SHS 461: Introduction to Fluency Disorders

                                                                                                                           Fall Semester, 2003



SCHEDULE:         M-W-F: 8:00 - 8:50 AM

LOCATION:         Room 2330 UCOM Speech Pathology and Audiology

CREDITS:              3 semester hours


INSTRUCTOR:     Stephen B. Hood, Ph.D., CCC-SLP

                                             UCOM, Office 2102

                                             Office: 380-2628

                                             Home: 342-3927

                                             Email: sbhood(

OFFICE HOURS:    Mondays and Wednesdays 11:00 to 12:00 AM and 2:00 to 3:00 PM

Thursdays and Thursdays 9:00 to 11:00 PM

Subject to change depending upon clinic schedule.

***Also available by appointment.


CATALOG DESCRIPTION:                     A beginning course in stuttering and related disorders, with emphasis upon symptomatology, testing, rehabilitation and prevention.




    The purpose of this course is to present students with lecture, textbook, handout and audio-visual material

that will introduce them to fluency and fluency disorders, and to prepare them to take more advanced

course work at the graduate level. In order to do this, students will be given basic information about the

nature of stuttering, the onset and development of stuttering, the assessment of stuttering, and factors

related to prevention, early intervention and treatment for stuttering.


    Students are expected to read all required materials assigned. Students are strongly encouraged to begin

their readings as early as possible in order to be maximally prepared for class. Some of the material

presented in class will be covered in the text books, but much of it will not. Therefore, the ability to take

good notes will aid you tremendously. You will find that some of the reading material is redundant. Fear

not — this is to aid the learning process. In addition, you will receive supplemental class handouts to assist


     SPA 461, Fluency Disorders, is a difficult course to teach, and a difficult course to take. This is because of

the vast complexity of the problem of stuttering: the nature, onset, development, maintenance, prevention,

early intervention and treatment. The disorder of stuttering is not yet fully understood. More than a

disorder of speech, stuttering is a problem in interpersonal communication. Therapy must be a logical

outgrowth of your philosophy of the disorder. Therefore, certain theoretical, philosophical and

experimental points of view become important. In addition, the relationships among the fields of

speech-language pathology, counseling, psychology, learning theory and other specialties are of critical


     We will do all we can to combine theoretical background with clinical application. Please, make every

effort to do as much observation of ongoing stuttering evaluations and therapy as possible. Clinic

schedules will be given to you as soon as they become available so you can take advantage of the

opportunities that are available. You will find that therapy is an ongoing process rather than a static event.


PREREQUISITE: You must have earned a "C" or better grade in SPA 331 and 341.




                    Barry Guitar. (1998). Stuttering: An Integrated Approach to its Nature and Treatment. Williams and Wilkins



                       Stuttering Foundation of America. Memphis, TN. Series of Pamphlets and books.


Ainsworth:                 If Your Child Stutters: A Guide for Parents

Starkweather:            Therapy for Stutterers

Conture:                      Stuttering and Your Child: Questions & Answers

Hood:                          Stuttering: Words.

Hood:                          Advice to Those Who Stutter Stutterer

Gruss:                          Stuttering Therapy: Transfer & Maintenance

Gruss:                          Counseling Stutterers

Fraser:                         Do You Stutter: A Guide for Teens

Fraser:                         Self Therapy for the Stutterer

Dell:                             Treating the School Aged Stutterer

Guitar:                         Stuttering: Integration of Therapies

Gregory:                     Stuttering Therapy: Prevention & Intervention

SUPPLEMENTARY READINGS: Class Handouts and handouts of Power Point slides will be available.

STUDENTS WITH SPECIAL NEEDS: It is the policy of USA to accommodate students with disabilities. Any

student with a qualified disability that requires accommodations should see the instructor during the first week of

classes. A student must verify that he/she has a qualified disability through Disabled Student Services (460-7213),

Student Center Room 270, Ms. Bemita Pulmas, director.

POLICY ON ACADEMIC MISCONDUCT: Any dishonesty related to academic work or records constitutes

academic misconduct. Academic misconduct is incompatible with the standards of the academic community. Such

acts are viewed as moral and intellectual offenses and are subject to investigation and disciplinary action through

appropriate University procedures. Penalties may range from the loss of credit for a particular assignment to

dismissal from the University. (See The Lowdown, Student Academic Conduct Policy.)

PROGRAM ACCREDITATION: The Council of Academic Accreditation (CAA), under the auspices of the

American Speech Language Hearing Association (ASHA), has certified the Department of Speech Pathology and

Audiology at USA as an authorized educational facility. This means that credentials obtained by graduates in

Speech-Language Pathology or Audiology will automatically be accepted by ASHA when these graduates apply for

certification. If students wish to contact CAA for additional information, they may do so at the following address:



Council of Academic Accreditation

The American Speech Language Hearing Association

1080 IRockville Pike

Rockville MD 20852






     Upon completion of the course, the student will:


1. Demonstrate and understanding of the affective, behavioral and cognitive dimensions of fluency, disfluency and stuttering.

2. Be able to identify the risk factors that make certain children more vulnerable to the development of stuttering.

3. Understand the similarities and differences between normal nonflunecies, stutter-like disfluencies, and stuttering.

4. Know the core features of stuttering, secondary features of stuttering, and related attitudes and feelings.

5. Comprehend the development of stuttering in terms of behavioral, emotional and attitudinal components.

6. Be able to apply the principles of learning theory to the onset, development and maintenance of stuttering.

7. Understand the parameters of diagnostic assessment to the overt and covert features of stuttering.

8. Be aware of the general principles of prevention and early intervention in preschool children.

9. Be able to identify the general principles of treatment for borderline stuttering.

10. Demonstrate an understanding of the general principles of treatment for mild, intermediate and advanced                  stuttering.

11. Understand the similarities and differences to stuttering therapy programs based on "fluency shaping" and

      "stuttering modification" techniques.

                       Objectives 1 through 11 directly address ASHA Standards III-B, III-C and III D. Knowledge of basic

human communication processes. Communication Differences and Disorders, and Prevention,

Assessment and Intervention.



12. Write narrative summaries of situational assignments designed to help them understand and appreciate some of the problems experienced by persons who stutter.

13. Write narrative summaries of assigned tasks to expose student to internet resources devoted to the area of  stuttering.


                       Objectives 12 and 13 Address Standard ASHA III-A, Skill in written communication.





     100 points (objective questions)

     100 points (objective questions)

     100 points (objective questions plus short narrative answers)

     100 points (objective questions plus short narrative answers)


Each regular examination will emphasize topics covered in the unit, but will also include important concepts from previous units. A comprehensive final examination will be given during examination week. For students who do better on the final examination than their average based on the first three exams, the final will count double. This is a way to reward students who are able to tie things together at the end of the term.

Writing Assignments will also be made, in compliance with the guidelines and requirements of the University Writing Program. These assignments will be graded as "S/U" based upon style and content. Students whose first attempt is unsatisfactory must rewrite the assignment. Assignments must be word processed.


To make an a-priori prediction of the final grade scale is dangerous due to the fact that the predicted scale may be too high or too low. The final determination of course grades will approximate the following percent distribution.


                    A = 90 -100

                       B = 80 - 89

                       C = 70 - 79

                       D = 60 - 69

                       F= <60





     Since attendance is important to learning, students are expected to attend class. However, the class is operated on the assumption that university students are responsible for their own behavior, including attendance, so formal attendance will not be taken for the purpose of computing your final course grade. From time to time, unannounced quizzes might be given. These will result in "bonus points" that can boost your final class grade. You are responsible for the material presented in class, and unless there is sufficient reason, time spent during office hours is not designed for individual tutoring of materials missed due to absences.


                      Students must be in class on the day of examinations. Absences not previously granted by the instructor must be accompanied by a formal university or medical excuse. This will be discussed in class. Hopefully, members of the Mobile Chapter of the National Stuttering Association will visit class. This will be announced well in advance.

Attendance on this date will be mandatory.



Internet and World Wide Web


                    Students who have regular access to e-mail and the WWW should plan to meet with me so that I can explain some of the exciting opportunities that are available to you! I'll make some general comments about this in class. For students who are not now on-line, but would like to be, please see me for details. As part of the (W) writing requirements for this course, you will need to access Web Sites dealing with stuttering.


NOTE TO STUDENTS: The course objectives, assignments, and schedule of lecture topics may be changed with 24 hours notice, via in-class announcement.



     Important Dates to Remember



                                         Exam 1        Sep. 24

Exam 2        Oct. 22

                                             Exam 3        Dec 3

Final            Dec. 8


     Outside Assignments


Letter                           Nov. 7

Stuttering                      Nov. 17

Observing                     Nov. 17



                                        Home Page                 Sep. 12

ISAD                             Oct. 29








 UNIT I. The Nature of Stuttering: Onset and Development

                       August 25 - September 26


                       READING ASSIGNMENTS:

                                           (R) Hood, Class Handouts

                       (R) Hood. Stuttering Words

                       (R) Guitar, Chapters 1,3, 4, 5.


                       In Chapter 4, just skim generally the information on pages 89-100.



     August 25-27                           Models of Stuttering                                                                 Ch. 1, and Handouts

     August 29-Sep 3                                            Key Terms and Concepts                                                                    Ch. 1, and Handouts

     Sep 5                                          Factors related to Fluency

     Sep 8                                               Definitions: Johnson, Van Riper, Bloodstein                                                   Pgs. 70-77

     Sep. 10-12                                Core Features, Secondary Features, Feelings and Attitudes.                                             Pgs. 10-13, Ch 5

                       Developmental and Environmental Issues                                       Ch 3 (Skim)

     Sep. 15                                      Diagnosogenic Theory, Anticipatory-Struggle,

                       Demands-Capacities                                                                  pgs 70-77

     Sep. 17-19                                Stuttering Development                                                                                Pgs 79- 89 and Ch. 5

                                                                                                                                          Handouts: VR, Q&D


                       September 22 will be a review session

                       September 24 will be Examination I,

                       September 26 will be a chance to go over the exam and give feedback.


UNIT II. Applications of Learning Theory to the Problem of Stuttering and its Diagnosis


September 29 - October 24

                        Sep 29 - Oct 8   Learning Theory                                                                              Pgs 89-100. Handouts

                       Oct. 10-17     Diagnosis                                                                                                       G. Ch 7. Handouts

                       October 20 will be a review session

                       October 22 will be Examination II

                       October 24 will be a chance to go over the exam and give feedback.



UNIT III. Therapy


                       October  27 -  December  5

                       Oct. 27-Nov 3   The Advanced Stutterer:                  Chapters 8-9 and Handouts.

                                              Skim the following SFA books for ideas to supplement Guitar and Handouts

                                              Hood. Advice to Those Who Stutter

                                              Fraser. Self Therapy for the Stutterer

                                              Fraser. Therapy for Stutterers


                       Nov 5-10                    The Intermediate Stutterer       Chapters 10-11 and Handouts

                                              Skim the Following SFA book to supplement Guitar and Handouts.

                                              Fraser. Do You Stutter: A Guide for Teens

                                              Dell. Treating the School Aged Stutterer


                       Nov 12 -14      The Beginning Stutterer                                            Chapters 12-13 and Handouts


                       Nov 17-24.     The Borderline Stutterer                                             Guitar. Chapter 14 and Handouts

                       Ainsworth. If Your Child Stutters

                       Conture. Stuttering and Your Child: Questions & Answers

                       Dec 1          will be a review session

                       Dec 3          will be Examination III

                       Dec 5          will be a chance to go over the exam and give feedback.


                       Final Examination: As per the date posted in University Exam Schedule. Tentatively scheduled for Monday,

December 8, at 10:00 A.M. For those with conflicts, we will try to establish an additional time.



Writing Assignments for SPA 461


     The purpose of this assignment is for the fluent speaking clinician to:


1.            develop an appreciation for some of the emotional correlates of stuttering.

2.            become partially desensitized to the emotional and behavioral components of stuttering. Become able to

approximate stuttering behaviors in stressful situations.

3.            write descriptive narratives regarding the above, as will be outlined below. Your writing assignments will be graded based upon both style and content.


                              The work you submit must be typed, single spaced, and word processed.


               Assuming the Role of the Stutter


     The class will be divided into groups of two students each. The assignment is to enter two REALISTIC speaking

situations such as talking to a store clerk, ordering a meal or placing a phone call. Or, you and your partner might go

out to lunch or dinner in a public restaurant - where one of you "stutters" and the other speaks "normally." (Then,

reverse your roles and do the assignment again.)


    NOTE: in order to be a realistic, you should find a situation where you will be doing a fair amount of talking.

As a general rule of thumb, you should select a situation in which you will be talking for about five

minutes, and where you will speak at least 100 words. We will discuss this in class.


     In each situation, one student is to serve in the role of a stutterer, and speak with REALISTIC stuttering. The other

student is to assume the role of a passive observer. Writing Assignments are as follows:

1.            Write a letter addressed to me, as your instructor, in which you describe your attitudes, feelings and emotions regarding your upcoming stuttering role. Try to give me an appreciation for what you are going to do, why you are going to do it, and how you expect things to go. Try to relate the experience to what you have learned about the overt and covert dimensions of stuttering in class.

               NOTE:   Do this before you actually go into the real world and stutter. Try to be as honest as possible.

DUE: November 7



 2.           After you have assumed the role of a person who stutters, write a description of your overt stuttering behaviors and covert emotional reactions during this speaking situation. Try to be as specific as possible. Again. relate your experience to the things you are learning in class: e.g., the nature of stuttering, severity, emotional and behavioral correlates, etc.        

DUE: November 17

3.            Write an observation report regarding what you observed during your role as the observer.

DUE: November 17

4.            Internet Resources

For this assignment you are to visit Judy Kuster's Web Page on stuttering. You can locate it at the following address: < > Browse through the information dealing with ³Therapy for Stuttering,²  ³PWS Speak for Themselves,² ³ Personal Paths Toward Recovery² and ³Information about stuttering.²   You assignment is to select three significant contributions, and then write a one page abstract to summarize the article.  Turn in a copy of each of the three articles, along with the one page abstract of the article.  In other words - you will have one printed copy of the article plus your one page summary for each of the three articles that you have selected.

DUE: September 12

5.            ISAD. International Stuttering Awareness Day is in October. From Judy Kuster's home page, you can access this page. This assignment requires that you visit ISAD, and browse through the manuscripts that have been contributed. You will be able to access these articles, and post a question or make a comment about any of them.

After I have had a chance to read the articles, I will give you a list of those which are most appropriate for this      assignment. Your task will be to (1) visit ISAD and read through these articles. (2) Select the article that you find to be the most meaningful, insightful, thought or provoking. (3) Post at least one question or comment for the contributions that you find to be of interest. (4) Print out a hard copy of your post, and submit it to me.


    IMPORTANT NOTE:  It is ok if you care to mention that you are an undergraduate student, but Mrs. Kuster doesn't want a bunch of university names to be included in the responses. I will give more details in class.  After you have done this, print out the page that has your question and comment, and submit this to me.

  VERY IMPORTANT NOTE:       There will be a time period of approximately three weeks where people can post questions and make comments about the articles. In response, the author(s) of the papers will reply back to the person who posted the question or comment. Often, interesting dialogs go on between the author(s) and folks like you who make the comments or ask the questions.

               Once the deadline is passed, it will not be possible to post comments. I will give you details in class.


                              DUE: October 29