Stuttering and Related Disorders of Fluency

Stuttering and Related Disorders of Fluency
MedOne Access Information
Title Page
Copyright
Dedication
Contents
Videos
Foreword
Preface
Contributors
Section I: Some Characteristics and Theories
1 Common Characteristics
1.1 Purpose
1.2 Common Characteristics: Definitions of Stuttering, Speech Disfluency Types and Stuttered and Nonstuttered Disfluencies
1.2.1 Definition
1.2.2 Speech Disfluency Types
1.2.3 Stuttered and Nonstuttered Disfluencies
1.3 Common Characteristics: Measures of Stuttering and Associated Variables
1.3.1 Stuttering Frequency
1.3.2 Stuttering Severity
1.3.3 Associated (Non) Speech Behaviors
1.3.4 Speaking Rate and Speech Naturalness
1.4 Common Characteristics: Variability (General Aspects)
1.4.1 Variability
1.4.2 Non-normally Distributed
1.5 Common Characteristics: Variability (Specific Aspects)
1.5.1 Adaptation Effect
1.5.2 After the Effects of Adaptation Have Dissipated
1.5.3 Consistency Effect
1.5.4 Loci of Stuttering
1.6 Other Common Characteristics: Age at Onset, Gender, Persistence, and Recovery from Stuttering
1.6.1 Age at Onset
1.6.2 Gender
1.6.3 Stuttering Persistence and Recovery
1.7 Common Characteristics: Behaviors and Conditions that Decrease Stuttering
1.7.1 Behaviors Associated with Decreases in Stuttering
1.7.2 Conditions Associated with Decreases in Stuttering
1.8 Future Directions
1.9 Conclusion
1.10 Definitions
References
Further Readings
2 Some 20th- and 21st-Century Theories of Stuttering: A Brief Overview
2.1 Introduction
2.2 Humoral System of Medicine
2.3 The Beginnings: Shifting from Humoral to Scientific Approaches
2.4 The 18th and 19th Centuries: Establishment of the Scientific Method
2.5 The 19th and 20th Century: Physiological and Psychological Theories
2.6 The Early to Mid-20th Century: Physiological and Psychosocial Theories
2.6.1 Nature Perspectives
2.6.2 Nurture Perspective
2.7 The Late 20th Century: Learning and Multifactorial Theories
2.7.1 Nurture Perspectives
2.7.2 Nature and Nurture Interaction Perspectives
2.8 Late 20th to Early 21st Century: Prominent Contemporary Theories
2.8.1 Speech-Language Planning Theories
2.8.2 Multifactorial Theories
2.8.3 Computational/Neurocomputational Models
2.9 Further Considerations
2.9.1 Theories of Stuttering Etiology
2.9.2 Antecedents to versus Consequences of Stuttering
2.9.3 The Diagnosis versus the Behavior of Stuttering
2.9.4 Nature, Nurture, and Their Interaction
2.9.5 Different Measurements, Different Results
2.9.6 A Varying Effect, an Unvarying Cause
2.10 Conclusions
2.10.1 Recipes/Ingredients
2.10.2 Divergent Approaches to Same Topic
2.10.3 The Only Certainty is That Nothing is Certain
2.10.4 Facts Are the Foundation
2.11 Definitions
References
Section II: Processes Associated with Stuttering
3 Genetic Processes
3.1 Introduction
3.1.1 Heritability of Stuttering
3.2 Introduction to Basic Genetics
3.2.1 DNA
3.2.2 Chromosomes
3.2.3 Genes
3.2.4 RNA
3.3 Genetic Variation
3.3.1 Chromosomal Abnormalities
3.3.2 Another Variation in the Human Genome: Single Nucleotide Polymorphism (SNP)
3.4 Strategies for Measuring Genetic Variation
3.4.1 Epigenetic Factors in the Expression of DNA
3.5 Transmission Models of Inheritance
3.5.1 Autosomal Dominant Inheritance
3.5.2 Autosomal Recessive Inheritance
3.5.3 Approaches to Mapping Disease Genes: Linkage Analysis
3.5.4 Association Studies
3.6 Genetic Studies of Stuttering
3.6.1 Stuttering Risk: GNPTAB and Lysosomal Transport Genes
3.6.2 DRD2: A Potential Role for Dopamine in Stuttering Risk
3.6.3 AP4E1: Intercellular Trafficking and Stuttering Risk
3.6.4 Hormone Regulation May Explain Biological Sex Differences in Stuttering Risk
3.6.5 Introducing Genetic Mutations into Animal Models of Stuttering
3.7 Sources of Large-Scale Genetic Data from People Who Stutter
3.7.1 The International Stuttering Project
3.7.2 Biobanks
3.7.3 Phenome Wide Association Studies (PheWAS)
3.7.4 Additional Considerations: Analyzing Comorbidities Associated with Stuttering
3.7.5 Summary of Findings from Genetic Studies in Stuttering
3.8 Applying Research Findings to Models and Characteristics of Stuttering
3.8.1 Modeling Polygenic Risk of
3.8.2 Correlations between Stuttering Risk and Related Traits
3.9 Conclusions
Acknowledgments
3.10 Definitions
References
4 Speech, Language, and Cognitive Processes
4.1 Introduction
4.2 Linguistic Constraints on Stuttering
4.3 Speech and Language Abilities and Stuttering
4.3.1 Articulation and Phonology
4.3.2 Vocabulary and Morphosyntax
4.3.3 Summary
4.4 Cognitive Processes and Stuttering
4.4.1 Executive Function
4.4.2 Attention
4.4.3 Summary
4.5 Implications for Theory and Clinical Practice
4.5.1 Theoretical
4.5.2 Diagnostic
4.5.3 Treatment
4.6 Future Directions
4.7 Conclusions
4.8 Definitions
References
Further Readings
5 Neural and Physiological Processes
5.1 Introduction
5.2 Level 1: Perceptual Disfluency
5.3 Level 2: Articulatory, Laryngeal, and Respiratory Dynamics
5.4 Level 3: Neuromuscular Activation
5.5 Level 4: Electrocortical Activation
5.6 Level 5: Brain Regions and Networks
5.6.1 Structural Differences in Brain Regions and Networks of PWS
5.6.2 Functional Differences in Brain Regions and Networks of PWS
5.7 Discussion
5.7.1 Theoretical Implications
5.7.2 Treatment Implications and Future Directions
5.8 Conclusion
5.9 Definitions
References
Further Readings
6 Temperamental and Emotional Processes
6.1 Brief Overview of Temperament and Emotional Processes
6.1.1 Temperament
6.1.2 Measurement of Temperament
6.1.3 Emotion
6.1.4 Role of Temperament and Emotion
6.2 The Association between Temperamental and Emotional Processes and Developmental Stuttering
6.2.1 Differences between People Who Stutter and People Who Do Not Stutter
6.2.2 Association with Stuttering Frequency and Severity
6.2.3 Summary of Empirical Evidence and Takeaways
6.3 Theoretical and Clinical Implications
6.3.1 Directionality of the Effect
6.3.2 Theoretical Implications
6.3.3 Diagnostic Implications
6.3.4 Treatment Implications
6.4 Future Directions
6.5 Conclusions
6.6 Definitions
References
Further Readings
Section III: Diagnosis of Stuttering
7 Preschool-Age Children
7.1 Purpose
7.2 Setting the Stage for Assessing Preschoolers Who Stutter
7.2.1 Multidimensional Assessment of a Multifactorial Disorder
7.3 Preschool Stuttering Assessment: Look, Listen, and Learn
7.3.1 Considering “Risk Factors” for Persistent Stuttering
7.3.2 Assessing the Child
7.3.3 Compiling and Synthesizing Results and Making Recommendations
7.4 Closing the Visit
7.5 Case Studies
7.5.1 Case 1: “M”
7.5.2 Case 2: “J”
7.6 Conclusions
References
Appendix 7.1
Appendix 7.2
Appendix 7.3
Appendix 7.4
8 School-Age Children
8.1 Introduction
8.2 A Framework for Assessing Stuttering in School-Aged Children
8.2.1 School-Age Children and Stuttering
8.2.2 An Assessment Protocol for School-Aged Children Who Stutter
8.3 Case Scenario
8.3.1 Intake Information
8.3.2 Clinical Interview
8.3.3 Clinical Application Questions for the Case Study
8.4 Future Directions
8.5 Conclusion
References
Further Readings
9 Adolescents and Adults
9.1 Introduction
9.1.1 Basic Assumptions
9.1.2 Client Expectations: A Word about Controlled Speech versus Spontaneous Fluency
9.1.3 Impact of Stuttering and What Needs to Change
9.2 A Clinical Definition of Stuttering
9.3 Anticipation: Stuttering Below the Surface
9.4 Measuring the Unobservable and Observable: A Framework for Stuttering Assessment
9.4.1 Impact of Stuttering
9.4.2 Variability Not Frequency of Stuttering
9.4.3 Reframing Overt and Covert Aspects of Stuttering: Technical and Adaptive Challenges
9.5 The Assessment Process
9.5.1 Case History
9.5.2 Diagnostic Interview
9.5.3 Adaptive Measures
9.5.4 Technical Measures
9.5.5 Closing Interview
9.6 Case Study
9.7 Conclusion
9.8 Definitions
References
Further Readings
Appendix 9.1
Section IV: Treatment of Stuttering
10 Preschool-Age Children
10.1 Introduction
10.2 Therapy Approaches for Preschool Children Who Stutter
10.2.1 Palin Parent–Child Interaction Therapy
10.2.2 The Lidcombe Program
10.2.3 Restart-Demands and
Capacities Model Based Treatment
10.3 Discussion
10.4 Conclusions and Future Directions
References
Appendix 10.1
Appendix 10.2
11 School-Age Children
11.1 Introduction
11.2 The Importance of Assessment
11.3 General Considerations for Working with School-Age Children
11.3.1 School-Age Children Who
Stutter Are Still Growing
11.3.2 Stuttering Affects School-Age Children Differently from Preschool Children
11.3.3 School-Age Children Are Not Adolescents or Adults
11.3.4 Stuttering Also Affects
School-Age Children’s Caregivers
Differently
11.4 Comprehensive Treatment for School-Age Children Who Stutter
11.4.1 A Framework for Understanding Stuttering
11.4.2 Selecting Appropriate Treatment Goals
11.4.3 Focusing on Communication Rather than Speech Fluency as a Primary Outcome
11.4.4 The Importance of
Practice-Based Evidence
11.5 Sample Treatment Goals, Procedures, and Activities for School-Age Children Who Stutter
11.5.1 Sample Goals, Procedures, and Activities: Stuttering Impairment
11.5.2 Sample Goals, Procedures, and Activities: Child’s Reactions to Stuttering
11.5.3 Sample Goals, Procedures, and Activities: Environment’s Reactions to Stuttering
11.5.4 Sample Goals, Procedures, and Activities: Activity Limitations and Participation Restrictions
11.6 Discussion
11.7 Future Directions
11.8 Conclusion
11.9 Definitions
References
Further Readings
12 Adolescents and Adults
12.1 Introduction
12.2 What Needs To Be Changed about Stuttering and Who Decides?
12.3 What Contributes to Treatment Outcomes?
12.3.1 The Common Factors
12.3.2 Spotlight on the Client’s Contribution to Therapy Outcomes: Stages of Change
12.4 Getting Started: A Stage-Based Framework for Therapy Planning
12.4.1 Creating the Therapy Plan: Deciding What is Helpful
12.4.2 Implementing the Therapy Plan: Learning the Things that Help
12.5 Selecting Therapy Approaches: Learn to Speak More Fluently or Stutter More Easily
12.5.1 Normal Talking Process
12.5.2 Speak More Fluently
12.5.3 Stutter More Easily
12.5.4 Summary
12.6 Selecting Therapy Approaches: Changing Thoughts and Feelings
12.6.1 Listening and Valuing
12.6.2 Cognitive Behavioral Therapy
12.7 Mindfulness
12.7.1 Acceptance and Commitment Therapy
12.7.2 Solution-Focused Brief Therapy
12.7.3 Narrative Therapy
12.7.4 Bibliotherapy
12.7.5 Self-Help and Support
Organizations
12.8 Selecting Therapy Approaches: Approaching Talking without Avoiding
12.8.1 Avoidance Reduction Therapy for Stuttering
12.8.2 Pseudostuttering
12.8.3 Self-Disclosure
12.8.4 Summary
12.9 Putting it All Together: Two Cases
References
Appendix 12.1 Case Study: Teen
Appendix 12.2 Case Study: Adult
References
Section V: Additional Treatment Considerations
13 Language and Phonological Considerations
13.1 Introduction
13.2 Intervention Principles
13.3 Diagnostic Considerations
13.3.1 A Thorough Evaluation
13.3.2 Differential Diagnosis
13.3.3 Profiles of “Atypical” Disfluency
13.4 Treatment Options
13.4.1 Principles of Evidence-Based Practice and Practice-Based Evidence
13.4.2 Monitoring Outcomes
13.4.3 Therapeutic Approaches
13.4.4 Linguistic Context
13.4.5 Treating Concomitant Stuttering and Phonology
13.4.6 Treating Concomitant Stuttering and Language
13.5 Conclusions
13.6 Definitions
References
Further Readings
14 Bilingual and Multicultural Considerations
14.1 Introduction
Basic Concepts
14.2 Speech, Language, and Fluency in Bilingual Speakers
14.3 Challenges in Identifying Stuttering in Bilingual Speakers
14.3.1 Use of Monolingual Guidelines for Stuttering Assessment
14.3.2 Speech Disfluencies Produced by Bilingual Children Who Do Not Stutter
14.3.3 Misperception of Bilingualism as a Risk Factor for Stuttering
14.3.4 Inconsistency in the Description of Bilingualism
14.3.5 Assumption That Stuttering is Related to Language Dominance
14.4 Culturally and Linguistically Sensitive Assessment of Stuttering
14.4.1 Formal Assessment of Stuttering
14.4.2 Informal Assessment of
Stuttering
14.5 Additional Cultural Considerations
14.5.1 Age and Gender
14.5.2 Conversational Style
14.5.3 Views on the Cause of Stuttering
14.6 Considerations for Intervention
14.7 Conclusion
References
15 Pharmacological Considerations for the Treatment of Stuttering
15.1 Introduction
15.2 Stuttering and the Dopamine Hypothesis
15.3 Stuttering and the “Two-loop” Hypothesis of Speech Output
15.4 Background Pertaining to Pharmacotherapy for Stuttering
15.4.1 Neuropharmacological Impact on Neurotransmitters: Reuptake
15.4.2 Limiting or Controlling the Placebo Effect
15.4.3 Four Phases of Clinical Trials and the Example of Pagoclone
15.5 Medications for Stuttering: A Historical Perspective
15.6 The Effect of Medications Prescribed for Other Conditions on Stuttering
15.6.1 Parkinsonism versus Parkinson’s Disease and “Stuttering”
15.6.2 Schizophrenia, Bipolar Disorder, Major Depressive Disorder, and Stuttering
15.6.3 Anxiety Disorders and Stuttering
15.6.4 Tourette’s Syndrome and Stuttering
15.6.5 Attention Deficit Hyperactivity Disorder and Stuttering
15.6.6 Autoimmune Conditions and Stuttering
15.7 Recreational Drugs and Self-medicating Behaviors and Stuttering
15.8 Future Directions in Pharmacological Options for Adults Who Stutter
15.9 Conclusions
15.10 Definitions
References
Section VI: Related Fluency Disorders
16 Cluttering: Etiology, Symptomatology, Identification, and Treatment
16.1 Introduction
16.1.1 Common Characteristics of Cluttering: Past and Present
16.2 Diagnostic Considerations
16.2.1 Important Background Information
16.2.2 Continuous or Intermittent Rapid or Irregular Speech Rate
16.2.3 Excessive “Normal” Disfluencies
16.2.4 Excessive Moments of
Over-Coarticulation
16.2.5 Atypical Pauses
16.2.6 Co-occurring Symptoms/
Disorders
12.6.7 Patterns of LCD Symptoms
16.3 Cluttering Research: Past and Present
16.4 Treatment Options for Cluttering
16.4.1 Treatment of LCD Symptoms
16.4.2 Improving Self-Regulation
16.4.3 Treatment of Concomitant Symptoms/Disorders
16.4.4 Treatment of Affective and Cognitive Components of Cluttering
16.4.5 Cluttering and the Working Alliance
16.5 Future Directions in Cluttering
16.6 Conclusions
16.7 Definitions
References
Further Readings
17 Acquired Stuttering: Etiology, Symptomatology, Identification, and Treatment
17.1 Introduction
17.1.1 Definition
17.1.2 Subtypes
17.2 Etiology
17.2.1 Acquired Neurogenic Stuttering
17.2.2 Acquired Functional Stuttering
17.3 Symptomatology
17.3.1 Acquired Neurogenic Stuttering
17.3.2 Acquired Functional Stuttering
17.4 Diagnostic Considerations
17.4.1 General Considerations
17.4.2 Assessment Protocol
17.5 Treatment Options
17.5.1 General Considerations
17.5.2 Treatment Approaches
17.6 Case Study
17.6.1 Background
17.6.2 Assessment
17.6.3 Treatment
17.7 Concluding Remarks
Acknowledgments
References
Further Readings
Index
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