SPA 561. Advanced Fluency Disorders
Instructor: Stephen B. Hood, Ph.D.
Office 2110 University Commons
Class: T-Th: 12:30-1:45
Office Hours: T-Th: 8:00 - 10:00; & M-W: 1:00 - 3:00, or by
appointment. By appointment is preferred, particularly due to my
clinical and administrative responsibilities.
For students who seek additional information about the various
topics to be covered, I have a number of personal resources that may be
borrowed. The references listed below correspond to the supplemental
readings shown on the portion of the syllabus that pertains to units
and dates for topics to be covered.
Class Handouts will be available. Those who were undergraduate
students at USA will note that most of these are identical to what you
received in the undergraduate course. In this class, we will go into
- Bloodstein, O. (1995). A Handbook on Stuttering. San Diego, CA:
- Guitar, B. (1998.) Stuttering: An Integrated Approach to Its Nature
and Treatment. Baltimore, Williams and Wilkins.
- Hood, S. (1978). The Assessment of Fluency Disorders. In S. Singh
and J. Lynch (Eds.) Diagnostic Procedures in Hearing, Language and
Speech. Baltimore, MD: University Park Press.
- Starkweather, C. W. (1987). Fluency and Stuttering. Englewood Cliffs,
NJ: Prentice Hall.
- Starkweather, C. W. and Ackerman, J. G. Stuttering. Austin, TX: Pro-Ed
- Van Riper, C. (1982). The Nature of Stuttering. (2nd Edition).
Englewood Cliffs, NJ: Prentice Hall.
- Van Riper, C. (1973). The Treatment of Stuttering. Englewood Cliffs,
NJ: Prentice Hall.
I wish that I could assume that some sections of this course will
represent a review of materials presented at the undergraduate level.
But this assumption is increasingly dangerous because more and more
universities have stopped offering courses in specific topics such as
voice and stuttering. In recent years, this class has become
increasingly heterogeneous with respect to commonality of background.
For those who feel they have a weak background, I will hold additional
"catch-up" meetings. For those interested, we can determine a time
for this later. Supplemental additional readings are shown later in
this handout, and I can provide additional material, as well.
I am generally in the building and can be located for "emergencies." My
office has an open door policy as much as possible, so feel free to see
me at any time. Administrative and clinical responsibilities are
sometimes unpredictable, so it is better to schedule an appointment.
Students with Disabilities
Any student with a qualifying disability which requires accommodations
should talk with me after class so that arrangements can be made.
The student must verify that he or she has a qualified disability
through the Office of Special Student Services.
SPA 561 is designed to bridge the gap between theory, research and
clinical applications. The course is intended to investigate current
trends and to determine common strengths and weaknesses among them.
For students with a strong academic and/or clinical background in
stuttering, parts of this course may seem like a quick review; for
others, the challenge may appear extreme. It is my strong hope that
the class will develop a unity of curiosity that will lead to
provocative class discussions, arguments and attempts at better
understanding. But I cannot do this alone. Let's all work together to
make class meetings more of a dialog among us than a monolog from me.
This is not to imply a desire to all arrive at the same conclusions,
for this would be unrealistic. Let us strive to come to an
understanding based on an appreciation of various theoretical
positions, with which we can feel comfortable, and from which we can
provide optimum clinical services for our clients.
FEAR NOT -- The reading list!!! It looks more lengthy than it really
is. Redundancy is built into the readings to aid in learning. The major
highlights will be stressed in class, and will be the foundation upon
which examinations are built. No attempts will be made to be "tricky."
I am well aware of the cost of textbooks and have tried to limit the
number of textbooks for this course. Many books have been published in
recent years, and there really is no "single best book." With respect
to the supplemental readings, we can develop a system wherein copies
can be checked out as needed.
Tentative Course Outline
This year's group of students will again be heterogeneous. Much of
what we will be covering will involve reviewing and expanding upon
things you should already know (assuming your long term memory cells
are functioning) as well as getting into some things that are new and
different. If you find yourself getting confused, please see me as
soon as possible.
We will watch a number of video tapes. These tapes will
highlight things that cannot as easily be presented via straight
lectures or through reading assignments. In order to do this, there
may be a delicate balance between how much time we can spend with
various modes of presentation. (In past years, most students found the
tapes to be very helpful, but some students found them to be dull and
boring. I will need your feedback on this. How much time is spent on
lecture and how much time is spent with supplemental video tapes will
depend upon you as a class.)
BONUS: This year's class has a special bonus because one of your
classmates is a PWS. Joe Klein will be in a position to share with you
some personal insights, and I hope you will make the most of this.
Unit I. The Nature of Stuttering: Models of Stuttering
Aug. 24. Intro and Orientation to SPA 561.
Unit II. Application of Learning Theory to Stuttering
Aug. 26. Models of Stuttering: Overt and Covert Features
Aug. 31. Temporal Sequencing and Episodic Variation
Shapiro - Chapter 1
Hood, Words. Definitions Pgs. 9-12
Stuttering: as a Behavior -- as a Problem. Overt and Covert Features
Episodic/Cyclical Variations in young children
Schematic Portrayal of The "moment of stuttering"
Comparison of Brutten and Johnson (Learning Theory comes later)
Sept. 2 Classical and Operant Conditioning
Unit III. Normal Nonfluencies, and the Onset and Development of
Sept. 7 Brutten and Shoemaker Model
Sept. 9 Van Riper and Sheehan
Shapiro Pgs. 77-79,
Review of Learning Theory
Brutten and Shoemaker Model
Sheehan's Model: Approach-Avoidance Conflict
Van Riper's Models: PGAGH, and MIDVAS
Sept. 14 Van Riper, Peters and Guitar: Stages and Phases
Unit IV. Assessment of Stuttering
Sept. 16 Douglass and Quarrington: Interiorized and Exteriorized
Shapiro, Chapter 2
Shapiro, Ch. 3. Pgs. 70-78, 82-86, 86-91
Van Riper's 4 Stages
Douglass and Quarrington: Interiorized/Exteriorized
"Schematic Portrayal of the Moment of Stuttering" (again)
Sept. 21 Case History ñ Predisposing, Precipitating and Perpetuating
EXAM I: September 30
Sept. 23 Parent Interview, Client Interview, Collecting Speech Samples
Sept. 28 Disfluency Analysis
Shapiro, Chapter 4, Pgs. 97-104, 108-110
Shapiro, Chapter 8, Pgs. 217-262
Shapiro, Chapter 9, Pgs. 294-312
Shapiro, Chapter 10, Pgs. 367-406
Disfluency Analysis Worksheet
Riley, SSI-3 (Shapiro, Pgs. 252-253)
Unit V. Therapy for Adults, and older teens who stutter.
Oct. 5 These seven class periods will be a combination of lectures,
Unit VI. Therapy for Child Aged Children
Oct. 7 class discussion and video tapes. Selection of
which video tapes
Oct. 12 to watch will be made later.
Oct. 14 Oct. 19
Oct. 21 Oct. 26
Shapiro, Chapter 10, Pgs. 407-444
SFA Booklets: Therapy for
Self-Therapy for Stutterers
Advice for Those Who Stutter
Stuttering Therapy: Transfer and Maintenance
Do You Stutter? A
Guide for Teens
Oct. 28 Same format as Unit V
Unit VII Prevention and early intervention
Shapiro, Chapter 9. Pgs. 312-361
Treatment of the Young Stutterer in the School
Treating the School-Aged Stutterer
Nov. 18 Same format as Unites V and VI
Nov. 23 **Because of ASHA -
we will make this up at another time.
Shapiro, Chapter 8, Pgs. 262-286
Suggestions to Help Children Talk Fluently
Stuttering Therapy: Possible Problem Areas to Explore and PossibleThings to Do.
If Your Child Stutters
Prevention and Early Intervention with Children
Stuttering and Your Child
Listed below is the tentative grading scale, subject to modification if
25% Examination 1 (September 30 -- probably)
30% Examination 2 (during exam week: Thursday,
December 9. Time - TBA)
10% Project I (due October 14)
10% Project II (due October 21 -- probably)
25% Project III (due November 11 -- probably)
Projected Grading Scale:
A: 90 - 100
B: 80 - 89
C: 70 - 79 ---- I'm struggling
D: 60 - 69 ---- I'm sinking
F: < 60 ---- I'm Drowning
Speech Rate, Articulation Rate and "Normal Nonfluency"
The class will be divided into six groups of three students each. Each
group will select one (hopefully different) faculty member. The
assigned task is for you to tape record a two minute/200 word
spontaneous speech sample, perform an analysis of speaking rate,
articulation rate and disfluency. Submit a narrative paragraph
describing your procedures and results, as you would do in writing a
diagnostic report. Details will be given in class.
Turn in your transcript, worksheet, summary report and audio tape
by October 14.
Project II: Disfluency Analysis
You are to tape record yourself while you engage in a monologue of
sufficient length to allow the analysis of a 200-word spontaneous speech
sample. Your speech should realistically simulate the stuttering of
a person who would be in Van Riper's third stage of stuttering (Peters
and Guitar-- Intermediate Stuttering). Then, perform a disfluency
analysis, complete the disfluency analysis worksheet and write a
descriptive narrative, as you would for a diagnostic evaluation report.
Turn in your transcript, worksheet, summary report and audio tape by October 21.
Project III: Modeling the Target Behaviors
It is important that the clinician understand, to the extent possible,
the overt and covert dimensions of stuttering. This is what Joseph
Sheehan referred to as the "stuttering equivalent." It is also
important that the clinician be able to MODEL the desired target
responses for the client.
Listed below are your assignments. I suggest that you think about them
and begin to practice them. (You might be well advised to wait until
after the corresponding portions of the Van Riper tapes before actually
"doing them for real.")
NOTE: If the assignments listed below are too tough for you,
then you may need to also do some easier ones, for practice,
desensitization, etc. See me individually for details. I can get you
a reference book by Richard Ham which will help.
Listed below are the seven topic areas. You are to write one summary
report for each of the topic areas, so there will be a total of
seven reports in all. These reports are all due on November 11.
OPTIONAL - This is given to you for informational purposes, and
not as an assignment. However, some of you may be interested in
checking it out.
At the present time there are three Listservs devoted solely to
stuttering. These Listservs have some 300 - 400 subscribers. Of course
not all subscribers are active participants, but some are. Sometimes,
there are lines of discussion which are fascinating: sometimes, the
topics are boring and qualify for a "fast delete." If you find a topic
of interest, you can post a response, which will automatically go to
each of the several hundred subscribers.
You might find it interesting to visit one or more of these
Listservs. If you do, I would suggest that you may find the
discussions on STUTT-L to be the most meaningful.
I'll make further comments about this in class.
- Learning To Stutter
Stop three people on the street and ask directions on how to get
somewhere. Keep good enough eye contact to evaluate the reactions you
get from the listener. For each different person, engage in one of the
a. Fake moderately frequent part-word repetitions with associated
Write a report to summarize your experiences. How did you do? How did
you feel? What listener reactions did you obtain?
b. Fake moderate frequent silent blocks with associated
c. Fake moderately frequent vocalized
prolongations, with associated struggle
For practice, you and your partner(s) are to make up a list of ten
questions (e.g., what is your favorite kind of pet). In your answer
(complete sentences, please) voluntarily stutter on the subject word;
then pause for three seconds and say the word again, engaging in a slow
and deliberate utterance of the word. Your partner needs to observe to
be sure that you finish the word, pause long enough, and to be sure
that you are not too fluent the second time. (No need to write a
report on this one).
Select three words that occur regularly in everyday conversations.
Over a period of three to five days, deliberately stutter, then cancel
on these words, at least five times each day. When you cancel, be sure
to finish the word, pause immediately afterwards for at least two
seconds, and then repeat the word, slightly prolonging and increasing
the strength of the articulatory movement. Do not identify your
efforts unless your listener asks what you are doing. Write a report
of the words you picked, the situation you selected, the adequacy of
your pauses, the quality of your repeats, your listener's reactions and
your own feelings about the experience.
Prewrite three questions to ask during a single telephone call.
Underline one word in each question on which you will fake a moment of
stuttering. Pause for at least two seconds and then cancel by repeating
and "improving" your fake. Continue your cancellation report with the
same type of information requested in the previous assignment.
Enter three different commercial locations where you can ask directions,
seek information, or purchase an item. In each of these three
situations, fake at least three moderately severe moments of stuttering
accompanied by tension and struggle. Pause for at least two seconds,
then cancel the stuttering using a slow, exaggerated transition. If
possible, have your partner(s) along to evaluate your performance.
Continue your cancellation report with a summary of your experiences.
- Pullouts -
Just for practice to get started, take a word list and read 10 words
aloud, while looking in a mirror. Fake various kinds of severe
stuttering behaviors on each of the different words. During the middle
of the fake, gradually work to "freeze" yourself in the articulatory
posture, and then very gradually relax the freeze and then slowly and
deliberately pull out of the stuttering moment.
After you become proficient with the 10 words, continue talking
informally to your partner about any topic you wish. Converse long
enough for each of you to collect 15 faked moments of stuttering
followed by a gradual pull out. If any of your fakes or pull outs are
unsatisfactory, your partner is to signal you and you are to cancel the
behavior and do it again. You do not need to write a report for this.
Select a word that occurs fairly often in your everyday conversations.
Then set a target of faking a moderate to severe moments of
stuttering followed by a pull out. You are to do this 25 times.
Remember, the pull out must be slow, gradual, deliberate, and
vocalized. Collect your 25 examples as rapidly as possible, but you can
allow yourself up to three days to do this if necessary. Keep a
written running evaluation during the process, using criteria as noted
earlier, so that you can write a report to summarize your performance.
Did you have any problems with this? Were there any situations where
you planned to do one thing, but avoided? Write a report to summarize
- Preparatory Sets -
In ten different situations, utter the first one or two words of each
sentence with a slow, continuous, strong articulatory pattern. Be sure
you start each word with a gentle onset. Write a report on your
- Proprioceptive Monitoring, High Stimulus Speech and Transitions -
For this, you and your partner(s) are each to enter into four realistic
situations. During situation one, you are to engage in a high degree of
100% continuous phonation. During the second situation you are to
engage in a low degree of 100% continuous phonation. During the third
situation you are to engage in strong, exaggerated co-articulatory
transitions on approximately 10% of the words spoken. During the
fourth situation, you are to engage in mildly exaggerated
co-articulatory transitions on roughly 10% of the words spoken. Write
a report to summarize your experiences.
- Modeling "Turtle Talk" with children.
For this assignment, you are to engage in a ten minute "play therapy"
situation with a normally developing child between the ages of 3 and
Tape record and analyze the interaction, paying particular attention to
your own speech in terms of such things as: speech rate, articulation
rate, fluency/disfluency, turn taking, pausing, prosody, etc. Write a
report to summarize your experience. As specifically as possible,
comment on how you did with respect to your articulation and speech
rates, your turn-taking, and your prosody. (Turn in your audio tape
along with your report).
For each of the above six assignments, write a summary. These
summaries will be graded on the bases of both style and content.
(These should be carefully prepared, well written and word-processed).
These are due on or before November 11.
NOTE: We will go over the above six concepts in
class, and you will have a good opportunity to observe how to do these
behaviors while watching the Van Riper video tapes.
- Listservs and the Stuttering Home Page: (Also Due on or before
Whether your professional interests are in the area of stuttering, or
something else, it will be important that you become familiar with
information that is available on the Internet. The purpose of this last
section is to point you in this direction. Hopefully, you will be able
to generalize this information about Listservs and home pages to those
which deal with others disorder areas.
Part 1. The Stuttering Home Page
Judy Kuster's stuttering home page contains a tremendous amount of
information about stuttering and links to other stuttering pages.
The address is:
For this project, you are required to
visit the Stuttering Home Page. An example of the type of thing you
are apt to find on the Stuttering Home Page is the poem by Michael
Caggiano, which is included as the last page of this syllabus.
Select two (2) reports, papers, stories or other items of
interest. Print them out, and turn them in along with brief abstract
of the topic (one page or less for each topic.)
Part 2. ISAD: International Stuttering Awareness Day
In conjunction with National Stuttering Awareness Day (ISAD) the Second
Annual ISAD Conference will be held from October 1 - 22. It will have
panel discussions, articles, papers, and research reports, etc.,
presented both by professionals and consumers from around the world.
Some of the people posting to the conference will be people you have
studied in this and/or other courses you have taken. I think you might
enjoy communicating with some of the "famous names" of people currently
active in the area of stuttering, and also communicating with PWS's.
We will divide the class into groups of about four people. Your
assignment here is to (1) go to the ISAD Conference. (2) Select
two topics, papers, or panels of interest. (3) submit a question or
comment about the topic, and then (4) write a short (one-page maximum)
report on what you learned: e.g., the topics you visited, author(s),
what you posted, and what you learned from this experience.
A Listserv is an electronic communication group.
People send messages to the main computer and the computer then mails
out the message to everyone who has subscribed to the list. In order
to participate, you need to tell the main computer that you want to be
on the list. When you do, the computer will send you information about
the list. WHEN YOU GET THIS INFORMATION, BE SURE TO PRINT IT OUT AND
SAVE IT FOR FUTURE REFERENCE. One of the things that will be included
will be information about how to sign off the list when you no longer
wish to participate. When this happens, of if you will no longer have
your own e-mail account, BE SURE YOU UNSUBSCRIBE YOURSELF FROM THE
Students have the option of obtaining an account which will access the
university mainframe computer. From this, you have access to Southcat,
library database searches (ERIC and PSYCH LIT) and also access to
Internet and electronic mail. Several "listserves" are devoted solely
to the area of stuttering. There is a modest fee for obtaining this
account, which must be paid at the Bursar's Office: then, the code
request form is obtained in Room 114, CSCB Building.
At the present time, there are three Listservs that deal with
stuttering. You may sign up for any one of these lists, or a
combination of them.
STUTT-L: This was originally designed as a forum for clinicians,
researchers and theorists. The list is owned and operated by Dr. Woody
Starkweather, at Temple University. This is the busiest of the three
To subscribe, send the following message to: firstname.lastname@example.org
Subscribe Stutt-L firstname lastname
STUT-HLP: Dr. Robert Quesal, at Western Illinois
University, is owner and operator of this list. The original purpose
of the list was to serve as a support vehicle for persons who stutter
and their families.
To subscribe, send the following message to: email@example.com
Subscribe Stut-hlp firstname lastname
STUTT-X This list was originally designed as a forum for
students, but has more recently become an open forum for just about
everything. The list owner and operator is Dr. Don Mowrer, at Arizona
To subscribe, send the following message to: firstname.lastname@example.org
Subscribe Stutt-X firstname lastname
Stephen B. Hood, Ph.D.
USA Speech and Hearing Center
University of South Alabama
Mobile, AL 36688
added with permission August 24, 1999