Answer ONE  (1) of these three questions.  Although you should consider these to be "essay questions," feel free to use a modified outline format if you think this would be helpful.

  1. One of the themes that was mentioned on the first day of the semester back in January is the need to help "de-awfulize" and "de-terriblize" stuttering.  Van Riper tried to do this with Jeff, and you heard some similar themes in the recovery tapes (e.g., Manning and Murphy.)  This was also a theme that ran through the videos with school-aged kids shown during class.  This theme was also prevalent on the Power Point slides and the class handout booklet.

    1.  In working with kids, and younger teens who are just developing a stuttering problem, what are some of the things that clinicians can do to try to prevent the development of the attitude that stuttering is so awful and terrible?
    2. With adults, for whom stuttering has become such a terrible and awful problem, what are some of the ways in which the clinician can work to lessen these negative attitudes and feelings that have already developed.
  2. Attached to this exam is a transcript of a monologue of a seventeen-year-old boy, a disfluency analysis worksheet that has been completed, and the results of the Riley SSI evaluation

    Based upon the information given, you are to:

    1. Write a hypothetical descriptive summary just as you might for a diagnostic evaluation report, and then
    2. Discuss the major factors that should be considered in planning and conducting a treatment program.

Section II.          30 points.

Spend about 30 minutes on this section.  (Five minutes per question.)   Define, describe or otherwise explain the importance of SIX of the following terms/concepts with respect to stuttering.  

In addition to just telling me "WHAT" is involved, please try to explain the clinical relevance of WHY this is important.

REMEMBER !!!   Just answer SIX of these

  1. Advertising
  2. Secondary Gain
  3. Secondary Behaviors
  4. Speech Rate's -versus articulation rate                                            
  5. Cancellation: When Properly performed, what are four things the PWS must do in order to perform a successful cancellation?
  6. National Stuttering Association
  7. Time-Pressure
  8. Recoil Behaviors

SECTION III (20 points.).  Multiple choice and True False.   

True-False.         In addition to indicating the answer to the question – BRIEFLY explain WHY you believe this.

_____1. For the Stage I (incipient, borderline, mild) stutterer, the major goal of therapy is the direct reinforcement of "easy fluent stuttering."

WHY?

_____2. The clinician should reward avoidance behaviors when they are followed by fluency.

WHY?

_____3. Punishment results in an increase in the frequency of occurrence of escape behaviors.

WHY?

_____4. Fluency shaping techniques can often be effective when used with children whose stuttering is of "moderate severity" – but who have not yet developed excessive emotional baggage surrounding their stuttering.

WHY?

_____5. Direct confrontation and modification of stuttering behaviors should be initiated when the stutterer reaches Stage III (/Confirmed) of stuttering development.

WHY?

_____6. Jeff, in the Van Riper video tapes, would best be classified in Stage III of the Van Riper stages of development due to the high degree of audible-vocalized stuttering he demonstrated, the high degree of tension/struggle, and the low degree of fear and avoidances

WHY?

_____7. A good rationale for the use of cancellations in Stage III and Stage IV is based on the fact that during the cancellation of the stuttered word, the stutterer learns that he can be fluent.

WHY?

_____8. Good preparatory sets, high stimulus speech and proprioceptive monitoring teach the PWS an acceptable way to prevent overt stuttering.

WHY?

Multiple Choice.

____9.   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
  2. cancellation, a pull-out, prep-set
  3. cancellation, prep-set, pull-out
  4. prep-set, pull-out, cancellation
  5. pull-out, cancellation, prep-set

____10. Which of the following statements would show a high degree of what Dean Williams referred to as the "Language of Self Responsibility."

  1. I sometimes get blocked when I speak.
  2. My biggest problems result from tensing my jaw
  3. Stuttering happens when I am scared and nervous
  4. I almost always have problems talking to authority figures
  5. I am always fluent when counting, or saying something I have memorized.

____11. Most of the authorities that have been emphasized in class feel that the stutterer must do all of the following EXCEPT:

  1. give up avoidances and face the moment of stuttering more openly and honestly
  2. tackle feared words and sounds more openly
  3. get curious about your tensing behaviors
  4. employ tactile, kinesthetic and proprioceptive monitoring
  5. minimize stuttering by reducing it's frequency

____12. In pullouts the stutterer does all of the following EXCEPT:

  1. does not let 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. adds additional physical tension/effort in an attempt to learn to better cope with it
  5. reduces the struggle and tremor

____13. Cancellations represent a clinical form of

  1. punishment
  2. negative reinforcement
  3. non-reinforcement
  4. contingent negative emotion
  5. antecedent negative emotion

____14. The gradual learning of new behavior is best explained by:

  1. reward
  2. positive reinforcement
  3. successive approximation
  4. intermittent reinforcement
  5. punishment

____15. Prevention of stuttering in preschoolers who are "borderline stutterers" involves all of the following EXCEPT:

  1. working directly with the stuttering
  2. working directly with the talking
  3. working directly with pragmatics
  4. working directly with the parents/caretakers
  5. working directly with decreasing demands and increasing capacities.

____16. 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

__17.    The authorities that we have studied in class have emphasized that the advanced stutterer must do all of the following EXCEPT:

  1. give up avoidances and face the moment of stuttering more openly and honestly
  2. tackle feared sound, words and situations more directly
  3. get curious about better understanding the associated tensing and struggling behavior(s)
  4. employ tactile, kinesthetic, proprioceptive monitoring
  5. work hard to reduce the frequency of stuttering

___18.   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

___19.   Identification and Desensitization for the Advanced (Stage IV) stutterer should be directed toward:

  1. Core Features
  2. Secondary Features
  3. Associated Attitudes and Feelings
  4. A and B
  5. A, and B, and C

___20.   In the Identification State 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. A and B
  5. B and C
  6. A and B, and C

Demonstrating Stuttering and Stuttering Modification (10 points)

For this section of the examination you will need to come to my office to make some phone calls.  During these calls you will be asked to demonstrate your ease and facility by demonstrating such things as pseudostuttering, cancellations, pullouts, and proprioceptive monitoring, etc.

RELAX !!  Have an enjoyable break.

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