3 183 Introduction to Stuttering Anticipation Knott Johnson

3: 183 Introduction to Stuttering

Anticipation • Knott, Johnson, Webster (1937) • Adults who stutter indicated when expect to stutter while reading passage • 96% of anticipations did result in stuttering • 94% of all words stuttered were anticipated

Anticipation • Knott, Johnson, Webster (1937) • Adults who stutter indicated when expect to stutter while reading passage • 96% of anticipations did result in stuttering • 94% of all words stuttered were anticipated

Anticipation • If stuttering is the result of the expectancy to stutter, or what an individual does to not stutter, shouldn’t all stuttering be anticipated? • Some people who stutter cannot predict impending stuttering • Anticipation not as prevalent in children

Anticipation • Johnson interpreted such findings as resulting from a “low degree of consciousness” • Apparently, stuttering can be anticipated without being highly aware of it

VARIABLES THAT INFLUENCE STUTTERING FINDINGS • • Singing Talking to beat of metronome Whispering Oral reading in unison Altered auditory feedback (DAF, FAF) Talking in presence of noise (masking) Talking in a different manner (e. g. acting)

Explanations • Change in vocal function – Altered vocalization or prosody – Reduced inflection – Slowed rate • Other explanations – Novel situation – Distraction – Utilizing different neural circuits, avoiding the deficits that underlie stuttering

Use in Therapy • Allow individual to feel what it’s like to speak fluently – make changes • Increase confidence in individual • Use to create fluency in specific situations • Use to generalize to other situations • Obtain information about way individual stutters

• How might conditions/variables discussed in this section be used in the clinic? • Which ones are most useful in therapy room? When the client is on his own? • How might these conditions/variables generalize to other situations?

Stuttering in the media • How are PWS portrayed in the media? – Comic relief (e. g. porky pig) – Depict weakness and fear (e. g. Primal Fear, A Fish Called Wanda, The Cowboys) – Depict incompetence (My Cousin Vinny) – Depict a twisted-evil soul (Criminal Minds, CSI)

Stuttering in the media • There are some positive examples: – The King’s Speech – Rocket Science

Anxiety • Trait vs. State Anxiety • Trait anxiety is a stable characteristic • State anxiety comes and goes (fleeting) and is often context dependent • Adults who stutter tend to have higher state but not trait anxiety (Alm, 2007) and the state anxiety is related to stuttering • Anxiety is a consequence of stuttering and not causal

Social Anxiety • Social anxiety is a natural consequence of: – Negative listener reactions – Stereotypes – bullying and teasing – Social isolation – Rejection and relationship difficulties – Educational and occupational underachievement – expectancies of social harm – fear of speaking in social situations

Stuttering effects on social and emotional factors • Bullying – Children who stutter are bullied more often than fluent speakers (Blood, et al. 2011) – Bullying negatively affects self-esteem (Blood, 2004) – Bullying decreases psychosocial outcomes (e. g. less optimistic and lower satisfaction with life) – Leads to increased social isolation and anxiety

Stuttering effects on social and emotional factors • Inter-personal relationships – Due to fear of negative consequences in social situations, stuttering may interfere with creating and/or maintaining personal relationships

Stuttering effects on social and emotional factors • Vocational impacts – 85% of employers agreed that stuttering decreases a persons employability (Hurst and Cooper, 1983) – PWS have higher rates of unemployment, are discriminated when interviewed for jobs, and are denied promotions because of stuttering (Opp, et al. 1997)

Stuttering and the law • Rehabilitation Act (1973) • Americans with Disabilities Act (ADA) of 1990 • State and local anti-discrimination laws • But is stuttering a disability or handicap? • Andreson v. Fuddruckers, Inc. , Civil Action No. 03 -3294, 2004 WL 2931346 (D. Minn. , Dec. 14, 2004), specifically held that stuttering could qualify as a disability under the ADA.