Self-Assessment Questions

This section provides a review. Mark each statement on the Answer Sheet according to the factual materials contained in this issue and the opinions of the authors.

Article One (pp. 67–79)

1. According to studies reviewed in this article, which of the following statements is true regarding brain areas that support speech and language?

   • Brain structures outside of the perisylvian region do not have a role in supporting speech and language.

   • Perisylvian speech and language areas, such as the inferior frontal and superior temporal gyri, tend to develop most rapidly during childhood, compared with other areas in the brain.

   • Each brain area has a special function and supports a specific function that is independent of other brain areas.

   • Previous research suggests that there are no gender differences in the development of brain regions that support speech and language.

   • None of the above is true.

2. Which of the following statements about brain development is true?

   • During the first few years of life, there is a great increase in the number of nerve cells to support proper development

   • Compared with at birth, a child's brain contains many more neurons and much less white matter volume.

   • Brain development can be greatly influenced by environmental stimuli, such as learning and training.

   • Boys tend to experience faster peak growth in most areas of the brain than girls.

   • None of the above is true.

3. Which of the following statements about brain structural measurements obtained with magnetic resonance imaging (MRI) is true?

   • Brain structural measurements can only be obtained in adults but not from children whose brains are still developing.

   • Children who stutter cannot be scanned repeatedly with MRI due to exposure to radiation.

   • Diffusion tensor imaging is a technique that is used to measure gray matter development.

   • Changes in gray matter volume, density, and thickness that reflect brain development and neuroplasticity as a result of training can be examined using MRI.

   • Changes in white and gray matter related to training cannot be measured using MRI.

4. Research examining children who stutter suggests which of the following?

   • The brain responses of children who stutter in the left auditorymotor regions may be different from those of children who do not stutter.

   • Linguistic and prosodic functions are lateralized to the right hemisphere in children who stutter.

   • According to recent research findings, as a group, girls who stutter appear to have more typical connectivity in the auditory-motor regions compared with boys who stutter.

   • Both A and C are true.

   • All of the above are true.

5. Which of the following statements about potential clinical applications of neuroimaging research is false?

   • Neuroimaging methods can be used to examine treatment effects by comparing brain measurements before and after a treatment program.

   • Longitudinal studies that examine brain developmental trajectories in children who stutter have potential to reveal mechanisms of persistence versus recovery, which may aid in prognosis in the future.

   • Results from neuroimaging research can guide brain stimulation research that may seek to enhance neuroplasticity that is conducive to achieving fluent speech.

   • Currently MRI technology can reveal brain structure that predicts whether an individual will persist or recover in stuttering.

   • None of the above is false.

   Article Two (pp. 80–94)

6. This study suggested that significant life events and home environments

   • can predict stuttering severity

   • do not predict stuttering severity

   • could be significant for a child with a reactive temperament but cannot be generalized across all children who stutter

   • B and C

7. According to Goldsmith and colleagues, 4 temperament refers to

   • the emotional predisposition of young children and infants

   • contextually driven behavioral attributes in young children

   • emotionally driven behavioral attributes in young children

   • stable, early appearing differences in behavioral tendencies that have a constitutional basis

8. According to Rothbart and Bates (1998), Effortful Control is

   • part of a large executive system that works in combination with other systems regulating behavior, memory, and cognitive information

   • part of a small cognitive network that regulates temperament

   • the ability to control one's behaviors with a substantial amount of effort

   • directly related to negative affectivity and aggression in young children

9. In this study, poor Effortful Control was significantly correlated with

   • lower stuttering severity ratings

   • higher stuttering severity ratings

   • surgency and extraversion

   • no correlation was evident

10. It is proposed in this study that children who demonstrate high Effortful Control abilities

    • are better able to replace an undesired behavior with a desired behavior

    • can better cope with external stressors

    • can better resource flexibility in speech behaviors

    • all of the above

    Article Three (pp. 95–113)

11. The line of research focusing on the link between phonological factors and their role in fluency breakdown suggests which of the following?

    • Persons who stutter and those who do not are comparable in phonological knowledge and phonological processing abilities.

    • Persons who stutter show a higher propensity for stutter events at specific linguistic loci.

    • Children who stutter show reduced phonemic knowledge compared with those who not stutter.

    • Persons who stutter may be challenged in phonological encoding during speech production.

12. Which of the following tasks has not been used to study phonological encoding abilities in persons who stutter?

    • Rhyme judgment

    • Priming

    • Nonword repetition

    • Phoneme monitoring

    • Phonological processes

13. Which of the following is not a conclusion based on this review?

    • The occurrence of stuttering is influenced by phonological complexity of an utterance.

    • Subgroups of persons who stutter may exhibit poor phonological encoding skills in speech.

    • Children who stutter as a group differ from those who do not in standardized test measures of phonology.

    • Subgroups of children who stutter exhibit dissociations within the different language domains.

    • Studies of nonword repetition reveal the necessity to consider nonword properties in identifying differences between persons who stutter and those who do not.

14. Which of the following is attributed to reduced phonemic encoding efficiency in persons who stutter?

    • Reduced phonemic knowledge

    • Increased phonemic complexity

    • Reduced rhyme judgment abilities

    • Increased errors in speech plan

    • Limited incremental processing

15. Incremental processing in speech production can be defined as processes related to

    • generation of words from ideas

    • generation of individual sound segments and stress information

    • generation of syntactic features of spoken utterances

    • planning of subsequent linguistic units while simultaneously executing ongoing utterances

    • speech motor coordination

16. Which of the following is not relevant to manipulating phonemic complexity?

    • Using early 8, middle 8, and late 8 speech sounds

    • Increasing the occurrence of both bi– (e.g., sk–, st–, pl–, fl–) and trisyllable clusters (e.g., spl–, str–)

    • Varying phonotactic frequency of occurrence of sound combinations

    • Using both words and nonwords

    • Varying word familiarity

17. Which of the following is an implication for treatment from studies of speech (phoneme) monitoring?

    • Persons who stutter may exhibit slower encoding of speech sounds.

    • Treatments that focus on teaching self-monitoring skills may benefit from employing hierarchies of complexity (e.g., monitoring words, phrases, sentences, reading, conversation), thereby allowing for sufficient compartmentalization of resources for incremental processing.

    • Slower monitoring can deplete the availability of cognitive resources for speech planning and production.

    • The time course of encoding may be progressively delayed with increasing length of utterances.

    • Persons who stutter exhibit wordlearning difficulties.

18. Which of the following may not be a direct implication for stuttering treatment based on this review?

    • Incorporating mandatory phonemic knowledge training for all children who stutter

    • Using stimuli varying systematically in phonological complexity

    • Facilitating word learning through increased opportunities for practice

    • Facilitating self-monitoring of speech while facilitating compartmentalization of resources for ongoing planning and production

    • Promoting procedures, such as, chunking, to reduce constraints on incremental planning and to facilitate fluency

    Article Four (pp. 114–131)

19. Temperament can be thought of as

    • a group of related traits or characteristics, such as individual differences in emotional reactivity, emotion regulation, attention, motor activity, among others

    • a singular domain that specifies the magnitude of emotional response an individual has in novel situations

    • an environmentally endowed proclivity toward emotional reactivity and emotion regulation following learned environmental interactions

    • a psychological disorder of young children that influences speech and language development

    • only expressed once an individual reaches adulthood

20. Temperament, emotional reactivity, and emotion regulation are commonly assessed via

    • acoustic measures of linguistic stress

    • caregiver rating and report

    • measures of truthfulness

    • measures of height and weight

    • handwriting samples

21. In general, empirical studies have indicated that preschool-aged children who stutter (CWS), compared with their normally fluent peers, exhibit

    • more age-appropriate temperament during the summer time (when not participating in environmental challenges, i.e., school)

    • more negative affect/emotions

    • greater attention and emotion regulation

    • decreased disfluencies during emotional arousing situations with decreased regulatory behaviors

    • increased disfluencies with decreased negative affect

22. The article tentatively puts forth some clinical implications regarding temperament, emotion, and childhood stuttering. Which of the following is recommended based on “goodness-of-fit”?

    • Standardized treatments are most likely the best fit for all preschoolaged CWS.

    • Emotion regulation, when explicitly trained, decreases preschoolaged CWS' stuttering.

    • Stuttering severity is the most useful tool to use when recommending treatment.

    • Knowledge of temperamental characteristics may help a clinician better tailor therapy to a child's specific needs.

    • Temperament and emotion are related only to treatment outcome, not type of treatment.

23. Based on preliminary data discussed in this article, preschool-aged CWS with more expressive temperaments have been shown to

    • exhibit the greatest long-term decrease in stuttered and total disfluencies as a result of indirect treatment

    • exhibit a long-term increase in nonstuttered disfluencies during direct treatment

    • speak less in all forms of treatment when they become tired, and therefore require shorter more frequent therapy sessions

    • exhibit pragmatic changes in language prior to positive fluencyrelated changes

    • always recover from (“grow out of”) stuttering prior to their inhibited CWS peers

    Article Five (pp. 132–143)

24. Which of the following is true for young people who stutter compared with their fluent peers?

    • The life experiences are the same.

    • Lower levels of adverse impact are seen in young people who stutter.

    • Young people who stutter experience a reduced quality of life.

    • “Zero negative reactions” to speaking are essential for successful therapy outcomes.

    • Stuttering increases quality of life.

25. Frequency of stuttering and quality of life are possibly related in what way?

    • Low frequency of stuttering is related to reduced quality of life.

    • Higher levels of stuttering are related to reduced emotional functioning.

    • Severity of stuttering is not related to quality of life.

    • People with more severe stuttering are more likely to be impaired physically.

    • None of the above is true.

26. According to the sibling study, what is experienced by the sibling dyads with a child who stutters compared with those with exclusively fluent siblings?

    • greater closeness, greater conflict, and greater disparity

    • greater closeness, less conflict, and less disparity

    • greater closeness, greater conflict, and less disparity

    • less closeness, greater conflict, and greater disparity

    • less closeness, less conflict, and less disparity

27. The parenting research compared parents and children who stutter with parents of children who do not stutter and found

    • lower overall parental attachment, lower overall peer attachment

    • lower overall parental attachment, higher perceived parental trust, lower perceived peer communication

    • higher overall parental attachment, higher perceived parental communication, higher overall parental attachment

    • lower overall parental attachment, lower perceived parental trust, higher perceived peer communication

    • higher perceived parental alienation, higher perceived parental communication, lower perceived peer alienation

28. Research including the partners of adults who stutter revealed which of the following to be correct?

    • People who stutter reported more negative reactions to stuttering than their partners.

    • There were differences in the responses of speakers and their partners in terms of quality-oflife responses.

    • People who stutter reported less negative reactions to stuttering than their partners.

    • Partners had difficulty with acceptance of stuttering in their loved one.

    • Partners had difficulty offering support to their loved one who stutters.

29. Which of the following is the central aim of Acceptance and Commitment Therapy?

    • Suppress thoughts and control emotions

    • Promote psychological flexibility

    • Eliminate stuttered speech behaviors

    • Replace negative thoughts with positive ones

    • Engage in positive affirmations

30. Which of the following summarizes the core processes of Acceptance and Commitment Therapy?

    • Self-content, fusion, avoidance, mindfulness, goals, and committed action

    • Self-concept, fusion, acceptance, mindlessness, goals, and committed action

    • Self-content, defusion, avoidance, mindfulness, values, and action

    • Self-concept, illusion, acceptance, mindfulness, values, and committed action

    • Self-concept, defusion, acceptance, mindfulness, values, and committed action

    Article Six (pp. 144–152)

31. Which of the following is true regarding atypical disfluency (wordfinal repetition)?

    • The origin of atypical disfluency has been linked to developmental stuttering.

    • Case studies have documented atypical disfluency among children with autism spectrum disorders, children with acquired neurogenic disorders, and typically developing children with no known disorders.

    • Atypical disfluency is a known feature of autism spectrum disorder.

    • Atypical disfluency has been documented as a restricted repetitive behavior among those with autism spectrum disorder.

32. The child described in this study demonstrated

    • stuttering-like disfluencies accompanied by secondary behavior and emotional reaction

    • stuttering-like disfluencies and atypical disfluencies accompanied by secondary behavior and emotional reaction

    • stuttering-like disfluencies, other disfluencies (OD), and atypical disfluencies with no secondary behavior or emotional reaction

    • stuttering-like disfluencies and atypical disfluencies with no secondary behavior or emotional reaction

33. An important treatment strategy for reduction of atypical disfluency in this case was

    • prolonged speech

    • pullouts

    • easy onset

    • identification

34. In the case described, treatment resulted in all of the following except

    • reduction of speech rate (intended syllables per minute)

    • increased awareness of atypical disfluency

    • reduction of atypical disfluency

    • maintenance at posttreatment evaluations

35. Careful consideration was given to individualized teaching strategies

    • in developing home assignments for the child

    • for teaching the child to selfmonitor

    • when dealing with monologues and off-task behavior

    • appropriate for children who stutter