Stuttering: An Integrated Approach to Its Nature and Treatment

692 Pages·2013·19.375 MB·English

by  Barry Guitar

STUTTERING
An Integrated Approach to Its Nature and Treatment
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STUTTERING
An Integrated Approach to Its Nature and Treatment
FOURTH EDITION
BARRY GUITAR, PH.D.
Professor Department of Communication Sciences
the University of Vermont
Burlington, Vermont
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CONTENTS
Preface
Acknowledgments
SECTION 1 Nature of Stuttering
1 Introduction to Stuttering
Perspective
Overview of the Disorder
Definitions
The Human Face of Stuttering
Basic Facts about Stuttering and their Implications for the Nature of Stuttering
2 Constitutional Factors in Stuttering
Biological Background
Sensory and Sensory-Motor Factors
Language Factors
Emotional Factors
A Lay Description of Constitutional Factors
3 Research Findings about Constitutional Factors in Stuttering
Hereditary Factors
Congenital and Early Childhood Trauma Studies
Brain Structure and Function
Sensory and Sensory-Motor Studies
Sensory-Motor Control
Language Factors
Emotional Factors
4 Developmental, Environmental, and Learning Factors in Stuttering
Developmental Factors
Environmental Factors
Learning Factors
5 Research Findings on Developmental, Environmental, and Learning
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Factors in Stuttering
Physical and Motor Skill Development
Speech and Language Development
Cognitive Development
Environmental Factors
6 Theories about Stuttering
Theoretical Perspectives about Constitutional Factors in Stuttering
Theoretical Perspectives on Developmental and Environmental Factors
An Integration of Perspectives on Stuttering
7 Normal Disfluency and the Development of Stuttering
Overview
Normal Disfluency
Younger Preschool Children: Borderline Stuttering
Older Preschool Children: Beginning Stuttering
School-Age Children: Intermediate Stuttering
Older Teens and Adults: Advanced Stuttering
SECTION 2 Assessment and Treatment of Stuttering
8 Preliminaries to Assessment
The Client’s Needs
The Client’s Right to Privacy
Cultural Considerations
The Clinician’s Expertise
Assessment of Stuttering Behavior
Assessing Speech Naturalness
Assessing Speaking and Reading Rate
Assessing Feelings and Attitudes
Continuing Assessment
9 Assessment and Diagnosis
Preschool Child
School-Age Child
Adolescents and Adults
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10 Preliminaries to Treatment
Clinician’s Attributes
Clinician’s Beliefs
Treatment Goals
Therapy Procedures
11 Treatment of Stuttering in Younger Preschool Children: Borderline
Stuttering
An Integrated Approach
Other Clinicians
12 Treatment of Stuttering in Older Preschool Children: Beginning
Stuttering
An Integrated Approach
Another Clinician
Treatment of Concomitant Speech and Language Problems
13 Treatment of School-Age Children: Intermediate Stuttering
An Integrated Approach
Other Clinicians
14 Treatment of Stuttering in Adolescents and Adults: Advanced
Stuttering
An Integrated Approach
Other Approaches
15 Related Disorders of Fluency
Neurogenic Acquired Stuttering
Psychogenic Acquired Stuttering
Cluttering
References
Author Index
Subject Index
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Acquisitions Editor: Michael Nobel
Product Manager: Staci Wolfson
Marketing Manager: Shauna Kelley
Designer: Joan Wendt
Artist: Bot Roda
Compositor: SPi Global
4th Edition
Copyright © 2014 Lippincott Williams & Wilkins, a Wolters Kluwer business.
351 West Camden Street Two Commerce Square
Baltimore, MD 21201 2001 Market Street
Philadelphia, PA 19103
Printed in China
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Library of Congress Cataloging-in-Publication Data
Guitar, Barry.
Stuttering : an integrated approach to its nature and treatment / Barry Guitar. — 4th ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-60831-004-3 (pbk.)
I. Title.
[DNLM: 1. Stuttering—diagnosis. 2. Stuttering—etiology. 3. Stuttering—therapy. WM 475.7]
616.85'54—dc23
2012034909
DISCLAIMER
Care has been taken to confirm the accuracy of the information present and to describe generally accepted
practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any
consequences from application of the information in this book and make no warranty, expressed or implied,
with respect to the currency, completeness, or accuracy of the contents of the publication. Application of this
information in a particular situation remains the professional responsibility of the practitioner; the clinical
treatments described and recommended may not be considered absolute and universal recommendations.
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PREFACE
This 4th edition of Stuttering: An Integrated Approach to Its Nature and Treatment contains some major
renovations. As before, I’ve included new research that has been published since the previous edition. Most of
the new studies have been in the areas of (1) constitutional factors and (2) developmental, environmental, and
learning factors. To make this dense material more digestible, I’ve divided each of these areas into a chapter
that gives a broad overview of the research and a chapter that gives the fine details.
The chapters on assessment and treatment have been updated as new material has become available and as
I’ve gained a better understanding of how to assess and treat clients. I think the chapters on treating school-age
children and on treating adolescents and adults are most different from those in the previous edition. My
clinical experiences in these intervening seven years have given me a better sense of how to sequence treatment
and what are crucial experiences for clients.
Finally, I have provided some video clips online at LWW’s thePoint to illustrate our work with a variety of
clients. These, along with new test material and PowerPoint slides, will make this a more complete text from
which to teach.
Comments on the last edition—from students, clinicians, and instructors—have made this edition better. I
look forward to hearing how it works for you.
— Barry Guitar
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ACKNOWLEDGMENTS
Many people have made this book a pleasure to write, especially the individuals who stutter and the students
who have worked with me over the span of 40-something years.
I would also like to thank my publisher, Lippincott Williams & Wilkins, who took a big chance on me and
this text more than 20 years ago. One of their fine staff members, Staci Wolfson, has managed this project from
beginning to end, with encouragement, direction, gentle prodding, and tact. I am most grateful to her. In
addition, I appreciate the support from Mike Nobel, acquisitions editor; Shauna Kelley, marketing manager; Jen
Clements, art director; and Bot Roda, the artist whose fine work you see throughout the book.
As with earlier editions, Rebecca McCauley and Charles Barasch have contributed immensely to this text in
many ways, from editing my chaotic writing to suggesting drawings and ancillary material to providing
organizational ideas. I am indeed obliged to them.
Finally, I wish to thank my wife, Carroll, who has listened patiently to my endless talk of stuttering and who
has also carefully edited every page and chased down every reference, in addition to giving great help with the
video clips.
This edition is dedicated to Cully Gage and the memory of Charles Van Riper.
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