SLP Fluency Disorders & Stuttering 2 — Questions and Answers
Question 1: Which pharmacological agent has shown the most evidence in reducing stuttering frequency in clinical trials?
- Pagoclone (Correct answer)
- Haloperidol
- Risperidone
- Olanzapine
Correct answer: Pagoclone
Pagoclone, a partial GABA-A agonist, has shown the most promising results in randomized controlled trials for reducing stuttering.
Question 2: A client who stutters reports that his speech is fluent when whispering but disfluent during normal conversation. This phenomenon is best explained by:
- Reduced auditory feedback monitoring during whispered speech (Correct answer)
- Increased laryngeal tension during voiced speech
- Disrupted coarticulation patterns at normal vocal intensity
- Decreased neural firing rate in Broca's area during normal speech
Correct answer: Reduced auditory feedback monitoring during whispered speech
Whispering reduces the intensity of auditory feedback, which can temporarily disrupt the aberrant feedback loop believed to contribute to stuttering.
Question 3: The Lidcombe Program for preschool children relies primarily on which therapeutic principle?
- Operant conditioning with verbal contingencies (Correct answer)
- Desensitization and systematic relaxation
- Prolonged speech shaping with metronome pacing
- Parent-child interaction therapy without direct feedback
Correct answer: Operant conditioning with verbal contingencies
The Lidcombe Program uses operant conditioning in which parents deliver verbal contingencies (praise for stutter-free speech, acknowledgment of stuttering) in natural settings.
Question 4: Neuroimaging studies in adults who stutter most consistently reveal:
- Underactivation of right hemisphere motor areas and overactivation of left auditory cortex
- Overactivation of right hemisphere motor areas and underactivation of left auditory cortex (Correct answer)
- Bilateral hypoactivation of the supplementary motor area
- Hypoactivation of Wernicke's area with normal Broca's area function
Correct answer: Overactivation of right hemisphere motor areas and underactivation of left auditory cortex
Adults who stutter show overactivation of right hemisphere motor regions compensating for underactivation of the left auditory cortex and speech motor network.
Question 5: Which assessment tool provides a standardized measure of stuttering severity that includes both frequency and duration components?
- Stuttering Severity Instrument (SSI-4) (Correct answer)
- Overall Assessment of the Speaker's Experience of Stuttering (OASES)
- Perceptions of Stuttering Inventory (PSI)
- Communication Attitude Test (CAT)
Correct answer: Stuttering Severity Instrument (SSI-4)
The SSI-4 quantifies stuttering severity using frequency of disfluencies, duration of longest stutters, and physical concomitants to yield a composite severity score.
Question 6: Cluttering is differentiated from stuttering primarily by the presence of:
- Rapid or irregular speech rate with reduced self-awareness (Correct answer)
- Tense sound prolongations with high anxiety
- Consistent word-final repetitions
- Avoidance of specific phonemes under communicative pressure
Correct answer: Rapid or irregular speech rate with reduced self-awareness
Cluttering is characterized by rapid or irregular speech rate, excessive disfluencies, and typically reduced awareness of the problem, distinguishing it from stuttering.
Question 7: In the Demands and Capacities Model of stuttering, an SLP would reduce communicative DEMANDS by:
- Using shorter, simpler sentences when speaking to the child (Correct answer)
- Teaching the child to use slower speech rate
- Increasing the child's phonological working memory
- Strengthening the child's laryngeal musculature
Correct answer: Using shorter, simpler sentences when speaking to the child
Reducing demands involves environmental modifications such as simplifying linguistic input, slowing parental speech rate, and reducing time pressure on the child.
SLP Fluency Disorders & Stuttering 2
Which pharmacological agent has shown the most evidence in reducing stuttering frequency in clinical trials?