CSD 554 Stuttering                                                                  Dr. Barbara Mathers-Schmidt

Winter, 2006                                                                                         Parks Hall 33

M,W 1-2:20 P.M.;F 1:00-1:50                          Office Hours: to be posted

Parks Hall 220                                                                                   E-mail Address: Barbara.Mathers-Schmidt@wwu.edu



TEXTS:                        Guitar, B. (2006). Stuttering: An integrated approach to its nature and treatment. Baltimore, MD: Lippincott Williams & Wilkins.


                                                      Zebrowski, P.M. & Kelly, E.M. (2002). Manual of stuttering intervention. Clifton Park, NY: Singular Publishing.


                                                      Speech Foundation booklets (to be ordered as a group; optional)


                                                      Readings (See attached listing)




This course is a graduate level seminar on the nature and treatment of stuttering. It is expected that all students enrolled in CSD 554 have completed CSD 454, or its equivalent. I have designed this course so that you will have the opportunity to read and discuss current (and some classic) literature regarding the nature of stuttering, its treatment, and research. We also will review key articles regarding atypical disfluency.


My objectives for you are the following: 1) To review current research articles regarding the nature of stuttering; 2) To develop a perspective about stuttering, based on empirical research evidence and rational inquiry; 3) To consider the nature of related disorders (cluttering and "neurogenic stuttering"); 4) To develop an approach to assessing stuttering, which both addresses the multifactorial nature of the disorder and also allows you to make important differential diagnostic determinations; 5) To consider and practice treatment approaches to stuttering, always with a consideration of the unique constellation of factors which have contributed to stuttering development and maintenance in each individual who stutters.


As always, it is my hope that you will be clinicians who will respect and practice the science of your profession--applying keen observational skills; developing questions (clinical hypotheses) based on a solid understanding of this disorder; being open to the unexpected; and making assessment and treatment decisions based on current research findings, accepted models of stuttering, and sensitivity to the particular needs of each client.


Specific learning outcomes are attached. Mastery of the knowledge related to these outcomes is required. Students who fail to demonstrate a satisfactory degree of knowledge acquisition, based on their performance on a variety of formative assessments, or who communicate to the instructor their own perception of an inadequate grasp of concepts, will be provided alternatives for learning and demonstration of mastery of course-related knowledge.
Page Two

CSD 554 - Course Syllabus




Your assigned readings include the text chapters, selections from the readings I have compiled, and booklets from the Stuttering Foundation of America. ALL ASSIGNED MATERIAL MUST BE READ PRIOR TO THE SESSION IN WHICH IT WILL BE DISCUSSED. SEE THE SYLLABUS FOR DISCUSSION DATES. I am eager to discuss the materials with you, and am looking forward to hearing about your reactions and questions. Class participation, including reviews of assigned articles, will be evaluated throughout the quarter.



You will have a midterm (75 points) and a final examination (75 points). The midterm exam will consist of essay questions. The final exam will be a comprehensive oral exam. Make-up exams will be given only for absences excused in advance. Under such rare circumstances the exam will be given LATE. No student will be allowed to take an exam early.


Assessment Project (20 points)

You will complete an analysis of the stuttering of an adult client. Videotaped samples will be analyzed using the SSI-3 and a protocol which will be provided in class. Your results must be summarized using both test forms and a report-writing format (provided in class). You will compare your findings to those of at least one classmate. Finally, you will write a three page (double-spaced) summary of the results, your interpretation of those results, and a commentary regarding the validity/reliability of the SSI as an assessment tool. You will lose two points for every day this assignment is late.

Term Project (50 points)

This assignment consists of two modes of presentation: an oral presentation to be delivered in class during the last two weeks of the quarter; and a detailed, written outline of your presentation, along with a list of references. Due dates will be discussed in class.


You are to work with partners in completing this assignment. Your task is to learn all that you can about a specific approach to working with individuals who stutter. I will provide a list of experts/programs from which to choose. In your presentation you MUST review the following: apparent or stated theoretical bases for the approach; key aspects of the approach; clients for whom this type of treatment may be most/least helpful; related treatment efficacy research; YOUR IDEAS regarding the advantages and drawbacks of this approach. In addition, your partner and you must demonstrate key aspects of the treatment so that students will have a good idea of specific procedures which the author(s) recommend. Finally, you must use Power Point and handouts to provide clear and useful information for your peers.


This project will be graded on both the content and how well it is presented.
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CSD 554 - Course Syllabus


Date                                                                 Topic                                                                                                                   Reading Assignment

1/4                                           Review syllabus; historical perspective of theories of stuttering; case                                                                                                                                       examples


1/6                                           Introduction to Stuttering                                                                         Guitar (2006), Ch. 1

                                                      Stuttering as a multifactorial, dynamic

                                                      disorder                                                                                                                                      Smith,1999 (All)


1/9                                           Epidemiology and Genetics                                                            Guitar, Ch. 2

                                                      (See discussion questions)                                                                      Yairi et al., 1996 (All)


1/11                                       Persistence and Recovery Rates                                           Yairi & Ambrose,1999


1/13-1/20                    Pathophysiology of Stuttering                                                   Guitar, Ch. 2

                                                      A Motor Control Disorder                                                                 Ludlow, 2003 (All)

                                                      Respiratory and Laryngeal Control                                   Smith et al., 1996                                                                                                                           Neuromuscular Activity                                                                         Van Lieshout et al., 1995


                                                      Brain Imaging and Stuttering                                                       Guitar, Ch. 2

                                                                                                                                                                  Blomgren & Nagarajan, 2004 (All);                                                                                                                                                                                                    Ingham et al., 2004; Salmelin et al., 2000; De                                                                                                                                                                                           Nil et al.,2003;Cuadrado & Weber-Fox, 2003



1/23                                       Arousal States and Stuttering                                                   Guitar, Ch. 2

                                                      (Emotion and Cognition States)                                        Miller & Watson, 1992;

                                                                                                                                                                                                                        Vanryckeghem & Brutten1997;                                                                                                                                                                                                                               Weber & Smith,1990;Weber-Fox et                                                                                                                                                                                                                                       al., 2004; Menzies, et al., 1999; Craig                                                                                                                                                                                                                                                   et al., 2003 (All)


1/25                                       Psycholinguistic Perspective                                                         Guitar, Ch. 2 & 3

                                                                                                                                                                                                                        Kleinow & Smith, 2000; Paden et al.,                                                                                                                                                                                                                                 2002;Watkins et al.,1999; Trautman,                                                                                                                                                                                                                                                    et al.,2001;Silverman & Ratner, 1997;                                                                                                                                                                                                                       Nippold, 2002 (All)                                                                                           

1/27                                       Lab: Reactions--clinical application of psycholinguistic perspective


1/30-2/1                         Home Env./Parent-Child Interaction                        Guitar, Ch. 3

                                                                                                                                                                                                                        Nippold & Rudzinski, 1995


                                                      Learning and Stuttering                                                                       Guitar, Ch. 3

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CSD 554 - Course Syllabus


2/3                                           Lab: Role play clinical scenarios/responses to FAQs (Self-eval; 5 pts)


2/3                                           MIDTERM DISTRIBUTED (Due 2/13)


2/6-2/8                  Theories About Stuttering                                        Guitar, Ch. 3


2/10                                       Lab: Videotape review of parent/client interviews; relate to multifactorial model

                                                      (Directed paraphrasing: Relating multiple factors to dev/maintenance of stuttering)


2/13                                       Normal Disfluency and Development of Stuttering           Guitar, Ch.4

                                                      Childhood Stuttering                                                                                                                   Yairi (C&S), 1997 (All)

                                                                                                                                                                                                                                                   Ambrose & Yairi (1999) (All)

                                                      Guitar & Conture--The Child Who Stutters: To the Pediatrician

                                                      (Stuttering Foundation booklet)


2/15-2//22                  Assessment and Diagnosis                                                                Z&K Chapter 2; Guitar Chs. 6-7                                           Assessment of Bicultural/Bilingual PWS            Watson& Kayser,1994 (All)


                                                      (Review assessment project; due 2/24) (Complete self-study; 5 pts; due 2/22)

(2/17)                                 Lab: SSI practice (assessment tools and their limitations)

                                                      (“Quick write”: Compare/contrast secondary characteristics and apparent                                                                                          psychological concomitants, given videotaped behaviors and apparent psychological                                                     concomitants of 3 clients)

(2/22)                                 Lab: Outcome measures review;                                        Yaruss (1998) (All-opt.)

                                                      Assessing reactions, disability, and handicap; ABC scales


2/24                                       Debate re: early intervention                                                      Curlee & Yairi, 1997;                                                                                                              (Self-eval/instructor eval; 10 pts)                                              Onslow, 1992; Packman &                                                                                                                                                                                                                                                              Onslow, 1998 (All)

2/27                                       Treatment Considerations                                                               Guitar Ch. 8; Z & K Ch 1

                                                      Professional Practice Standards                                                    (Websites;handout)

                                                      Notion of stuttering prevention (Minute papers re: prevention of stutt development                                                              and prevention of neg. emotional/cognitive overlays associated with stuttering)


                                                      Intervention Perspective and Guidelines            Z&K Ch 3


3/1                                           Stuttering Modification                                                                          Guitar Chs.9-12

                                                      and Fluency Shaping                                                                                 Sander, 1970 (All)


3/3-6                                    Lab: Tension discrimination/control; fl shaping; stutt mod exercises


3/8                                           Therapy for Young Children                                                     Z&K Ch. 4 & 5;                                                                                                                                   IDEA & IEP’s re: fluency disorders                                                      Whitmire,2002(All)

Page Five

CSD 554 - Course Syllabus


3/8                                           Therapy for Adolescents and Adults                                                     Z & K Ch. 6

                                                      Therapy for Children’s Stuttering and Emotions;

                                                      Counseling Adolescents and   Adults who Stutter          Collins & Blood, 1990 (All)


                                                      Directed paraphrasing: Critique and discuss evidence re: risk factors for social                                                            disabilities and societal limitation of PWS. Minute paper: Describe                            strategies for                                                             recognizing, preventing, assessing, and treating possible social sequelae of stuttering                                                           in terms of disabilities and societal limitation


3/8 (6-8 pm)         STUDENT PRESENTATIONS (and pizza party!). PH 220


3/10                                       Related Disorders of Fluency                                                                                Guitar, Ch 13


3/15                                       FINAL EXAMINATION, Wednesday (Oral, by scheduled appointment)

CSD 554 Readings


1.       Smith, A. (1999). Stuttering: A unified approach to a multifactorial, dynamic disorder. In N.       Bernstein Ratner & E.C. Healey (Eds.), Stuttering research and practice: Bridging the       gap (pp. 27-44). Mahwah, NJ: Lawrence Erlbaum Associates.


2.       Yairi, E., Ambrose, N., & Cox, N. (1996). Genetics of stuttering: A critical review. Journal        of Speech and Hearing Research, 39, 771-784.


3.       Yairi, E., & Ambrose, N. (1999). Early childhood stuttering I: Persistency and recovery rates.       Journal of Speech, Language, and Hearing Research, 42, 1097-1112.


4.       Ludlow, C.L., & Loucks, T. (2003). Stuttering: A dynamic motor control disorder. Journal of Fluency Disorders, 28, 273-295.


5.       Smith, A., Denny, M., Shaffer, L. A., Kelly, E. M., & Hirano, M. (1996). Activity of intrinsic laryngeal muscles in fluent and disfluent speech. Journal of Speech and Hearing      Research,39, 329-348.


6.       Van Lieshout, P. H. H. M., Starkweather, C. W., Hulstijn, W., & Peters, H. F. M. (1995).       Effects of linguistic correlates of stuttering on EMG activity in nonstuttering speakers.       Journal of Speech and Hearing Research, 38, 360-372.


7.       Blomgren, M., & Nagarajan, S. (2003). Brain activation patterns in stuttering and          nonstuttering speakers: Preliminary results and future directions. Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, 13(4), 8-11.


8.       Ingham, R., Fox, P., Ingham, J., Xiong, J., Zamarripa, F., Hardies, L.J., & Lancaster, J.            (2004). Brain correlates of stuttering and syllable production: Gender comparison and     replication. Journal of Speech, Language, and Hearing Research, 47, 321-341.


9.       Salmelin, R., Schnitzler, A., Schmitz, F., & Freund, H-J. (2000). Single word reading in developmental stutterers and fluent speakers. Brain, 123, 1184-1202.


10.  De Nil, L., Kroll, R., Lafaille S., Houle, S. (2003). A positron emission tomography study of            short- and long-term treatment effects on functional brain activation in adults who stutter. Journal of Fluency Disorders, 28, 357-79.


11.  Cuadrado, E., & Weber-Fox, C. (2003). Atypical syntactic processing in individuals who      stutter: Evidence from event-related brain potentials and behavioral measures. Journal of                   Speech,Language, and Hearing Research, 46, 960-976.


12.  Miller, S., & Watson, B. C. (1992). The relationship between communication attitude,       anxiety, and depression in stutterers and nonstutterers. Journal of Speech and                  Hearing Research, 35, 789-798.


13.  Vanryckegham, M., & Brutten, G. J. (1997). The speech-associated attitude of children who             do and do not stutter and the differential effect of age. American Journal of Speech-                 Language Pathology, 6, 67-73.


14.  Weber, C. M., & Smith, A. (1990). Autonomic correlates of stuttering and speech assessed in                  a range of experimental tasks. Journal of Speech and Hearing Research, 33, 690-706.


15.  Weber-Fox, C., Spencer, R.M.C., Spruill, J.E., & Smith, A. (2004). Phonologic processing                   in adults who stutter: Electrophysiological and behavioral evidence. Journal of Speech,         Language, and Hearing Research, 47, 1244-1258.


16.  Menzies, R. G., Onslow, M., & Packman, A. (1999). Anxiety and stuttering: Exploring a                complex relationship. American Journal of Speech-Language Pathology, 8, 3-10.


17.  Craig, A., Hancock, K., Tran, Y., & Craig, M. (2003). Anxiety levels in people who stutter:              A randomized population study. Journal of Speech, Language, and Hearing Research,      46, 1197-1206.


18.  Kleinow, J., & Smith, A. (2000) Influences of length and syntactic complexity on the speech                   motor stability of the fluent speech of adults who stutter. Journal of Speech, Language,          and Hearing Research, 43, 548-559.


19.  Paden, E. P., Ambrose, N., & Yairi, E. (2002). Phonological progress during the first 2 years                of stuttering. Journal of Speech, Language, and Hearing Research, 45, 256-267.


20.  Nippold, M. (2002). Stuttering and phonology: Is there an interaction? American Journal of Speech-Language Pathology, 11, 99-110.


21.  Watkins, R. V., Yairi, E., & Ambrose, N. (1999). Early childhood stuttering III: Initial status               of expressive language abilities. Journal of Speech, Language, and Hearing Research,      42, 1125-1135.


22.  Trautman, L., Healy, E. C., & Norris, J. A. (2001). The effect of contextualization on fluency                   in three groups of children. Journal of Speech, Language, and Hearing Research,44,       564-576.


23.  Silverman, S. W., & Ratner, N. B. (1997). Syntactic complexity, fluency, and accuracy of                sentence imitation in adolescents. Journal of Speech, Language, and Hearing Research,      40, 95-106.


24.  Nippold, M. A., & Rudzinski, M. (1995). Parents’ speech and children’s stuttering: A critique of the literature. Journal of Speech and Hearing Research, 38, 978-989.


25.  Yairi, E. (1997). Disfluency characteristics of childhood stuttering. In R.F. Curlee & G.M.       Siegel (Eds.), Nature and treatment of stuttering: New directions (2nd ed., pp. 49-78).       Boston: Allyn and Bacon.


26.  Ambrose, N., & Yairi, E. (1999). Normative disfluency data for early childhood stuttering.                  Journal of Speech, Language, and Hearing Research, 42, 895-909.


27.  Watson, J., & Kayser, H. (1994). Assessment of bilingual/bicultural children and adults            who stutter. Seminars in Speech and Language, 15, 149-163.


28.  Yaruss, J. S. (1998). Describing the consequences of disorders: Stuttering and the          international classification of impairments, disabilities, and handicaps. Journal of Speech,        Language, and Hearing Research, 41, 249-257.


29.  Curlee, R., & Yairi, E. (1997). Early intervention with early childhood stuttering: A critical          examination of the data. American Journal of Speech-Language Pathology, 6, 8-18.


30.  Onslow, M. (1992). Identification of early stuttering: Issues and suggested strategies.                  American Journal of Speech-Language Pathology, 1, 21-27.


31.  Packman, A., & Onslow, M. (1998). What is the take-home message from Curlee and Yairi?                 American Journal of Speech-Language Pathology, 7, 5-9.


32.  Sander, E. (1970). Talking plainly about stuttering: Guidelines for the beginning clinician. Central State Speech Journal, 21, 1-7.


33.  Whitmire, K. (2002). IDEA and IEPs for students with fluency disorders. SID-4          Newsletter, December, 3-6.


34.  Collins, C. R., & Blood, G. W. (1990). Acknowledgment and severity of stuttering as

         factors influencing nonstutterers’ perceptions of stuttering. Journal of Speech

         and Hearing Disorders, 55, 75-81.

ASHA Documents (ASHA Online Reference Library)



Guidelines for Practice in Stuttering Treatment (ASHA Document):



Knowledge and Skills Needed by Speech-Language Pathologists and Audiologists to Provide Culturally and Linguistically Appropriate Services



Evidence-Based Practice in Communication Disorders



Evidence-Based Practice in Communication Disorders: An Introduction



Prevention of Communication Disorders




Stuttering Foundation Resources (www.stutteringhelp.org)


Special Education Law and Children Who Stutter



Stuttering and the Bilingual Child



Cluttering: What It Is and How to Help



Obtaining Reimbursement for Stuttering Therapy





The Stuttering Home Page: Judith Kuster



Markers Bound To:

CSD 554 - Stuttering


The student will explain how multiple factors (genetics, environmental communication pressures, learning, cognition, emotion, psycholinguistics, neuromotor system for speech) may relate to the development and maintenance of stuttering.

The student will generate a research-based position statement regarding what contributes to the development and maintenance of stuttering.

The student will distinguish types of disfluencies, given videotaped clinical cases, and will compare his/her assessment of stuttering behaviors to those of a peer.

The student will identify, compare, and contrast secondary behaviors and apparent psychological concomitants, given videotaped recordings of people who stutter.

The student will explain strategies for preventing stuttering development.

The student will explain strategies for preventing negative emotional/cognitive overlays associated with stuttering.

The student will summarize and interpret assessment results of a videotaped client who stutters.

The student will critique the validity and reliability of stuttering assessment tools.

The student will relate specific etiological factors of stuttering to intervention plans.

The student will formulate and defend a position regarding the efficacy of early intervention.

The student will demonstrate fluency shaping and stuttering modification techniques, given hypothetical case scenarios.

Given a written case scenario, the student will develop an assessment and intervention plan that is individually tailored (child, adolescent, adult) and supported by current research.

The student will critique the theoretical basis, efficacy, advantages, and disadvantages of a fluency intervention approach.

The student will recognize the cultural issues that influence assessment of adults and children who stutter.

The student will critique current fluency research, a)explaining how the research contributes to our understanding of stuttering and b)explaining the clinical implications of the research.

The student will critique and discuss evidence regarding risk factors for social disabilities and societal limitations of people who stutter.

The student will describe strategies for recognizing, preventing, assessing, and treating the possible social sequelae of stuttering in terms of disabilities and societal limitations.