Kill Your Stutter Program
A sophomore presented at the university counseling center complaining of stuttering during her speech class. Her next speech, due in three weeks, was to be the longest yet, and she felt terrified. By using guided imagery to recreate the actual event of giving a speech, Jenna was able to explore changes in her anxiety level and automatic thoughts on a moment-to-moment basis, from preparing the speech the night before, to getting up to give the speech, to saying her first words, to starting to stutter, and then to finishing and sitting down again. Most of these cognitions focused on making a fool of herself. To deal with the immediate threat, the upcoming speech, graded exposure through imagery was used to help extinguish her anxiety reaction. Although the speech was not the very best in the class, it was also not the catastrophe she feared. Following this, therapy began to focus more broadly on self-esteem issues that had punished all attempts at self-assertion almost from her earliest...
Single tandem repeat genotyping is accomplished through multiplex PCR reactions designed to amplify up to 16 genetic markers or 32 different allelic targets in a single reaction. Its range of alleles and the presence of 1 bp variants confer high discrimination potential to the system and can be resolved with electrophoresis instrumentation designed for DNA sequencing applications. Several multiplexes configured for forensic application are commercially available and produce electropherograms balanced for intra- and inter-locus signal strength over a variety of forensic sample types. Precision and accuracy in allele calling are achieved on electrophoresis platforms with floating bins through the use of commercially available allelic ladders. A variable and generally small percentage of samples will either experience some random processing anomaly or present a rare but normal feature, both of which will be detected on electro-pherograms. These anomalies (e.g. 'spike', pull-up, saturated...
They have no interest in exploring the implications of a particular concept or developing a line of argument. For this reason, their thought processes are inherently diffuse. Seldom do they focus on any one idea for long. In contrast, avoidants are easily overloaded by external stimulation and may actively interfere with their own cognitive processes as a means of distracting themselves from overwhelming levels of anxiety or fear. Sean's stuttering, even in the safety of the therapy office, is a prime example, as is his inability to concentrate on his programming task knowing its social dimension.
'This is what I see in my dreams about final exams Two monkeys, chained to the floor, sit on the windowsill The sky behind them flutters, The sea is taking its bath. The exam is History of Mankind. I stammer and hedge. One monkey stares and listens with mocking disdain, the other seems to be dreaming away But when it's clear I don't know what to say He prompts me with a gentle Clinking of his chain' (Szymborska 1995). It is the appreciation that monkeys are our closest phylogenetic relatives and share some of our intimate biological secrets, that fuels Szymborska's irony. Among all the species around us, the monkey's brain resembles ours the most. It is there that we often go in search for
As the tension mounts, their speech may become slow and constrained, with noticeable fragments of confused or irrelevant digressions. They may stutter through their lack of confidence, as with the case of Sean (Case 6.2). Because avoidants often feel that others are watching for their gaffes, their body posture may seem stiff and highly controlled, though with periodic bursts of fidgety movements. Overt expressions of emotion are kept in check for fear that others might detect their anxiety, much to their own shame. Inevitably, the feeling of being awkward contributes to their awkwardness. This is especially true of avoidants, for whom every miskeyed movement is scrutinized and judged, or so they believe.
Artifacts such as air bubbles, crystals, and dye blobs, as well as sample contaminants, temperature variations, and voltage spikes, can interfere with consistent band migration. In addition, amplification artifacts occur during PCR. Some polymerases add an additional nontemplate adenine residue to the 3' end of the PCR product. If this 3' nucleotide addition does not include all the amplified products, a mixed set of amplicons will result in extra bands or peaks located very close together. Stutter is another anomaly of PCR amplification, in which the polymerase may miss a repeat during the replication process, resulting in two or more different species in the amplified product. These also appear as extra bands or peaks. Generally, the larger the repeat unit length, the less stutter is observed. These or other aberrant band patterns confuse the analysis software and can result in miscalling of alleles.
One example, particularly sensitive to even quite mild concussion, is the Paced Auditory Serial Addition Test ( PASAT).(1112) Here, the client is read a list of numbers, and as each one is read out so it has to be added to the previous number and the answer spoken aloud ( Table .6). This has to be done quickly or the next number will come along. There are several trials in which the numbers are delivered at a faster and faster pace, from one number every 2.4 s down to every 1.2 s. It sounds easy but in actuality is very demanding even at the slowest speed the average score is only about 70 per cent correct, and this falls away to only about 40 per cent at the fastest speed. Indeed, if a patient has any significant mental slowing, they often cannot do the test at all. Obviously the test cannot be used if the patient has a stammer, or is dysarthric or innumerate.
Dynamic intermittent occlusion is common (stuttering onset). Unstable angina is associated with non-occluding mural thrombus. Transient episodes of myocardial ischemia are caused by platelet emboli from the surface of the exposed mural thrombus impacting in the intramyocardial vascular bed. These microemboli cause microscopic foci of necrosis (Davies .etal 1986).
Fracture of the electrode or extension wiring can cause sudden loss of stimulation, but at times can have a stuttering onset and is usually associated with trauma, such as a motor vehicle accident that produces snapping of the head and neck, which can also move the electrode. In this case, checking the impedance of the electrode, through the telemetry system, will usually show that the electrode impedance has increased, which indicates loss of continuity of the wiring.
The DSM-IV task force considered other refinements to the criteria of social phobia. The parenthetical name 'social anxiety disorder' was added to acknowledge the significant impairment associated with social phobia and its differentiation from specific phobia. The criteria were also modified to include features specific to children 11.) There must be evidence that children are capable of forming social relationships, and anxiety must be evident in peer relationships. It is also acknowledged that children may manifest their anxiety differently than adults they may cry, throw tantrums, freeze, or shrink from interactions with strangers, and they may not acknowledge that their fears are irrational. Also, social anxiety may develop as a result of some medical conditions. For example, persons may become excessively anxious or avoid social situations because of obesity, acne, benign essential tremor, stuttering, or Parkinson's disease. These conditions are not considered exemplars of...
Many patients on haemodialysis develop a progressive dementia beyond that expected from the severity of the uraemia alone. This has been termed 'dialysis dementia'.(89 Progressive encephalopathy, stuttering, dysarthria, dysphasia, impaired memory, depression, suspiciousness, myoclonic jerking, and seizures characterize this syndrome. 'Dialysis dementia' has been found to correlate with high levels of aluminium in the brain tissue of patients and with outbreaks in dialysis units where the water supply was contaminated with excess aluminium concentrations. Because water treatment in the United States now removes aluminium from dialysate water, the incidence of dialysis dementia has markedly diminished.
The review of STR data can be relatively straightforward for pristine, single-source specimens such as those collected from convicted offenders. Still, regardless of sample type, a number of samples will present some anomalous features that may interfere with the final allele call and genotype assignment. Most anomalies (e.g. pull-up, saturated and split peaks, elevated baseline, heterozygote ratio imbalance, elevated stutter, profile slope) will present electrophoretic data signatures that can be recognized by suitably designed algorithms and quality metrics. In fact, automated quantitative assessment of quality metrics is likely to be more efficient at enforcing quality control thresholds than through human review. However, not all qualitative problem scenarios can be anticipated and coded into quality control algorithms intended for automated data review systems. In order to ensure that all anomalous results are scrutinized, the experience of trained analysts must bear on the final...
Speech disorders, such as stuttering, cluttering, and articulation defects, should be noted if they occur, since they may require specialist treatment. A number of psychiatric disorders also produce abnormalities in the form of speech, such as the low volume mumbling of some socially anxious or depressed individuals, the slowness of speech of psychomotor retardation, manic pressure of speech, and the prosodic abnormalities that may occur in some psychotic states or autism. Vocal tics may occur alone or in combination with motor tics.
A simple mixture of two individuals may be evaluated by comparing sizes of the fluorescent peaks of the electropherogram (Clayton et al., 1998). Otherwise, the likelihood ratio can be used (Weir et al., 1997 Evett et al., 1991), calculations based on the fluorescent peak area (Evett et al., 1998) or evaluating PCR stutter (Gill et al., 1998 Ladd et al., 2001).
Stammering Its Cause and Its Cure
This book discusses the futility of curing stammering by common means. It traces various attempts at curing stammering in the past and how wasteful these attempt were, until he discovered a simple program to cure it. The book presents the life of Benjamin Nathaniel Bogue and his struggles with the handicap. Bogue devotes a great deal of text to explain the handicap of stammering, its effects on the body and psychology of the sufferer, and its cure.