Clinical Decision Making in Fluency Disorders

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  • Edition: 3rd
  • Format: Paperback
  • Copyright: 2009-05-08
  • Publisher: Singular
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This thoroughly updated edition provides an expansive discussion of the therapeutic journey to increasing fluency. Humor, creativity, and other effective clinical techniques and principles are presented using a framework of personal experience. Thoroughly discussed are the options and challenges faced by those who stutter and the clinicians who assist them in effectively communicating. Whether you are a student or a clinician, this text will provide you with the tools essential in making stuttering less of a mystery.

Table of Contents

The Clinician and the Therapeutic Process
Chapter Objectives
The Effective Clinician
The Importance of the Clinician
Clinician Attitudes About Stuttering and People Who Stutter
Investigations of Clinical Preparation
How Clinicians Interpret the Disorder
Clinician Personality Attributes
Clinician Intervention Skills
Becoming Less Inhibited as a Clinician
Avoiding Dogmatic Decisions
Opening Your Treatment Focus
Calibrating to the Client
Observing Silence
Modeling Risk Taking
Challenging the Client
Developing Expertise: Implications for Clinicians
Decision Making with Rules and Principles
Specialty Recognition in Fluency Disorders
Humor and the Clinician
An Historical Perspective
Acknowledging Humor During Therapeutic Change
The Conceptual Shift
Distancing With Humor
Mastery and Humor
Topics for Discussion
Recommended Readings
The Nature of Fluent and Nonfluent Speech: The Onset of Stuttering
Chapter Objectives
The Characteristics of Normal Fluency
Fluency in Adult Speakers
Defining Stuttering and Related Terms
Definitions of Stuttering
Distinguishing Stuttering from Normal Fluency Breaks
The Speakers Loss of Control
The Fluency Breaks of Children
Characteristics at the Onset of Stuttering
Age and Gender
Rate and Uniformity of Onset
Stuttering-Like Disfluencies
Clustering of Disfluencies
Awareness and Reaction of the Child to Disfluency
Conditions Contributing to Onset
More Influential Factors
Genetic Factors
Cognitive Abilities
Motor Abilities
Speech and Language Development
Response to Emotional Events
Less Influential Factors
Physical Development and Illness
Culture, Nationality and Socioeconomic Status
Topics for Discussion
Recommended Readings
An Historical Perspective of Etiologies
Chapter Objectives
Stereotypes of People who Stutter
The Variety of the People We See
Theories of Etiology - An Historical Perspective
Stuttering as a Symptom of Repressed Internal Conflict
Evidence from Empirical Investigations
Stuttering as a Learned Anticipatory Struggle
The Diagnosogenic Theory
Evidence from Empirical Investigations
The Continuity Hypothesis
Modes of Stuttering as an Operant Behavior
Evidence from Empirical Investigations
Problems with the Speakers Anatomical and Physiological Systems
The Possibility of Cerebral Asymmetry
Evidence from Empirical Investigations
The Wada Test
Dichotic Listening Procedures
Electroencephalography (EEG) and Event +Related Potentials (ERPs)
Evidence of Cerebral Asymmetry from Neuroimaging Studies
Structural and Functional Neuroimaging
Indications of Structural Differences
Indications of Functional Differences
Changes in Asymmetry as the Result of Fluency-Inducing Activities and Treatment
Summary of Neuroimaging Evidence
Disruption of Cognitive-Linguistic and Motor Sequencing Processes
The Modified Vocalization Hypothesis
Evidence from Empirical Investigations
The Dual Premotor Systems Hypothesis
Evidence from Empirical Investigations
The Covert Repair Hypotheses
Evidence from Empirical Investigations
The Execution and Planning (EXPLAN) Model
Evidence from Empirical Investigations
Cybergenic and Feedback Models
Evidence from Empirical Investigations
Multifactorial Theories
The Demands and Capacities Model
The Dynamic-Multifactorial Model
The Neurophysiological Model
Evidence from the Human Genome
Topics for Discussion
Recommended Readings
The Assessment Process with Adolescents and Adults
Chapter Objectives
Fundamental Considerations
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