SLP Fluency and Its Disorders 4 — Questions and Answers
Question 1: The 'adaptation effect' in stuttering refers to:
- Increased stuttering when speaking to authority figures
- Decreased stuttering frequency across successive readings of the same passage (Correct answer)
- Stuttering reduction achieved through delayed auditory feedback
- Avoidance behaviors that reduce over time without treatment
Correct answer: Decreased stuttering frequency across successive readings of the same passage
The adaptation effect is the documented reduction in stuttering frequency across repeated readings of the same passage, thought to reflect habituation or reduced anticipatory anxiety.
Question 2: An SLP assessing a 3-year-old boy with 15 months of stuttering and a paternal history of persistent stuttering should:
- Reassure the parents that spontaneous recovery is highly likely and schedule a 6-month recheck
- Initiate treatment promptly given multiple chronic risk factors (Correct answer)
- Refer exclusively to a psychologist for anxiety management
- Wait until age 5 before beginning any intervention
Correct answer: Initiate treatment promptly given multiple chronic risk factors
Multiple risk factors (male sex, duration >12 months, family history of persistent stuttering) indicate high risk for persistence, supporting prompt intervention.
Question 3: Which physiological parameter is primarily targeted in Precision Fluency Shaping (PFS)?
- Laryngeal relaxation and gentle phonation onset (Correct answer)
- Diaphragmatic breathing and abdominal support only
- Oral motor speed and tongue placement precision
- Biofeedback of subglottal air pressure
Correct answer: Laryngeal relaxation and gentle phonation onset
PFS focuses on gentle voice onset, reduced rate, and continuous phonation to reshape the motor program for speech, with laryngeal control as a central target.
Question 4: The 'consistency effect' in stuttering means that:
- People who stutter show consistent fluency in choral speech across all trials
- Stuttering tends to recur on the same words across successive readings (Correct answer)
- Stuttering severity remains constant regardless of speaking situation
- Treatment gains are consistent across all clients who stutter
Correct answer: Stuttering tends to recur on the same words across successive readings
The consistency effect describes the tendency for stuttering to occur on the same specific words across multiple readings, indicating learned anticipation tied to particular linguistic items.
Question 5: A client uses prolonged speech with a slow rate and achieves high fluency in clinic but reports minimal carry-over to daily communication. The BEST next step is:
- Increase in-clinic practice time using more reading passages
- Transfer and maintenance activities across varied real-world speaking situations (Correct answer)
- Add pharmacotherapy to augment the behavioral gains
- Discontinue treatment and retest after 6 months
Correct answer: Transfer and maintenance activities across varied real-world speaking situations
Transfer activities targeting real-life situations (phone calls, meetings, social conversations) are essential when clinic fluency does not generalize to daily communication.
Question 6: Which assessment tool uses a 9-point severity scale ranging from 'very mild' to 'very severe' based on frequency, duration, and physical concomitants?
- Stuttering Severity Instrument (SSI-4) (Correct answer)
- Perceptions of Stuttering Inventory (PSI)
- Overall Assessment of the Speaker's Experience of Stuttering (OASES)
- Behavior Assessment Battery (BAB)
Correct answer: Stuttering Severity Instrument (SSI-4)
The SSI-4 combines frequency, duration of longest stutters, and physical concomitant ratings to yield a composite severity score on a 9-point scale.
Question 7: Covert stuttering (interiorized stuttering) is characterized by:
- High frequency of overt blocks observable to listeners
- Extensive word substitution and avoidance with few observable moments of stuttering (Correct answer)
- Rapid speech rate masking the underlying fluency disorder
- Onset exclusively during adolescence or adulthood
Correct answer: Extensive word substitution and avoidance with few observable moments of stuttering
Covert stutterers substitute words, avoid situations, and hide their stuttering so effectively that observers may not detect the disorder despite significant internal struggle.
SLP Fluency and Its Disorders 4
The 'adaptation effect' in stuttering refers to: