Introduction
“Stuttering has been described as a motor speech disorder that interrupts the timing and/or coordination between the respiratory, laryngeal and vocal tract subsystems of speech…. [including] repetitions, prolongations, and cessations of sounds interwoven with elements that exists below the surface“ (Beilby, 2010, p. 133). One of the elements that can exist below the surface is anxiety. Anxiety, defined by Iverach, Menzies, O 'Brian, Packman, & Onslow, (2011) is a complex psychological construct composed of verbal cognitive behavioral and physiological components. The experience of anxiety can include thoughts and expectancies of negative events, escape or avoidance behaviors, and physical sensations such as muscles tension and
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Therefore, there is a need to utilize a more comprehensive approach in stuttering treatment, including both traditional aspects such as fluency shaping, in addition to cognitive restructuring approaches. One cognitive restructuring approach is cognitive behavioral therapy. Cognitive behavioral therapy (CBT) is a psychological and anxiety reducing treatment approach, which mainly centers on coaching the individual who stutters to monitor his or her speech in addition to viewing their stutter as a component of their speech rather than their identity. (Blomgren, 2010). The main components of CBT include “exposure, cognitive restructuring, behavioral experiments, and attentional training” (Menzies, O’Brian, Onslow, & Packman, 2009, p. 189). Exposure is a longstanding hallmark for many behavioral therapy programs which aim is to target anxiety. During exposure, the individual is exposed to a situation that would typically cause an overwhelming amount of anxiety; the individual is then taught to remain in the uncomfortable, other than reverting to typical strategies of avoidance situation until anxiety begins to decrease. In CBT programs used specifically for stuttering treatment, exposure is used to practice fluency in anxiety-ridden situations in a …show more content…
In this system articles are rated based on eight standards, including a clear purpose statement, objective literature review, suitable methodology, repeatability of intervention, reliability measure, sufficient sample size, clear results, generalizability of findings. Scores of 1, 2, and 3 were given in eight areas leading to a total possible score of 24. A score of 1 indicated insufficient information; a score of 2 meant adequate information, and a score of 3 equaled thorough, clear, and concise information. Articles were also rated by level of evidence (table 2). 1A equaled a meta-analysis of multiple well designed controlled studies, 1 equaled well designed randomized controlled trials, 2 equaled well designed non-randomized controlled trial (quasi-experimental), 3 equaled non experimental designs, and 4 equaled expert opinion
A review of the National Stuttering Association has been conducted using the official website for the association. The National Stuttering Association (NSA) was founded in 1977 by Bob Goldman and Michael Sugarman ("About the NSA", 2014, para. 10). The NSA is the accumulation of 125 local chapters nationwide. It used to be called the National Stuttering Project and the main focus was community outreach. Efforts for stuttering awareness were made through technology: public service announcements, local newspaper advertisements, and local radio and television appearances.
The details of the study included literature review, purpose, method, data analysis, results, discussion, limitations, nursing implications, recommendations for future research and conclusion. The results were clearly presented. Study limitations were identified. The conclusion was based on study results. This review was of good quality.
“On Stuttering” by Edward Hoagland This personal piece written by Edward Hoagland reflects on his past experiences of living with a stutter. It’s significant that the way Hoagland writes is so complex yet precise and to the point. As he explains, having a stutter is like, “trying to run with loops of rope around your feet”(153). Yet his word choice and sentence structure contradicts that and he is clearly able to explain his point. I also enjoyed his metaphor in comparison to football in paragraph 4.
Several young children knowing that they have a speech disorder many think that their dream of becoming who they want to become won’t be accomplished. Stuttering happens when the person can’t clearly pronounce words, phrases, and sounds. Julia Roberts was one of those many children with stuttering problem. Her dream was to become a veterinarian but after finding out that she had “an inability to deal with science on a brainiac kind of level”, she abandoned it (Biography.com, 1). She didn’t know if acting was right for her because of her stuttering problem.
Other thing is that, Hayley S. Arnold, Ph.D. Purdue University mentioned in her article (2009) on "The Stuttering Foundation" website that while she was doing doctoral work at Vanderbilt University, she measured emotions using a special device on the behaviors produced by nine children who stutter and other nine children who don’t stutter. She analyzed behaviors; the children who stutter were less skilled at emotion arrangement. She found that the children who stutter using fewer emotion arrangement strategies stuttered
SAY, the Stuttering Association for the Youth, supports children who stutter feel less alone, and feel more self-confident. Stuttering can make a person repeat, or stretch out syllables, and/or become silent in the middle of a word or sentence. As mentioned in the article,” The Incredible Power of Speech”, it’s no surprise that scientists find it difficult to discover a cure for stuttering. The complex production of your voice includes the working together of your body parts. Regardless of the curing process being a hard and an extremely complicated one, according to, “The Incredible Power of Speech”, scientists have managed to pinpoint parts of the brain that control speech.
Evidence-based practice is the Institute of Medicine’s (IOM) third healthcare core competency that focuses on providing patient-centered care (Finkelman & Kenner, 2016). The definition according to the IOM is the combination of the highest research, clinical ability, and patient benefit while providing care to each individual patient (Greiner & Knebel, 2003). By implementing an evidence-based practice, healthcare providers can provide the best practice while abstaining from the “underuse, misuse, and overuse of care” (Greiner & Knebel, 2003, p. 56). Studies have shown evidence-based practice encourages improved healthcare quality, enhanced health results, and decreased care and costs (Melnyk, Gallagher-Ford, Long, & Fineout-Overholt, 2014). Components of Evidence-Based Practice
I don’t know. What I do know – and what I have grappled with over the past several years – is that I was not alone in this struggle. Stuttering can be crippling and it can touch anyone. Over time, I understood that having a stutter isn’t something to conceal, but rather embrace. I was ashamed of being a stutterer, but as I came to
Tourette’s syndrome, discovered by French physician George Grilled de la Tourette in 1885, is an incurable neuropsychiatric disorder that onsets in childhood and is characterized by “the presence of multiple motor tics and one or more vocal tics, not necessarily concurrently, that last longer than one year.” (Cavanna and Shah, 2010) There are two types of tics; motor and phonic (vocal), which may be simple or complex. “Simple motor tics involve isolated muscles, producing movements such as blinking or sniffing. Complex motor tics involve contractions in different muscle groups and coordinated movements that resemble normal motor gestures.”
The model outlines specific steps to a practice question, evaluating, and developing recommendations and implementing practice change. It also has a rating scale to determining the value of evidence for research and non-research data. Unlike ACE, it includes both clinician and patient expertise. The critical appraisal component guides the teaching process of evidence review to students. While it is adaptable to clinical settings, is has little emphasis in the organization cultural
During the first stage of the experiment, the group labeled ‘normal speakers’ were given positive encouragement but the other group was not. The group labeled ‘stutterers’ were made more self-conscious about stuttering. They were lectured about stuttering and told to take extra care not to repeat words. Other teachers and staff at the boarding school they attended were even unknowingly recruited to reinforce the label as the researchers told them the whole group they were stutterers. Of the six 'normal ' children in the stuttering group, five began stuttering after the negative reinforcement therapy.
Keeping an open mind and being transparent when doing a literature search is key in producing a comprehensive and meaningful literature review. Discussion 5: 1) Read “How to search evidence” PowerPoint, and 2) discuss at least 5 things what you learned about searching evidence. Five points learned from the Power Point include: 1. Using professional databases such as PubMEd, CINAHL, Cochrane, EBSCO, etc. is essential in finding reliable, current and valid data. 2.
How does the process of exercise change apply to the stages of changes as identified in the Transtheoretical Model (TTM)? The Transtheoretical Model (TTM): proposes that individuals pass through five main stages as their behavior changes from ‘unhealthy’ to ‘healthy’. In addition to these five stages, the model incorporates 10 social and psychological processes of change which are thought to be important in the transition through the stages. The stages and processes of change are generally presented in pictorial form as a circle to illustrate the proposition that individuals can move backwards as well as forwards through the stages 2.
In 1939, Mary Tudor, graduate student at the University of Iowa, conducted a stuttering experiment under the supervision of psychologist Dr. Wendell Johnson. Johnson wanted to prove his hypothesis that stammering is a learned behaviour rather than the effect of a psychological defect. Performed on 22 orphan children from Davenport, this experiment would later be labelled as the Monster Study, for being one of the most highly unethical studies in history. This paper will outline the details of how the Monster Study was conducted, the ethical issues concerning the experiment and the possible disadvantages and benefits that arose from conducting it. Description of the study Mary Tudor collected 22 orphan children between the age of 5-15 years old, including 10 children who were identified as stutterers and 12 who had no problem with their speech.
According to University College London (UCL) (2011), critical evaluation helps to filter necessary information, identify studies that are applicable clinically and also for continuous professional development (CPD). However, evaluation of an article, is assessed using pre-designed instrument that encourages a more thorough and systematic method; it is designed for different study design and ask specific questions as pertain validity of the study such as: if the study has given an answer to the research question and has met its set aims and objectives, the methodology, analysis and interpretation of findings (Harder, 2014; Burls, 2009; Whiffin and Hasselder, 2013). It could be said that a good critical assessment plays a vital in evidence-based practice. Therefore, a critical appraisal skills programme (CASP, 2009) checklist will be used to evaluate the selected paper for this