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Fluency items on the Praxis 5331 test your ability to differentiate typical disfluency from stuttering, choose age-appropriate intervention (Lidcombe for preschool, stuttering modification for school-age/adults), and counsel on affective/cognitive components.
The diagnostic core of these items is disfluency type, not disfluency count. Stuttering-like disfluencies are part-word repetitions, single-syllable whole-word repetitions, prolongations, and blocks. Typical or 'other' disfluencies are multisyllabic word and phrase repetitions, interjections, revisions, and hesitations. A child producing many revisions and interjections is generally not stuttering; a child producing part-word repetitions with tension likely is.
The commonly cited threshold is three or more stuttering-like disfluencies per 100 syllables, evaluated alongside secondary behaviors, physical tension, and the child's own awareness and reaction. Severity ratings also consider duration of the longest blocks and the presence of escape and avoidance behaviors, which is why a low frequency count can still describe significant stuttering.
Roughly 75 to 80 percent of children who begin stuttering recover without treatment, so risk assessment drives the decision about when to intervene. Factors associated with persistence include a family history of persistent stuttering, male sex, onset after age three and a half, stuttering that has continued longer than six to twelve months, a concomitant speech or language disorder, and strong negative reactions from the child or family.
The exam expects you to weigh those factors rather than adopt a blanket wait-and-see position. A stem describing a four-year-old boy stuttering for a year with a stuttering father and rising frustration is asking you to recommend treatment now, not monitoring.
Fluency shaping modifies the entire speech pattern using easy onsets, light articulatory contacts, continuous phonation, and rate control to produce fluent speech. Stuttering modification, in the Van Riper tradition, accepts stuttering and teaches the speaker to stutter more easily through identification, desensitization, and the cancellation, pull-out, and preparatory set sequence. Most contemporary programs blend both and add cognitive and affective work on avoidance and attitudes.
For preschoolers, the Lidcombe Program uses parent-delivered verbal contingencies in everyday settings and has the strongest evidence base in that age range. For school-age children and adults, the scored answers generally combine fluency techniques with desensitization, self-advocacy, and classroom or workplace accommodations. Answers that instruct the child to slow down, take a breath, or stop and start over are distractors.
Answer one question at a time and get the rationale instantly — just like the real multiple-choice format.
Which disfluency type is most indicative of stuttering rather than typical disfluency?
Try answering before revealing the rationale — mark misses to retry later.
Q1.Which intervention has the strongest evidence for preschool children who stutter?
Correct: C. The Lidcombe Program is the most-researched, evidence-based intervention for preschool children who stutter. It uses parent-delivered contingent verbal feedback in daily 10-15 min sessions.
Q2.A 30-year-old adult client wants to stutter more easily rather than eliminate stuttering. The MOST appropriate approach is:
Correct: B. Stuttering modification (Van Riper) helps the client stutter more easily and openly — matching this client's goal. Fluency shaping targets replacing stuttering with fluent speech patterns.
Q3.Which disfluency type is MOST characteristic of stuttering vs typical disfluency?
Correct: C. Blocks and prolongations are stuttering-like disfluencies. Whole-word repetitions, revisions, and interjections are typical disfluencies and do not distinguish stuttering.
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Is stuttering ever the fault of parents?
No — modern evidence points to neurobiological etiology. Praxis will never endorse blaming the family.
When is Lidcombe not appropriate?
For school-age and older clients who need stuttering modification or a hybrid approach — Lidcombe is preschool-specific.
What is OASES?
The Overall Assessment of the Speaker's Experience of Stuttering — measures affective and cognitive impact, not just observable disfluency.