Evidence-Based Treatment of Stuttering

Empirical Bases and Clinical Applications

Anne K. Bothe

• Publisher: Psychology Press
• Year: 2004
• eBook ISBN: 9781135622244
• Topic: Éducation
• Subtopic: Éducation inclusive

This book is the result of a "State-of-the-Art-Conference" held at the University of Georgia dedicated to the evidence-based treatment of stuttering. An international group of prominent fluency researchers and clinicians were invited to present and discuss current data and issues related to the treatment of stuttering. The topic was defined to include evidence about stuttering, evidence about stuttering treatment, and discussions of how that evidence should guide the continuing research and practice. The explicit link between empirical evidence and suggestions for clinical practice is the goal of the book.


The book begins by addressing the notion of "evidence-based practice" and considers its implications for stuttering treatment. Part II presents the intersection of the nature of stuttering; the theories of stuttering; and the implications of nature, theory, and other knowledge for stuttering treatment decisions. Part III provides two of the many measurement issues facing stuttering treatment followed by Part IV, which is devoted to the quality of treatment research evidence, for specific treatments and in terms of some more general methodological and professional issues. The final part summarizes the clinical recommendations made throughout the book and discusses evidence-based, outcomes-focused clinical decisions for stuttering.


These chapters are intended to provide "state-of-the-art" information to researchers, clinicians, and students who are interested in developing, identifying, or using the best possible evidence-based treatments for stuttering.

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CONCLUSION

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Evidence-Based, Outcomes-Focused Decisions About Stuttering Treatment: Clinical Recommendations in Context

Anne K. Bothe
The University of Georgia

The chapters in this volume touched on some of the many questions and problems currently facing clinicians and researchers interested in stuttering treatment. This chapter summarizes some of the clinical recommendations provided by the chapter authors and then suggests a larger context within which the many remaining questions might be addressed.

SUMMARY OF CLINICAL RECOMMENDATIONS

To begin with, several of the chapters in this volume address the nature of stuttering, or our theories of stuttering, and the influence of that information on treatment. Webster (chap. 2, this volume), for example, reviewed his and others’ neuropsychological research and suggested that successful stuttering treatment should incorporate two factors. First, treatment should require the speaker to pay attention to deliberate speech motor movements, to overcome the deficits in kinesthetically controlled movement that appear to characterize persons who stutter. Second, treatment should work to reduce avoidance, withdrawal, and apprehension, because these changes may reduce right-hemisphere activations that Webster posits as interfering with speech production. Ingham (chap. 3, this volume), in his related review of neuroimaging studies in stuttering, also provides two clinical suggestions, one that is similar to Webster’s and one that may be in conflict. First, Ingham suggests that the neural areas functionally related to stuttering are auditory and motor areas; thus, he suggests that neuroimaging research might support auditory and speech motor production approaches to treatment. In particular, Ingham suggests heightened selfmonitoring of speech production, a recommendation based directly on the apparent role of temporal lobe deactivations in stuttering that may be quite similar to Webster’s call for attention to deliberate speech-motor movements. Th...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• List of Contributors
• Preface
• Acknowledgments
• I Introduction
• II The Nature and Theory of Stuttering: Implications for Evidence-Based Treatment
• III Measurement Issues for Evidence-Based Assessment and Treatment of Stuttering
• IV Stuttering Treatment Research: Evaluating the Available Evidence
• V Conclusion