Stuttering: An Integrated Approach to Its Nature and Treatment PDF
Preview Stuttering: An Integrated Approach to Its Nature and Treatment
STUTTERING An Integrated Approach to Its Nature and Treatment 2 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 3 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 4 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 5 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 6 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 All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above- mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via e-mail at [email protected], or via Web site at lww.com (products and services). 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. To purchase additional copies of this book, call our customer service department at (800) 638-3030 or fax orders to (301) 223-2320. International customers should call (301) 223-2300. Visit Lippincott Williams & Wilkins on the Internet: http://www.lww.com. Lippincott Williams & Wilkins customer service representatives are available from 8:30 am to 6:00 pm, EST. 9 8 7 6 5 4 3 2 1 7 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 8 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. 9 10
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