SPA 561. Advanced Fluency Disorders
Fall, 1999

Instructor: Stephen B. Hood, Ph.D.
Office 2110 University Commons
Phone: 380-2628
E-Mail: SBHOOD@JAGUAR1.USOUTHAL.EDU
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.

Required Texts:
Supplemental Readings:

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 more depth.

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.

Course Purpose


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
Unit II. Application of Learning Theory to Stuttering
Unit III. Normal Nonfluencies, and the Onset and Development of Stuttering
Unit IV. Assessment of Stuttering EXAM I: September 30

Unit V. Therapy for Adults, and older teens who stutter.

Unit VI. Therapy for Child Aged Children Unit VII Prevention and early intervention
Grading


Listed below is the tentative grading scale, subject to modification if necessary.
Projects:


Project I.

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.

  1. 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 following: Write a report to summarize your experiences. How did you do? How did you feel? What listener reactions did you obtain?
    Cancellations - 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.
  2. 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 your efforts.
  3. 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 efforts.
  4. 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.
  5. 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
  6. 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.

  7. Listservs and the Stuttering Home Page: (Also Due on or before November 11) 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: http://www.mnsu.edu/~stutter 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.

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.

Listservs

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 LIST.

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 Listservs. To subscribe, send the following message to: listserv@listserv.temple.edu 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: listproc2@ecnet.net 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 State University. To subscribe, send the following message to: listserv@asuacad.edu Subscribe Stutt-X firstname lastname

Stephen B. Hood, Ph.D.
USA Speech and Hearing Center
Phone: 334/380-2628
2000 UCOM
FAX 334/380-2699
University of South Alabama
Mobile, AL 36688
e-mail: sbhood@JAGUAR1.USOUTHAL.edu

added with permission August 24, 1999