Table Of Contentنﺎﺑز ﺖﻨﮑﻟ
ةﺄﺗﺄﺗ
ਿਹਲਾਉਣਾ
(cid:895)(cid:920)(cid:929)
ن ﺎ ﺑ ز ﺖ ﻨ ﮑ ﻟ заикаنнﺎиﺑеز ﺖ ﻨ ﮑ ﻟ نﺎﺑز ﺖﻨﮑﻟ
ة ﺄ ﺗ ﺄ ﺗ �তাতলা ة ﺄ ﺗ ﺄ ﺗ ةﺄﺗﺄﺗ
نﺎﺑز ﺖﻨﮑﻟ
ةﺄﺗﺄਿ ਹﺗਲ ਾ ਉ ਣ ਾ ਿਹਲਾਉਣਾ ਿ ਹ ਲ ਾ ਉ ਣ ਾ ਿਹਲਾਉਣنਾﺎﺑز
ﺖﻨﮑﻟ
(cid:929)
(cid:920) (cid:929)
(cid:895) (cid:920)
(cid:895)
ਿਹਲਾਉਣਾ (cid:895)(cid:920)(cid:929) (cid:895)
(cid:920)(cid:929)ةﺄﺗﺄﺗ
ﺖ ﻨ ﮑ ﻟ з а и к а н и е з а и к а н и е
ن ﺎ ﺑ ز نﺎﺑز(cid:895)(cid:920)ﺖﻨ(cid:929)ﮑﻟ
نﺎﺑز ﺖﻨﮑﻟ نﺎﺑనز�� �ﺖﻨﮑ�ﻟ �� డటం заикаਿਹниਲеਾਉਣਾ نﺎﺑز ﺖﻨﮑﻟ
ة ﺄ ﺗ ﺄ ﺗ заикан� иতеা ত ল া � ত া ত ল া
ةﺄﺗﺄﺗ
(cid:1939)(cid:1879)(cid:1904)
ةﺄﺗﺄﺗ ةﺄﺗﺄﺗ نﺎﺑز ﺖﻨﮑﻟ �তাতলা(cid:895)(cid:920)(cid:929) ةﺄﺗﺄﺗ
ਿ ਹ ਲ ਾ ਉ ਣ ਾ ਿਹਲਾਉ�তਣাতਾ লা ਿ ਹ ਲ ਾ ਉ ਣ ਾ ਿ ਹ ਲ ਾ ਉ ਣ ਾ
ਿਹਲਾਉਣਾ 말더듬ةﺄ기ﺗﺄﺗ ਿਹਲਾਉਣਾ
ਿਹਲਾਉਣਾ
(cid:895) (cid:920) (cid:929) (cid:895)(cid:920)(cid:929) (cid:895) (cid:920) (cid:929) نﺎﺑز ﺖنﻨﺎﮑﺑﻟز ﺖﻨﮑ!ﻟ ணறl (cid:895) (cid:920) (cid:929)ਿਹਲਾਉਣзਾаикание
(cid:895)(cid:920)(cid:929)ਿਹਲਾਉਣਾ ਿਹਲਾਉਣਾ (cid:895)(cid:920)(cid:929)
(cid:895)(cid:920)(cid:929)
з а и к а н и е ззааиик(cid:895)каа(cid:920)ннии(cid:929)نееﺎ ﺑ ز నﺖ�ﻨ� ﮑ�ﻟ �ةﺄﺗ��ﺄﺗడ టةంﺄﺗﺄﺗ заиतкोतаरнपे (cid:895)иणеा(cid:920)(cid:929)ننﺎﺎﺑﺑززన �ﺖﺖ�(cid:895)ﻨﻨ�ﮑﮑ(cid:920)ﻟﻟ�ن(cid:929)ﺎ��ﺑ�তنزడাﺎতటﺖﺑলﻨزంﮑাﻟﺖﻨﮑﻟ ن ﺎ ﺑ ز ﺖ ﻨ ﮑ ﻟ заикаنнﺎиﺑеز ﺖ ﻨ ﮑ ﻟ نﺎﺑز ﺖﻨﮑﻟ
� ত া ত ল া نﺎﺑز ﺖﻨﮑﻟ(cid:1879) (cid:1904)ਿਹਲਾਉਣਾ ਿਹਲਾਉਣਾ ةﺄﺗﺄﺗ (cid:1904) ة ﺄ ﺗ ﺄ ﺗ ة ﺄ ﺗ ﺄ ﺗ ةﺄﺗﺄﺗ
ਿ ਹ(cid:895)ਲ(cid:920)ਾ ਉ(cid:929)ਣ ਾ �ਿ(cid:895)ਹত�তਿਲা(cid:920)ਹতাਾতਲਉ(cid:1939)말నল(cid:929)লਾةਣ�ਉা더(cid:1879)�াﺄਾਣ�듬ﺗ(cid:1904)ਾ ﺄةਿﺗ�ﺄ기ਹ(cid:895)ﺗਲﺄ(cid:920)�ਾ ਉﺗ� (cid:1939)(cid:929)ਣ말డ!ਾ 더టண듬(cid:895)ంற(cid:920)l기(cid:929) (cid:895)за(cid:920)نиﺎк(cid:929)ﺑаزн�ਿиਹতﺖеਲাﻨতnእਾﮑਉলaየﻟ-ਣተা aਾንз�sতተаụাиতባ кলተnਿ(cid:895)аਹsةাበнਿਲụﺄਹ(cid:920)(cid:895)иﺗਾਲਉе(cid:929)ﺄ(cid:920)ਾ(cid:1939)(cid:1939)ਣਉﺗన말(cid:929)ਾਣ!(cid:1879)(cid:1879)�더ਾண� 듬�(cid:1904)றةਿ(cid:895)(cid:895)ਹl기ਿﺄਿਹਲ�(cid:920)ਹﺗة(cid:920)ਾਲﺄਉਲﺄ(cid:929)ﺗਾਣ(cid:929)�ﺗਾਉਉ�ਾﺄਣਣడﺗਾਾBrundageటBernstein RatneంBloodstein Aoنةਿਹﺎﺄਲﺑﺗnਾزﺄਉਿ ਹﺗ(cid:895)ਣ ਲﺖਾ(cid:920)ﻨਾHਉﮑ(cid:929)ਣﻟਾ andboਿ�ਹতਲাoতਾਉলਣা kਾਿ ਹ(cid:895)ਲ(cid:920)ਾ ਉ (cid:929)ਣ ਾ (cid:895)ਿਹ(cid:920)ਲਾ(cid:929)ਉਣਾ
ਿਹਲਾਉਣਾ (cid:895) r (cid:895)(cid:920)(cid:929)
న �� � �న�����!డ(cid:895)ண�ట(cid:920)றం(cid:929)l�� зడаటи ంк аतнो तиरеेप ण ा ਿਹਲਾਉ(cid:895)ਣਾ(cid:920)(cid:929) заизк말ааин더киа듬ен иనзе기�а�и(cid:920)�ка(cid:929)н�иеS�ev�enడth نటﺎంﺑنزﺎS(cid:895)ﺑﺖزﻨ(cid:920)ﮑtﻟﺖ(cid:929)ﻨзﮑuаﻟи к аtн иtе ering з а и к а н и езаиنﺎкﺑаزниﺖеﻨﮑﻟ
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त(cid:3084)ोत(cid:5486)रपेत(cid:5486)(cid:3084)णोत(cid:2796)ा(cid:5486)रेप(cid:5486)णा(cid:2796) !말(cid:1939)ண더(cid:1879)듬ற(cid:1904)l기 (cid:1939)말!እየண더(cid:1879)ተ듬(cid:1904)றንlተ기त(cid:3084)ባोተत(cid:5486)रበपे (cid:5486)ण(cid:2796)ा !तोணतरपे றእన(cid:1939)말णnlየ�ा더(cid:1879)a� ተ�듬-(cid:1904)ንa�ተs기ụባ� ተ� nడበsటụం त(cid:3084)nोaत(cid:5486)-रన(cid:1939)पेaत(cid:5486)(cid:3084)णsो�nत(cid:1879)�(cid:2796)ụाa(cid:5486)र�े प-(cid:1904)n(cid:5486)णas�sा(cid:2796)ụụ �!말n� ணs더డụ듬టறlం기 말!ண더(cid:895)న듬�(cid:920)ற� �l(cid:929)기त(cid:3084)ो�त(cid:5486)रपे (cid:5486)�ण� (cid:2796)ाడ!त(cid:3084)ोటணत(cid:5486)रంपे (cid:5486)றእ(cid:1939)말णnl(cid:2796)የा더(cid:1879)aተ듬-(cid:1904)ንaተs기ụባ ተnበs(cid:3084)nụa(cid:5486)-a(cid:5486)s(cid:2796)ụ nsụ
na-asnụa -nassụụ nsụ (cid:3084)(cid:5486)(cid:5486)(cid:2796) 말더듬 기 तोतरपे णा (cid:1939)(cid:1879)(cid:1904)na-asụ nsụ!ணறl እየተንተባተበ
तोतरपे णा
तोतरपे णा तोतरपे णाna-asụ nsụ!ணறl እየተንተእየባተተንበተባተበ na-asụ nsụ
እየተንተእየባተተንበተባተበ እየተንተባnaተ-በasụ nsụ !ணறl (cid:3084)(cid:5486)(cid:5486)(cid:2796) (cid:3084)(cid:5486)말더(cid:5486)듬(cid:2796)እየ기ተንተባተበ तोतरपे णा
(cid:3084)(cid:5486)(cid:5486)(cid:2796) እየተንተባተበ
(cid:3084)(cid:5486)(cid:5486)(cid:2796) तोतरपे णा
እየተንተባተበ तोतरपे णा na-asụ nsụ na!-aணsụற lnsụ (cid:3084)(cid:5486)(cid:5486)(cid:2796)
na-asụ nsụ na-asụ nsụ (cid:3084)(cid:5486)(cid:5486)(cid:2796)
(cid:3084)(cid:5486)(cid:5486)(cid:2796)እየተንተባተበ እየतተोतንरተपे णባाተበ
na-asụ nsụ
እየተንተባተበ
እየተንተባተበ
na-asụ nsụ
na-asụ nsụ (cid:3084)(cid:5486)(cid:5486)(cid:2796) እየተንተባተበ
እየተንተባተበ
እየተንተባተበ
na-asụ nsụ
እየተንተባተበ
A Handbook on Stuttering
Seventh Edition
A Handbook on Stuttering
Seventh Edition
Oliver Bloodstein
Nan Bernstein Ratner
Shelley B. Brundage
5521 Ruffin Road
San Diego, CA 92123
e-mail: [email protected]
Website: https://www.pluralpublishing.com
Copyright © 2021 by Plural Publishing, Inc.
Typeset in 10/12 Garamond by Flanagan’s Publishing Services, Inc.
Printed in the United States of America by Integrated Books International
All rights, including that of translation, reserved. No part of this publication may be reproduced, stored
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Library of Congress Cataloging-in-Publication Data
Names: Bloodstein, Oliver, author. | Ratner, Nan Bernstein, author. |
Brundage, Shelley B., author.
Title: A handbook of stuttering / Oliver Bloodstein, Nan Bernstein Ratner,
Shelley B. Brundage.
Description: Seventh edition. | San Diego, CA : Plural Publishing, Inc.,
[2021] | Includes bibliographical references and index.
Identifiers: LCCN 2021002993 (print) | LCCN 2021002994 (ebook) | ISBN
9781635503173 (hardcover) | ISBN 1635503175 (hardcover) | ISBN
9781635503180 (ebook)
Subjects: MESH: Stuttering
Classification: LCC RC424 (print) | LCC RC424 (ebook) | NLM WM 475.7 |
DDC 616.85/54--dc23
LC record available at https://lccn.loc.gov/2021002993
LC ebook record available at https://lccn.loc.gov/2021002994
Contents
Foreword vii
Preface ix
About the Authors xi
Reviewers xiii
Acknowledgments xv
Section I. Understanding the Nature of Stuttering
1
Defining and Describing Stuttering 3
2
The Demography of Stuttering: Across the Life Span, Families, and Communities 41
3
Early Childhood Disfluency and Stuttering Onset 85
4
Developmental, Medical, Familial, and Educational History of PWS, and the Social 115
and Vocational Impacts of Stuttering
5
Theories and Models of Stuttering 135
Section II. The Quest for Underlying Mechanisms
6
Central Neurological Findings 171
7
Motor and Sensory Abilities 245
8
Anticipation, Anxiety, and Stuttering 275
9
Personality and Temperament 291
10
Cognitive and Linguistic Abilities 311
Section III. Assessment and Treatment of Stuttering
11
Conditions Under Which Stuttering Fluctuates 349
12
Myths and Mysteries About Stuttering 381
13
Assessment of Stuttering 389
14
Treatment 413
References 477
Index 567
v
Foreword
A Handbook on Stuttering had its origin in 1959 as ing e-mailed Nan only days earlier about research
an 88-page booklet entitled A Handbook on Stutter- issues in stuttering. We hope that those not fortu-
ing for Professional Workers. The National Society nate to have known him will visit a more complete
for Crippled Children and Adults (Easter Seal Soci- description of his life, work, and passions at https://
ety) had called on the American Speech and Hearing www.mnsu.edu/comdis/kuster/pioneers/bloodstein/
Association to prepare a publication on stuttering for bloodsteinobit.html
distribution to physicians. The editor of the associa- As Nan contemplated the next edition, which
tion, Robert West, gave the task to Oliver Bloodstein was being delayed by a variety of issues we discuss
at Brooklyn College, one of the first students of the later in this Foreword, it was clear that, like Oliver,
newly developed field of speech-language pathol- she would need a capable, dedicated, and selfless
ogy, founded at the University of Iowa, and a stu- colleague to join in the effort. Given the advances in
dent of Wendell Johnson. As Bloodstein saw it, his Internet search capacity, it was clear that thousands
task was to provide a brief summary of what we of articles and books would need to be reviewed.
had learned from this research. Unexpectedly, the In some months, more than 100 potentially relevant
booklet soon began to be adopted as a text in uni- publications would be indexed by search engines.
versity courses on stuttering. As a result, the Easter Nan was fortunate enough to find such a talented
Seal Society published an expanded version in 1969 and altruistic colleague in Shelley Brundage. Nan and
that would be more suitable as a textbook. That was Shelley had shared numerous relationships over the
the first edition of A Handbook on Stuttering. As the years (as student–teacher, coauthors, program admin-
research findings grew, new editions appeared. By istrators, and fluency organization board members);
2005, when the sixth edition was contemplated by what united most of these experiences was an abid-
its then publisher (Cengage), Oliver was 85 years old ing interest in the evidence base for what we know
and he asked Nan Bernstein Ratner to undertake the about stuttering and how best to work with people
revision with him. Nan had been inspired to do her who stutter and their families.
master’s thesis (later appearing as Bernstein, 1981) Even as the sixth edition was being prepared,
by one of Oliver’s articles and was thrilled to join in Oliver and Nan knew that some hard decisions were
what was truly a decades-long act of love and sup- on the horizon: as the editions and the research piled
port to the stuttering community. up, so did the page length of the Handbook. The
In doing the sixth edition of the Handbook with sixth edition wound up being more than 550 double-
him, Nan marveled that Oliver had by then completed columned, small-font pages. They discussed remov-
seven versions of this incredible resource before ing unpublished materials, materials without English
computer technology or the Internet; he had literally summaries (Oliver was a polyglot), and small, unrep-
spent thousands of hours in brick-and-mortar librar- licated studies of single cases. This caused Oliver no
ies, poring over journals and theses and writing letters small amount of distress: he knew it was necessary,
and postcards to researchers asking for reprints. Revi- but could not bear to do it. With his typical sense of
sions of the Handbook over the years were hampered humor, he pointed out that Nan could do it the next
by now outdated publishing procedures that made time, “after I’m gone.”
anything but adding material sequentially almost And so we have. But we can’t bear to cut mate-
impossible. Together, Oliver and Nan brought the rial any more than Oliver did. Thus, our thoughtful
sixth edition of the Handbook to press in 2007, and publisher, Plural Publishing, has agreed to provide
Oliver lived long enough to enjoy favorable reviews a link to the old Handbook for purchasers of the
before leaving us behind in 2010. As befit one of new edition. It will host those materials on the Inter-
the founding fathers of American speech-language net so that scholars of the deep history of stuttering
pathology, he passed away on the fourth of July, hav- research will not lack for the thorough coverage of all
vii
viii A Handbook on Stuttering
work, large and small, that Oliver felt merited inclu- undertaken by Nan and Oliver’s son Danny. Searches
sion in prior editions. for a new publisher hit unexpected snarls. We are
Bringing a seventh edition to press on Oliver’s incredibly grateful to Christina Gunning and her col-
typical speedy schedule was unexpectedly compli- leagues at Plural Publishing for agreeing to shepherd
cated by a number of issues. The prior publisher this seventh edition to press. We could not have done
stopped working in the field of communication disor- it without her.
ders and a long process of reassuming copyright was
Preface
In the dozen years that have passed since the last conference presentations, theses, and dissertations)
revision of A Handbook on Stuttering, thousands of and many older references (prior to 1950) that are
new studies of stuttering have been reported. It was not available in English language versions. Those
certainly a large task to tackle this growth in knowl- who will miss these materials should be reassured
edge, and so, now two authors bring you the most that a link will be hosted by the publisher to the last
recent incarnation of the Handbook. edition and to all of those highlighted citations (for
Readers of past editions of the Handbook will easier viewing) that were removed.
find this edition quite differently organized, with In addition, we have removed one chapter and
new and reconceptualized chapters. Some of this was the Appendix. Oliver and Nan shared some common
enabled by changes in publishing; whereas Oliver views of stuttering, but even they disagreed on some
had been limited to making changes more or less issues. Writing a chapter together on “Inferences
in chronological presentation of information, with and Conclusions” was an interesting process in the
new findings appended to older ones, we had more last edition. In the current edition, we have decided
freedom to shuffle content to better position — in our not to include one. We will let the readers of the
opinion, some questions that people tend to want Handbook reach their own. We have also decided
answered before others — and to integrate findings to eliminate the “Treatment Appendix.” The current
across topics and chapters. treatment chapter attempts to provide detail for all
Some chapters are brand new in this edition. Oli- major therapies having current evidentiary support,
ver had never explicitly offered a chapter on assess- in our opinion. Since the last edition, there has been
ment. In our opinion, great strides have been made an explosion of articles on a small set of treatments,
in this area and inform appropriate treatment. As a leading to what we perceive would be an uneven
result, Chapter 13, for the first time in Handbook his- proportion of the Appendix dedicated to somewhat
tory, synthesizes best practices and instruments for overlapping data. It might persuade readers to equate
assessment of stuttering in people who stutter across the number of publications on a particular treatment
the life span. approach with the strength of combined evidence
The Internet has also made tracking citations of across a smaller number of publications. For instance,
the Handbook relatively easy, and so we made note one fairly recent head-to-head trial treated more chil-
of the fact that many fields use the Handbook to find dren than a large number of individual reports on
basic facts about stuttering, as do, in our experience, one of the treatments combined. Thus, we have opted
people who stutter themselves and their families. to contextualize the strengths and weaknesses of
To more concisely address many of the questions currently employed therapies within Chapter 14’s
that many of them bring to reading the Handbook, text. As with other features of the prior edition that
we have now prepared a new chapter on what we will be maintained on the Plural website, the past
call “Myths and Mysteries About Stuttering” to bet- “Treatment Appendix” will still be available for inter-
ter inform different audiences about some lay beliefs ested readers.
about stuttering and its features. Some things we will not change. As always, the
As noted earlier, one thing that has changed in Handbook endeavors to provide the most up-to-date
this edition is that we have removed some material information about stuttering that it can, in as neutral
that Oliver referenced in prior editions, with his con- and unbiased fashion that we can (noting our opin-
sent (discussed before he passed away in 2010). To ions when appropriate), as we were adding refer-
improve the scientific basis for our discussions and to ences up to the point of final copyediting. Advances
be able to add new, high-quality published research to in technology lie at the core of many of the recent
this edition without making it unreasonably long, we themes that have grown incredibly even since the
have removed all nonpublished references (including previous edition, such as genetics and brain imaging.
ix
