Clinical Decision Making in Fluency Disorders

by Manning, Walter H.

• ISBN13: 9781418067304
• ISBN10: 141806730X
• Edition: 3rd
• Format: Paperback
• Copyright: 2009-05-08
• Publisher: Singular

Summary

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

Conclusion

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

Age

Gender

Genetic Factors

Twinning

Cognitive Abilities

Motor Abilities

Speech and Language Development

Response to Emotional Events

Less Influential Factors

Physical Development and Illness

Culture, Nationality and Socioeconomic Status

Bilingualism

Imitation

Conclusion

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

Conclusion

Topics for Discussion

Recommended Readings

The Assessment Process with Adolescents and Adults

Chapter Objectives

Fundamental Considerations

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