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 ABCs of Stuttering

 Affective

BehavioralCognitive

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 Affective Component

Emotion and Stuttering

Charles Van Riper (1973)

Formula of stuttering severity and prognosis

Factors to includeP=vulnerability to penalties of stuttering

F= frustration A= anxiety

G=guilt or shame

H=hostility

Sf=situational fears

Wf=word fearsCs=communicative stress

M=motivation + morale or ego strength

Fl= fluency client already possesses

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Ss=PFAGH+SfWf+Cs

M + Fl

Emotional and cognitive responses tostuttering behaviors influence a

persons to manage speech

disfluencies.

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Emotion

Person¶s psychological response to

environmental stimuli

Mediated by the ANSInvoluntary

Development of emotion (Lewis,

1992)4 steps

Emotions are transformed and

integrated into self 

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Step 1: Primary emotions emerge

Happiness, surprise, interest, sadness, disgust,

anger, fear 

Step 2: Cognitive capacity for objectiveself awareness; interacts with

environmental socialization process

Step 3: Self conscious emotions

(embarrassment, empathy, envy). Non-

evaluative;not correlated with thought,

actions or feelings

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Step 4: Self-conscious evaluative emotionChild internalizes rules, standards and goals of achievement

Higher level cognitive process needed todevelop pride, embarrassment and guilt

Core emotions develop as particular emotions are repeated

Integration of memory with emotionInterpersonal aspects (They won¶t like me if..)

Intrapersonal aspects (I cannot do this right)

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³«a healthy balanced emotional life

require an individaul to experience a

feeling, recognize, accept and

express it, and then let it go.´ Field

(1995)

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Emotions and Stuttering

 Anger 

May be an emotion of choice

May block awareness of underlyingpainful emotions

Side effects to anger 

Rigidity and resistanceResult in helplessness in the face of 

emotion

Shifting the blame for pain or problem

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Guilt

Normal reaction to breaking social rule

Focus is on the transgression; not onself 

It was mean of me to tell on Bobby.

Rather than: I am mean

Common emotion in parents of disabledchildren

I did something to cause this

I should have found help sooner 

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People who stutter 

Guilt that stuttering is their fault

Guilt that they make listeners

uncomfortable

Guilt that they cannot use techniques

Sheehan¶s 6 sources of guilt reactions

in PWSPrimary guilt: feeling that precedesstuttering

Secondary guilt: feeling of failure after 

stuttering

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 Audience punishment guilt

Stuttering offensive or aversive tolisteners

Therapy-induced guiltPWS angry at self or clinician

Perception that therapy is not helping

Clinician induced guiltClient blamed for not working hardenough

Not performing to expectation

Not practicing

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Timing guilt

Readiness to change behavior 

Enter new situations

Shame

Evaluation of self rather than one¶sactions

Painful internal feeling of unexpected

exposure

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Internal components

Feelings of failure

Inadequacy

Desire to cover up

HideWithdraw

External components Averting eye contact

BlushingNervous movements

Inability to speak

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Feeling ashamed being made to feel

ashamed of oneself 

Impact of criticism or teasingImpact of ignoring/silence

Shame continuum (Karen, 1992)

Healthy shame

Unhealthy shame

Toxic shame

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Shame and resistance

Grief process (Kubla-

Ross, 1969)Denial

 Anger 

Bargaining

Depression

 Acceptance

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Temperament

High degree of sensitivity to changes in

routine

Perfectionistic tendencies

Slow to adapt to new situations

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Behavioral Components of 

Stuttering: the role of learning

Classical conditioned behavior 

Pavlov

InvoluntaryMediated by ANS

May be learned in one trial

Unlearned through deconditioning or 

systematic desensitization

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Operant conditioned behavior 

Skinner 

VoluntaryMediated by CNS

Follows law of effect

Reinforcement

punishment

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 Application to stuttering

Brutten & Shoemaker¶s Two Factor 

Theory of Stuttering

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Cognitive Components of Stuttering

Cognition: ³the act or process of 

knowing including both awareness

and judgment.´ (Webster¶s Collegiate

Dictionary, 1990)

Thoughts related to speech before,

after and during stuttering