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Clinical Decision Making in Fluency Disorders

ISBN-10: 0769301169
ISBN-13: 9780769301167
Edition: 2nd 2001 (Revised)
List price: $190.95
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Description: Students and clinicians discover the adventure of fluency disorder diagnosis and treatment in a text that emphasizes the excitement of the assessment-treatment process. Clinical Decision Making in Fluency Disorders details counseling as a central  More...

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Book details

List price: $190.95
Edition: 2nd
Copyright year: 2001
Publisher: Delmar Cengage Learning
Publication date: 11/7/2000
Binding: Paperback
Pages: 560
Size: 6.25" wide x 9.25" long x 1.25" tall
Weight: 1.936
Language: English

Students and clinicians discover the adventure of fluency disorder diagnosis and treatment in a text that emphasizes the excitement of the assessment-treatment process. Clinical Decision Making in Fluency Disorders details counseling as a central aspect of fluency disorders and looks at the facilitation of therapeutic chance. Dealing with client motivation and resistance and matching treatment strategies to client stages of change are other clinical qualities outlined. Emphasis is given to looking at the characteristics of effective clinicians, with a unique nod given to humor as an important variable in the communication disorder treatment process. Specific examples of the decision making process are presented in story form. TEXTBOOK

Walter H. Manning received his PhD from Michigan State University. He is a member of the American Speech-Language Hearing Association, the International Society of Phonetic Sciences, the American Academy of Forensic Sciences and the Tennessee Association of Audiologists and Speech-Language Pathologists. The author of numerous articles Dr. Manning is currently a Professor in the School of Audiology and Speech Language Pathology at the University of Memphis in Tennessee.

Preface
Acknowledgments
Clinician Characteristics
Introduction
The Importance of the Clinician
Clinician Attitudes About Stuttering and People Who Stutter
Specialty Recognition in Fluency Disorders
Educational Activities
Guided Practice
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
Using Silence
Modeling Risk Taking
Challenging the Client
Humor and the Clinician
A Historical Perspective
What's So Funny?
Humor in Psychotherapy
Using Humor in Treatment
The Conceptual Shift
Distancing With Humor
Mastery and Humor
Conclusion
Study Questions
Recommended Readings
Theories of Etiology
Introduction
Attempts to Define Stuttering and Related Terms
Some Definitions of Stuttering
Theories of Etiology--A Historical Perspective
Stuttering From a Physiological Perspective
Theories of Cerebral Dominance
Evidence from Neuroimaging Techniques
Temporal-Processing Abilities
Genetic Influences
Auditory Feedback
The Covert Repair Hypothesis
Stuttering as an Emotional or Psychological Problem
Stuttering as Learned Behavior
Multifactorial Models
The Demands and Capacities Model
The Multifactorial-Dynamic Model
A Neurophysiological Model
A Summary of Models
Conclusion
Study Questions
Recommended Readings
Characteristics of Stuttering Onset and Development
Introduction
Stereotypes of Stuttering and People Who Stutter
Characteristics of Normal Fluency
When Is It Stuttering?
The Features on the Surface
Distinguishing Normal and Abnormal Surface Features
A Sequence of Development?
Conditions Contributing to Onset
Less Influential Factors
Physical Development
Illness
Imitation
Shock or Fright
Emotional and Communicative Conflicts
Socioeconomic Status of the Family
Nationality
More Influential Factors
Sex
Age
Genetic Factors
Twinning
Brain Injury
Speech and Language Development
Motor Coordination
Conclusion
Study Questions
Recommended Readings
Assessing Adolescents and Adults
Introduction
The Variability of Fluency
Surface and Intrinsic Features
Two Basic Principles of Assessment
Assessing Older Speakers
Severity Versus Handicap
The Nonrepresentative Sample of Clients
Assessing Intrinsic Features
Identifying Loss of Control
Testing the Link Between Control and Fluency
Assessing the Speaker's Decision-Making
Mapping the Surface Features of Stuttering
Frequency
Duration and Tension
Fragmentation
Subtle Surface Features
Avoidance
Substitution
Postponement
The Client's Self-Assessment
Determining the Client's Desire for Change
Formal Measures of Severity
Stuttering Severity Instrument (SSI-3)
Modified Erickson Scale of Communication Attitudes (S-24)
Perceptions of Stuttering Inventory (PSI)
Locus of Control of Behavior (LCB)
Self-Efficacy Scaling for Adult Stutterers
The SEA-Scale: Self-Efficacy Scaling for Adolescents Who Stutter
Crowe's Protocols: A Comprehensive Guide to Stuttering Assessment
Assessing Atypical Fluency Problems
Acquired Stuttering
Neurogenic Stuttering
Psychogenic Stuttering
Distinguishing Between Acquired Neurogenic and Psychogenic Stuttering
Cluttering
Spasmodic Dysphonia as a Fluency Disorder?
Conclusion
Study Questions
Recommended Readings
Assessing Fluency Disorders in Children
Preliminaries to Assessment With Children
Determining Whether or Not the Child Is Stuttering
Eliciting Fluency Breaks
The Nature of Fluency Breaks
Indicators of Awareness
Determining a Child's Level of Anxiety About Speaking
Parent Participation in Assessment
Examples of Assessment Measures
The Component Model: One Comprehensive Diagnostic Approach
Determining the Likelihood of Chronicity
Fluency Breaks That Signal Chronicity
Making the Decision to Intervene
(Stream I children who have all five recovery factors)
(Stream I children who have four of five recovery factors)
(Stream II and III children with a score of seven recovery factors)
(Stream II and III children with a score of six or fewer recovery factors)
(Stream IV children with a score of four or fewer recovery factors)
Using At-Risk Registers
Conclusion
Study Questions
Recommended Readings
Facilitating the Change Process
Introduction
The Nature of Change
The Likelihood of Success
Matching Treatment to Client Stages of Change
Precontemplation
Contemplation
Preparation
Action
Maintenance
Processes of Change
Difficulties in Initiating and Maintaining Change
Leading From Behind
The Goals of Treatment
Levels of Fluency
Achieving Spontaneous Fluency
The Importance of Modeling
Variables in Choosing a Treatment
The Timing and Duration of Treatment
The Complexity of Treatment
The Cost of Treatment
The Treatment Setting
Conclusion
Study Questions
Recommended Readings
Counseling Strategies and Techniques
Introduction
Egan's Three-Stage Skilled-Helper Model
How to "Do Counseling"
The Necessity of Counseling
Counseling in Psychology
Counseling in Communication Disorders
Emotions Encountered During Treatment
Counseling Strategies
Behavioral Counseling
Humanistic Counseling
Existential Counseling
Cognitive Counseling
Examples of Counseling Techniques
Nonverbal Behaviors of the Clinician and the Client
Verbal Behaviors
The Content Response
The Counterquestion Response
The Affect Response
The Reframing Response
The Sharing Response
The Affirmation Response
Active-Listening Techniques
Expressing Empathy
Probing the Client
Challenging the Client
Using Humor
Client Responsibilities
Metalinguistic Indicators: Changing How the Client Describes the Problem
Choosing a Future
Clinician Characteristics
Conclusion
Study Questions
Recommended Readings
Treatment for Adolescents and Adults
Introduction
The Special Case of Adolescents
Choosing a Treatment Strategy
Some Specifics of Fluency-Modification Strategies
Some Specifics of Stuttering-Modification Strategies
Identification
Desensitization
Variation
Modification
Stabilization
Cognitive Restructuring
Experimental Treatment
Group Treatment
Determining Group Membership
Advantages of Group Treatment
Potential Problems With Group Activities
The Effective Group Leader
Establishing Group Norms
Structuring Group Activities
Relaxation-Imagery Exercises
Role-Playing
Public Speaking
Demonstration of Client Skills and Progress
Treatment of Atypical Fluency Cases
Acquired Neurogenic Stuttering
Acquired Psychogenic Stuttering
Cluttering
Conclusion
Study Questions
Recommended Readings
Treatment for Preschool and School-Age Children
Introduction
Basic Considerations When Treating Young Children
Indirect and Direct Strategies
The Role of the Parents
Stages of Parent Involvement
Educational Counseling
Facilitating Communicative Interaction
Parents as Observers and Participants
Treatment Strategies and Techniques
Using the Demands and Capacities Model
Enhancing the Child's Ability to Produce Fluent Speech
Helping the Child to Respond to Stuttering
Cognitive and Affective Considerations
Stuttering Coexisting with Other Communication Disorders
Two Effects of Coexisting Problems
Transfer and Termination Issues
The Possibility of Relapse With Children
Suggestions for the Classroom Teacher
The Problem of Teasing
Examples of Fluency Programs
The Successful Stuttering Management Program (SSMP)
Personalized Fluency Control Therapy (PFC)
Extended Length of Utterance (ELU)
CAFET for Kids
Speak More Fluently, Stutter More Fluently
Easy Does It
The Fluency Development System for Young Children (TFDS)
The Stuttering Intervention Program (SIP)
The Fluency Rules Program (FRP)
Gradual Increase in Length and Complexity of Utterance (GILCU)
Systematic Fluency Training for Young Children
Conclusion
Study Questions
Recommended Readings
Indicators of Progress During Treatment
Introduction
Defining Progress
The Variability of Change
Chronic Perseverative Stuttering
Paper-and-Pencil Measures
The Locus of Control of Behavior (LCB)
Self-Efficacy Scaling
The Modified Erickson Scale of Communication Attitudes (S-24)
Asking the Client
The Multidimensional Nature of Therapeutic Change
Variables Influencing Progress
The Treatment Strategy
The Nature of the Fluency Disorder
The Age of the Client
The Intensity of Treatment
Indicators of Progress
Increasing the Client's Self-Monitoring Ability
Increasing the Client's Ability to Produce "Open Speech"
Decreasing the Frequency and Duration of Motoric Fluency Breaks
Increasing the Frequency of Formulative Fluency Breaks
Increasing the Naturalness of Fluent Speech
Development of a Naturalness Rating Scale
The Effect of Feedback
Acoustic Features of Speech Naturalness
The Effect of Speaking Task
Audio and Video Samples
Metalinguistic Changes
Increasing Open Decision-Making
Decreased Avoidance
Increased (Speech) Assertiveness
Increased Risk-Taking
Improved Self-Concept, Improved Self-Esteem, and Role Changes
Increased Distancing and Objectivity Through Humor
Criteria for the Termination of Formal Treatment
Conclusion
Study Questions
Recommended Readings
Determining Progress Following Treatment
Introduction
Our Limited View of Change
Maintenance and Transfer
The Nature of Relapse
The Possibility of Relapse
Defining Relapse
Possible Causes of Relapse
Neurophysiological Loading
Continued Effort Is Required
Client Adjustment to a New Role
Listener Adjustment to a New Speaker
Speaking in a Nonhabitual Manner
Failure to Follow Maintenance Procedures
The Cyclical Nature of Fluency
Overt and Covert Measures of Long-Term Change
Predicting Success Following Treatment
The Importance of Support Groups
Reports of Long-Term Success
Transfer and Maintenance Activities
Conclusion
Study Questions
Recommended Readings
Epilogue
References
Appendices
Annotative Listing of Assessment Procedures
Resources and Support Groups in Fluency Disorders
Useful Booklets and Videotapes for Parents, Teachers, and Spouses
Guidelines for Practice in Stuttering Treatment
Subject Index

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