Ehud Yairi, PhD, CCC-SPL, F-ASHA, is an internationally renowned scholar and an expert on stuttering. A recipient of major grants from the National Institutes of Health, his research and clinical work on many aspects of the disorder throughout the age range, especially in children, had incorporated a wide range of its aspects, including environmental and genetic factors. Dr. Yairi was the first recipient of the Researcher Award of Distinction from the International Fluency Association, is a recipient of the Honors of the Association (the highest award of the American Speech-Language-Hearing Association), the Malcolm Fraser Award for excellence in the field of stuttering from the Stuttering Foundation of America, and many others. He is the author (with Nicoline Ambrose) of Early Childhood Stuttering (2005), as well as of numerous scientific articles.****** Carol Hubbard Seery, PhD, CCC-SLP, is an Emeritus Professor of the Department of Communication Sciences and Disorders at the University of Wisconsin-Milwaukee where she served as Graduate Program Coordinator for about 15 years and then Department Chair for 8 years. Her research primarily focused on areas of psycholinguistic factors in stuttering and fluency, and differential diagnosis of subtypes of stuttering. She has had extensive experiences with the disorder of stuttering in various clinical settings, such as public schools and university clinics, has taught undergraduate and graduate courses on stuttering, was a branch Principal Investigator of an NIH grant, and has published her research in various scientific journals.

• Part I. Nature of Stuttering Chapter 1. What Is Stuttering? Defining Stuttering: Bases and AimsWhy is the Definition Important? Practical ImplicationsPopulation IdentificationQuantification and MeasurementClinical DecisionsWhat to Define: Atypical (Abnormal) Speech or Complex Disorder?Stuttering as Atypical SpeechNormally Fluent Speech ProductionNormal Disfluency or Instances of Stuttering?Speech-Oriented "Definitions"Examples of Stuttering Denoting Speech EventsFluent Speech of People Who StutterStuttering as a Complex DisorderMultidimensional Characteristics of the Stuttering DisorderDisorder-Oriented "Definitions"Examples of Stuttering Denoting Complex DisorderOther Views Our Point of ViewSummaryStudy Questions and Discussion TopicsWebsitesSuggested ReadingsChapter 2. Who and How Many Stutter? Incidence and PrevalenceInterpretation of Incidence and Prevalence DataThe Significance of Incidence and PrevalenceImplications for Research and TheoryImplications for Professional TrainingImplications for Clinical Service DeliveryImplications for Public Awareness and FundingResearch Methodology for Incidence and PrevalenceApproaches to Prevalence ResearchApproaches to Incidence ResearchDefining StutteringSelecting InformantsPrevalence: FindingsEarly InvestigationsLater ResearchIncidence: FindingsBiological Factors in Stuttering Incidence and PrevalenceFamilialityAgeGenderGeography, Race, and CultureGeographyRaceCultureBilingualismPrevalence in Clinical SubpopulationsHearing ImpairmentCleft PalateCognitive ImpairmentOther GroupsSummaryStudy Questions and Discussion TopicsWebsitesSuggested ReadingsChapter 3. When and How Does Stuttering Begin? How Does It Develop?Theoretical and Clinical SignificanceOnsetGeneral Issues and Research MethodsStudies Concerning OnsetWhen Does Stuttering Begin?How Does Stuttering Begin?Features of Early StutteringEmotional and Physical HealthPhonology and LanguageDevelopmentHistorical Perspectives on Developmental ProgressionDifferential Developmental ProgressionsNatural RecoveryThe Statistical EvidenceRetrospective EvidenceIndirect Longitudinal EvidenceDirect Longitudinal EvidenceImplications of Developmental FindingsPredictive FactorsSummaryOnsetDevelopmentStudy Questions and Discussion TopicsSuggested ReadingsChapter 4. Where Does Stuttering End? What Are Its Advanced Characteristics?Advanced StutteringSpeech DisfluencyTypes of DisfluencyMajor Disfluency ClassesDimensions of DisfluencyPhysical ConcomitantsOther Speech CharacteristicsVoiceSpeaking RateEmotional Characteristics and CognitionEmotional ReactionsCognitionConcomitant DisordersThe Dynamics of Advanced StutteringPatterns of OccurrenceLoci of StutteringConditions That Diminish StutteringConditions That Increase StutteringSummaryStudy Questions and Discussion TopicsSuggested ReadingsPart II. Explanations of Stuttering Chapter 5. Why Do People Stutter? Evaluating Theories and ModelsTheories and ModelsHow to Analyze a Stuttering TheoryScience, Superstition, and Stories About StutteringThe Need for an Integrated FrameworkCriteria for Strong Theories and ModelsTesting Theories and ModelsAre There Stuttering Subtypes?SummaryStudy Questions and Discussion TopicsSuggested ReadingsChapter 6. Is Stuttering Psychological? Theories and InvestigationsIs Stuttering Psychological?Psychoemotional TheoriesPsychoanalytic TheoryAlternative Views of Psychoemotional DisturbancePersonality Factors in StutteringSummary of Psychoemotional TheoriesPsychobehavioral TheoriesStuttering as a Reactive Avoidance BehaviorStuttering as a Conditioned Anxiety ResponseStuttering as an Operant BehaviorTwo-Factor Theory of StutteringThe Demands-Capacities ModelSummary of Psychobehavioral TheoriesPsycholinguistic TheoriesPsycholinguistic Processes Resulting in Fluent SpeechPsycholinguistic Factors in StutteringA Theory of Covert-Repair?The Fault Line HypothesisRelated Areas of ResearchSummary of Psycholinguistic TheoriesSummaryStudy Questions and Discussion TopicsSuggested ReadingsChapter 7. Is Stuttering Biological? Theories and InvestigationsIntroductionGenetic PerspectivesFamilial IncidenceTwin StudiesFamily AggregationBiological GeneticsNeurological PerspectivesCerebral Hemispheric DominanceThe Modern Era of Brain and Other Neurological ResearchSummary of Neurological PerspectivesAuditory PerspectivesThe Role of AuditionSummary of Auditory PerspectivesPhysiological and Motor PerspectivesMotor Learning Theories of StutteringBrainstem Reflexes: A Disorder of MovementSensorimotor DysfunctionMultifactorial Theory from a Motor PerspectiveEvidence of Motor DifferencesSummary of Physiological and Motor PerspectivesSummaryStudy Questions and Discussion TopicsSuggested ReadingsPart III. Clinical Management of Stuttering Chapter 8. Assessment of Adults and School-Age Children General ConsiderationsAssessment of StutteringSpecial Considerations for School-Age ChildrenAssessment ObjectivesBackground and Case HistoryObservations and Examinations: SpeechSpeech Sample ContextSpeech Sample SizeMeasures of Stuttering or DisfluencySpeech Recordings and TranscriptionProcedures for Speech Sample AnalysisDisfluency Reference DataSeverity of Stuttered SpeechPhysical ConcomitantSpeaking RatesVoice and Other Communication SkillsAffective and Cognitive DomainsSituational Rating ProtocolsAttitude Rating ScalesInterpretations and Treatment RecommendationsDiagnosisTreatment RecommendationsThe Diagnostic ReportSummaryStudy Questions and Discussion TopicsSuggested ReadingsChapter 9. Assessment of Preschool-Age ChildrenChallenges, Objectives, and Settings for the Initial EvaluationStuttering versus Normal Disfluency: A Diagnostic ChallengeOther Key Diagnostic IssuesObjectives of the Initial EvaluationSetting and PreparationThe Case HistoryCase History Form: Preschool ChildrenCollecting Clinical DataObtaining Speech SamplesOther Related AssessmentsAnalyzing Clinical DataDisfluency Frequency and TypesDisfluency LengthSpeech RateInterpreting Clinical DataDisfluency StatusStuttering SeverityBorderline CasesMaking PrognosisThe Illinois Prediction CriteriaConcluding Parent ConferenceDiagnosis, Prognosis, and RecommendationsParent CounselingSummaryStudy Questions and Discussion TopicsSuggested ReadingsChapter 10. Stuttering Therapy Overview: Issues and Directions IntroductionTheoretical ConsiderationsThe Objectives of TherapyIncreased FluencyManaged StutteringImproved Cognitive-Emotional AdjustmentGeneral Therapeutic ApproachesThe Client-Clinician RelationshipEmpathySelf-CongruenceUnconditional Positive RegardClinical ApplicationsDeveloping Appropriate Treatment ObjectivesIndividual Versus Group Therapy SessionsImplementing TreatmentSkill Maintenance and Prevention of RelapseEvidence-Based PracticeA Case Study to Illustrate the Steps in EBPClinical ResearchEvaluating EfficacyGroup StudiesSingle-Subject StudiesIssues Regarding Clinical EfficacyEthicsQuestions Concerning EthicsSummaryStudy Questions and Discussion TopicsSuggested ReadingsChapter 11. Therapy for Adults: Focus on Emotional Reactions Adults Who StutterTreatmentsPsychotherapy and RelaxationPsychoanalysisRational-Emotive TherapyRelaxationSummary of Psychotherapy and RelaxationDesensitizationSystematic DesensitizationDesensitization in VivoDesensitization to Stuttered SpeechDesensitization to ListenersSummary of DesensitizationMindfulness Therapy; Acceptance and Commitment TherapyAssertiveness Training and Group TherapyAssertiveness TrainingGroup TherapySummary of Assertiveness Training and Group TherapyAntianxiety DrugsWhy Drugs?Drugs for What?Studies of Pharmaceutical Treatments for StutteringSummary of Antianxiety DrugsSummaryStudy Questions and Discussion TopicsWebsitesSuggested ReadingsChapter 12. Therapy for Adults: Focus on Stuttering and Fluency IntroductionIdentificationRationalePhase I: AwarenessPhase II: AnalysisSummary of IdentificationModificationStep I: Post-Block ModificationStep II: In-Block ModificationStep III: Pre-Block ModificationSummary of ModificationFluency Oriented TherapiesFluency-Focused Therapy BasicsRhythmic SpeechSlow Stretched SpeechBehavioral ReinforcementSummary of Fluency-Focused TherapiesFluency-Inducing InstrumentsMetronome Pacing of SpeechAuditory MaskingAltered Auditory FeedbackBiofeedbackSummary of Fluency-Inducing InstrumentsIntegrated ApproachesInternet, Mass Media-Based and TeletherapySummaryStudy Questions and Discussion TopicsSuggested ReadingsChapter 13. Therapy for School-Age Children School-Age Children Who StutterAwareness and Emotional ReactionsOvert StutteringAcademic PerformanceThe School and Home FactorsThe Age FactorPrognosis and Objectives for TherapyWhy Is Stuttering in School-Age Children Difficult to Treat?Therapy Alternatives and ObjectivesHome and School EnvironmentsCounseling ParentsTeachers and PeersTherapy: Explaining StutteringThe Speech SystemWhat Can Go Wrong with the Speech System?ExperimentationTherapy: Focus on Emotional ReactionsAdapted Desensitization ActivitiesAssertiveness, Resilience, TeasingBullyingTherapy: Focus on Stuttering and FluencyIdentification and AnalysisChanging SpeechStuttering ModificationFluency Facilitating Speaking SkillsGeneralizationOther Therapy ProgramsConditioning Fluent SpeechFamily Stuttering ProgramsGroup TherapyClinical ResearchSummaryStudy Questions and Discussion TopicsWebsitesSuggested ReadingsChapter 14. Therapy for Preschool-Age Children General ConsiderationsA Brief Historical ReviewDirect TreatmentsIndirect TreatmentsWinds of ChangeCurrent Issues Concerning Early InterventionFactors Pertaining to StutteringFactors Pertaining to AgeWho Should Be Treated? When?Current TherapiesFocus on Learning PrinciplesFocus on Parent-Child InteractionFocus on Speech/Motor PatternsFocus on EmotionalityClinical ResearchPast and Current ResearchWeaknesses and Other Issues in ResearchGeneral ReflectionsSummaryStudy Questions and Discussion TopicsWebsitesSuggested ReadingsChapter 15. Other Fluency Disorders; Cultural and Bilingual IssuesIntroductionChildhood DisordersUnusual Breathing PatternsWord-Final DisfluencyLanguage DisordersClutteringAcquired StutteringNeurogenic StutteringPsychogenic StutteringMalingeringStuttering in Bilingual and Multicultural PopulationsIncidenceDiagnosisTreatmentSummaryStudy Questions and Discussion TopicsWebsitesSuggested ReadingsReferencesIndex

Ehud Yairi, PhD, CCC-SPL, F-ASHA, is an internationally renowned scholar and an expert on stuttering. A recipient of major grants from the National Institutes of Health, his research and clinical work on many aspects of the disorder throughout the age range, especially in children, had incorporated a wide range of its aspects, including environmental and genetic factors. Dr. Yairi was the first recipient of the Researcher Award of Distinction from the International Fluency Association, is a recipient of the Honors of the Association (the highest award of the American Speech-Language-Hearing Association), the Malcolm Fraser Award for excellence in the field of stuttering from the Stuttering Foundation of America, and many others. He is the author (with Nicoline Ambrose) of Early Childhood Stuttering (2005), as well as of numerous scientific articles.****** Carol Hubbard Seery, PhD, CCC-SLP, is an Emeritus Professor of the Department of Communication Sciences and Disorders at the University of Wisconsin-Milwaukee where she served as Graduate Program Coordinator for about 15 years and then Department Chair for 8 years. Her research primarily focused on areas of psycholinguistic factors in stuttering and fluency, and differential diagnosis of subtypes of stuttering. She has had extensive experiences with the disorder of stuttering in various clinical settings, such as public schools and university clinics, has taught undergraduate and graduate courses on stuttering, was a branch Principal Investigator of an NIH grant, and has published her research in various scientific journals.

• Part I. Nature of Stuttering Chapter 1. What Is Stuttering? Defining Stuttering: Bases and AimsWhy is the Definition Important? Practical ImplicationsPopulation IdentificationQuantification and MeasurementClinical DecisionsWhat to Define: Atypical (Abnormal) Speech or Complex Disorder?Stuttering as Atypical SpeechNormally Fluent Speech ProductionNormal Disfluency or Instances of Stuttering?Speech-Oriented "Definitions"Examples of Stuttering Denoting Speech EventsFluent Speech of People Who StutterStuttering as a Complex DisorderMultidimensional Characteristics of the Stuttering DisorderDisorder-Oriented "Definitions"Examples of Stuttering Denoting Complex DisorderOther Views Our Point of ViewSummaryStudy Questions and Discussion TopicsWebsitesSuggested ReadingsChapter 2. Who and How Many Stutter? Incidence and PrevalenceInterpretation of Incidence and Prevalence DataThe Significance of Incidence and PrevalenceImplications for Research and TheoryImplications for Professional TrainingImplications for Clinical Service DeliveryImplications for Public Awareness and FundingResearch Methodology for Incidence and PrevalenceApproaches to Prevalence ResearchApproaches to Incidence ResearchDefining StutteringSelecting InformantsPrevalence: FindingsEarly InvestigationsLater ResearchIncidence: FindingsBiological Factors in Stuttering Incidence and PrevalenceFamilialityAgeGenderGeography, Race, and CultureGeographyRaceCultureBilingualismPrevalence in Clinical SubpopulationsHearing ImpairmentCleft PalateCognitive ImpairmentOther GroupsSummaryStudy Questions and Discussion TopicsWebsitesSuggested ReadingsChapter 3. When and How Does Stuttering Begin? How Does It Develop?Theoretical and Clinical SignificanceOnsetGeneral Issues and Research MethodsStudies Concerning OnsetWhen Does Stuttering Begin?How Does Stuttering Begin?Features of Early StutteringEmotional and Physical HealthPhonology and LanguageDevelopmentHistorical Perspectives on Developmental ProgressionDifferential Developmental ProgressionsNatural RecoveryThe Statistical EvidenceRetrospective EvidenceIndirect Longitudinal EvidenceDirect Longitudinal EvidenceImplications of Developmental FindingsPredictive FactorsSummaryOnsetDevelopmentStudy Questions and Discussion TopicsSuggested ReadingsChapter 4. Where Does Stuttering End? What Are Its Advanced Characteristics?Advanced StutteringSpeech DisfluencyTypes of DisfluencyMajor Disfluency ClassesDimensions of DisfluencyPhysical ConcomitantsOther Speech CharacteristicsVoiceSpeaking RateEmotional Characteristics and CognitionEmotional ReactionsCognitionConcomitant DisordersThe Dynamics of Advanced StutteringPatterns of OccurrenceLoci of StutteringConditions That Diminish StutteringConditions That Increase StutteringSummaryStudy Questions and Discussion TopicsSuggested ReadingsPart II. Explanations of Stuttering Chapter 5. Why Do People Stutter? Evaluating Theories and ModelsTheories and ModelsHow to Analyze a Stuttering TheoryScience, Superstition, and Stories About StutteringThe Need for an Integrated FrameworkCriteria for Strong Theories and ModelsTesting Theories and ModelsAre There Stuttering Subtypes?SummaryStudy Questions and Discussion TopicsSuggested ReadingsChapter 6. Is Stuttering Psychological? Theories and InvestigationsIs Stuttering Psychological?Psychoemotional TheoriesPsychoanalytic TheoryAlternative Views of Psychoemotional DisturbancePersonality Factors in StutteringSummary of Psychoemotional TheoriesPsychobehavioral TheoriesStuttering as a Reactive Avoidance BehaviorStuttering as a Conditioned Anxiety ResponseStuttering as an Operant BehaviorTwo-Factor Theory of StutteringThe Demands-Capacities ModelSummary of Psychobehavioral TheoriesPsycholinguistic TheoriesPsycholinguistic Processes Resulting in Fluent SpeechPsycholinguistic Factors in StutteringA Theory of Covert-Repair?The Fault Line HypothesisRelated Areas of ResearchSummary of Psycholinguistic TheoriesSummaryStudy Questions and Discussion TopicsSuggested ReadingsChapter 7. Is Stuttering Biological? Theories and InvestigationsIntroductionGenetic PerspectivesFamilial IncidenceTwin StudiesFamily AggregationBiological GeneticsNeurological PerspectivesCerebral Hemispheric DominanceThe Modern Era of Brain and Other Neurological ResearchSummary of Neurological PerspectivesAuditory PerspectivesThe Role of AuditionSummary of Auditory PerspectivesPhysiological and Motor PerspectivesMotor Learning Theories of StutteringBrainstem Reflexes: A Disorder of MovementSensorimotor DysfunctionMultifactorial Theory from a Motor PerspectiveEvidence of Motor DifferencesSummary of Physiological and Motor PerspectivesSummaryStudy Questions and Discussion TopicsSuggested ReadingsPart III. Clinical Management of Stuttering Chapter 8. Assessment of Adults and School-Age Children General ConsiderationsAssessment of StutteringSpecial Considerations for School-Age ChildrenAssessment ObjectivesBackground and Case HistoryObservations and Examinations: SpeechSpeech Sample ContextSpeech Sample SizeMeasures of Stuttering or DisfluencySpeech Recordings and TranscriptionProcedures for Speech Sample AnalysisDisfluency Reference DataSeverity of Stuttered SpeechPhysical ConcomitantSpeaking RatesVoice and Other Communication SkillsAffective and Cognitive DomainsSituational Rating ProtocolsAttitude Rating ScalesInterpretations and Treatment RecommendationsDiagnosisTreatment RecommendationsThe Diagnostic ReportSummaryStudy Questions and Discussion TopicsSuggested ReadingsChapter 9. Assessment of Preschool-Age ChildrenChallenges, Objectives, and Settings for the Initial EvaluationStuttering versus Normal Disfluency: A Diagnostic ChallengeOther Key Diagnostic IssuesObjectives of the Initial EvaluationSetting and PreparationThe Case HistoryCase History Form: Preschool ChildrenCollecting Clinical DataObtaining Speech SamplesOther Related AssessmentsAnalyzing Clinical DataDisfluency Frequency and TypesDisfluency LengthSpeech RateInterpreting Clinical DataDisfluency StatusStuttering SeverityBorderline CasesMaking PrognosisThe Illinois Prediction CriteriaConcluding Parent ConferenceDiagnosis, Prognosis, and RecommendationsParent CounselingSummaryStudy Questions and Discussion TopicsSuggested ReadingsChapter 10. Stuttering Therapy Overview: Issues and Directions IntroductionTheoretical ConsiderationsThe Objectives of TherapyIncreased FluencyManaged StutteringImproved Cognitive-Emotional AdjustmentGeneral Therapeutic ApproachesThe Client-Clinician RelationshipEmpathySelf-CongruenceUnconditional Positive RegardClinical ApplicationsDeveloping Appropriate Treatment ObjectivesIndividual Versus Group Therapy SessionsImplementing TreatmentSkill Maintenance and Prevention of RelapseEvidence-Based PracticeA Case Study to Illustrate the Steps in EBPClinical ResearchEvaluating EfficacyGroup StudiesSingle-Subject StudiesIssues Regarding Clinical EfficacyEthicsQuestions Concerning EthicsSummaryStudy Questions and Discussion TopicsSuggested ReadingsChapter 11. Therapy for Adults: Focus on Emotional Reactions Adults Who StutterTreatmentsPsychotherapy and RelaxationPsychoanalysisRational-Emotive TherapyRelaxationSummary of Psychotherapy and RelaxationDesensitizationSystematic DesensitizationDesensitization in VivoDesensitization to Stuttered SpeechDesensitization to ListenersSummary of DesensitizationMindfulness Therapy; Acceptance and Commitment TherapyAssertiveness Training and Group TherapyAssertiveness TrainingGroup TherapySummary of Assertiveness Training and Group TherapyAntianxiety DrugsWhy Drugs?Drugs for What?Studies of Pharmaceutical Treatments for StutteringSummary of Antianxiety DrugsSummaryStudy Questions and Discussion TopicsWebsitesSuggested ReadingsChapter 12. Therapy for Adults: Focus on Stuttering and Fluency IntroductionIdentificationRationalePhase I: AwarenessPhase II: AnalysisSummary of IdentificationModificationStep I: Post-Block ModificationStep II: In-Block ModificationStep III: Pre-Block ModificationSummary of ModificationFluency Oriented TherapiesFluency-Focused Therapy BasicsRhythmic SpeechSlow Stretched SpeechBehavioral ReinforcementSummary of Fluency-Focused TherapiesFluency-Inducing InstrumentsMetronome Pacing of SpeechAuditory MaskingAltered Auditory FeedbackBiofeedbackSummary of Fluency-Inducing InstrumentsIntegrated ApproachesInternet, Mass Media-Based and TeletherapySummaryStudy Questions and Discussion TopicsSuggested ReadingsChapter 13. Therapy for School-Age Children School-Age Children Who StutterAwareness and Emotional ReactionsOvert StutteringAcademic PerformanceThe School and Home FactorsThe Age FactorPrognosis and Objectives for TherapyWhy Is Stuttering in School-Age Children Difficult to Treat?Therapy Alternatives and ObjectivesHome and School EnvironmentsCounseling ParentsTeachers and PeersTherapy: Explaining StutteringThe Speech SystemWhat Can Go Wrong with the Speech System?ExperimentationTherapy: Focus on Emotional ReactionsAdapted Desensitization ActivitiesAssertiveness, Resilience, TeasingBullyingTherapy: Focus on Stuttering and FluencyIdentification and AnalysisChanging SpeechStuttering ModificationFluency Facilitating Speaking SkillsGeneralizationOther Therapy ProgramsConditioning Fluent SpeechFamily Stuttering ProgramsGroup TherapyClinical ResearchSummaryStudy Questions and Discussion TopicsWebsitesSuggested ReadingsChapter 14. Therapy for Preschool-Age Children General ConsiderationsA Brief Historical ReviewDirect TreatmentsIndirect TreatmentsWinds of ChangeCurrent Issues Concerning Early InterventionFactors Pertaining to StutteringFactors Pertaining to AgeWho Should Be Treated? When?Current TherapiesFocus on Learning PrinciplesFocus on Parent-Child InteractionFocus on Speech/Motor PatternsFocus on EmotionalityClinical ResearchPast and Current ResearchWeaknesses and Other Issues in ResearchGeneral ReflectionsSummaryStudy Questions and Discussion TopicsWebsitesSuggested ReadingsChapter 15. Other Fluency Disorders; Cultural and Bilingual IssuesIntroductionChildhood DisordersUnusual Breathing PatternsWord-Final DisfluencyLanguage DisordersClutteringAcquired StutteringNeurogenic StutteringPsychogenic StutteringMalingeringStuttering in Bilingual and Multicultural PopulationsIncidenceDiagnosisTreatmentSummaryStudy Questions and Discussion TopicsWebsitesSuggested ReadingsReferencesIndex

Ehud Yairi, PhD, CCC-SPL, F-ASHA, is an internationally renowned scholar and an expert on stuttering. A recipient of major grants from the National Institutes of Health, his research and clinical work on many aspects of the disorder throughout the age range, especially in children, had incorporated a wide range of its aspects, including environmental and genetic factors. Dr. Yairi was the first recipient of the Researcher Award of Distinction from the International Fluency Association, is a recipient of the Honors of the Association (the highest award of the American Speech-Language-Hearing Association), the Malcolm Fraser Award for excellence in the field of stuttering from the Stuttering Foundation of America, and many others. He is the author (with Nicoline Ambrose) of Early Childhood Stuttering (2005), as well as of numerous scientific articles.****** Carol Hubbard Seery, PhD, CCC-SLP, is an Emeritus Professor of the Department of Communication Sciences and Disorders at the University of Wisconsin-Milwaukee where she served as Graduate Program Coordinator for about 15 years and then Department Chair for 8 years. Her research primarily focused on areas of psycholinguistic factors in stuttering and fluency, and differential diagnosis of subtypes of stuttering. She has had extensive experiences with the disorder of stuttering in various clinical settings, such as public schools and university clinics, has taught undergraduate and graduate courses on stuttering, was a branch Principal Investigator of an NIH grant, and has published her research in various scientific journals.

• Part I. Nature of Stuttering Chapter 1. What Is Stuttering? Defining Stuttering: Bases and AimsWhy is the Definition Important? Practical ImplicationsPopulation IdentificationQuantification and MeasurementClinical DecisionsWhat to Define: Atypical (Abnormal) Speech or Complex Disorder?Stuttering as Atypical SpeechNormally Fluent Speech ProductionNormal Disfluency or Instances of Stuttering?Speech-Oriented "Definitions"Examples of Stuttering Denoting Speech EventsFluent Speech of People Who StutterStuttering as a Complex DisorderMultidimensional Characteristics of the Stuttering DisorderDisorder-Oriented "Definitions"Examples of Stuttering Denoting Complex DisorderOther Views Our Point of ViewSummaryStudy Questions and Discussion TopicsWebsitesSuggested ReadingsChapter 2. Who and How Many Stutter? Incidence and PrevalenceInterpretation of Incidence and Prevalence DataThe Significance of Incidence and PrevalenceImplications for Research and TheoryImplications for Professional TrainingImplications for Clinical Service DeliveryImplications for Public Awareness and FundingResearch Methodology for Incidence and PrevalenceApproaches to Prevalence ResearchApproaches to Incidence ResearchDefining StutteringSelecting InformantsPrevalence: FindingsEarly InvestigationsLater ResearchIncidence: FindingsBiological Factors in Stuttering Incidence and PrevalenceFamilialityAgeGenderGeography, Race, and CultureGeographyRaceCultureBilingualismPrevalence in Clinical SubpopulationsHearing ImpairmentCleft PalateCognitive ImpairmentOther GroupsSummaryStudy Questions and Discussion TopicsWebsitesSuggested ReadingsChapter 3. When and How Does Stuttering Begin? How Does It Develop?Theoretical and Clinical SignificanceOnsetGeneral Issues and Research MethodsStudies Concerning OnsetWhen Does Stuttering Begin?How Does Stuttering Begin?Features of Early StutteringEmotional and Physical HealthPhonology and LanguageDevelopmentHistorical Perspectives on Developmental ProgressionDifferential Developmental ProgressionsNatural RecoveryThe Statistical EvidenceRetrospective EvidenceIndirect Longitudinal EvidenceDirect Longitudinal EvidenceImplications of Developmental FindingsPredictive FactorsSummaryOnsetDevelopmentStudy Questions and Discussion TopicsSuggested ReadingsChapter 4. Where Does Stuttering End? What Are Its Advanced Characteristics?Advanced StutteringSpeech DisfluencyTypes of DisfluencyMajor Disfluency ClassesDimensions of DisfluencyPhysical ConcomitantsOther Speech CharacteristicsVoiceSpeaking RateEmotional Characteristics and CognitionEmotional ReactionsCognitionConcomitant DisordersThe Dynamics of Advanced StutteringPatterns of OccurrenceLoci of StutteringConditions That Diminish StutteringConditions That Increase StutteringSummaryStudy Questions and Discussion TopicsSuggested ReadingsPart II. Explanations of Stuttering Chapter 5. Why Do People Stutter? Evaluating Theories and ModelsTheories and ModelsHow to Analyze a Stuttering TheoryScience, Superstition, and Stories About StutteringThe Need for an Integrated FrameworkCriteria for Strong Theories and ModelsTesting Theories and ModelsAre There Stuttering Subtypes?SummaryStudy Questions and Discussion TopicsSuggested ReadingsChapter 6. Is Stuttering Psychological? Theories and InvestigationsIs Stuttering Psychological?Psychoemotional TheoriesPsychoanalytic TheoryAlternative Views of Psychoemotional DisturbancePersonality Factors in StutteringSummary of Psychoemotional TheoriesPsychobehavioral TheoriesStuttering as a Reactive Avoidance BehaviorStuttering as a Conditioned Anxiety ResponseStuttering as an Operant BehaviorTwo-Factor Theory of StutteringThe Demands-Capacities ModelSummary of Psychobehavioral TheoriesPsycholinguistic TheoriesPsycholinguistic Processes Resulting in Fluent SpeechPsycholinguistic Factors in StutteringA Theory of Covert-Repair?The Fault Line HypothesisRelated Areas of ResearchSummary of Psycholinguistic TheoriesSummaryStudy Questions and Discussion TopicsSuggested ReadingsChapter 7. Is Stuttering Biological? Theories and InvestigationsIntroductionGenetic PerspectivesFamilial IncidenceTwin StudiesFamily AggregationBiological GeneticsNeurological PerspectivesCerebral Hemispheric DominanceThe Modern Era of Brain and Other Neurological ResearchSummary of Neurological PerspectivesAuditory PerspectivesThe Role of AuditionSummary of Auditory PerspectivesPhysiological and Motor PerspectivesMotor Learning Theories of StutteringBrainstem Reflexes: A Disorder of MovementSensorimotor DysfunctionMultifactorial Theory from a Motor PerspectiveEvidence of Motor DifferencesSummary of Physiological and Motor PerspectivesSummaryStudy Questions and Discussion TopicsSuggested ReadingsPart III. Clinical Management of Stuttering Chapter 8. Assessment of Adults and School-Age Children General ConsiderationsAssessment of StutteringSpecial Considerations for School-Age ChildrenAssessment ObjectivesBackground and Case HistoryObservations and Examinations: SpeechSpeech Sample ContextSpeech Sample SizeMeasures of Stuttering or DisfluencySpeech Recordings and TranscriptionProcedures for Speech Sample AnalysisDisfluency Reference DataSeverity of Stuttered SpeechPhysical ConcomitantSpeaking RatesVoice and Other Communication SkillsAffective and Cognitive DomainsSituational Rating ProtocolsAttitude Rating ScalesInterpretations and Treatment RecommendationsDiagnosisTreatment RecommendationsThe Diagnostic ReportSummaryStudy Questions and Discussion TopicsSuggested ReadingsChapter 9. Assessment of Preschool-Age ChildrenChallenges, Objectives, and Settings for the Initial EvaluationStuttering versus Normal Disfluency: A Diagnostic ChallengeOther Key Diagnostic IssuesObjectives of the Initial EvaluationSetting and PreparationThe Case HistoryCase History Form: Preschool ChildrenCollecting Clinical DataObtaining Speech SamplesOther Related AssessmentsAnalyzing Clinical DataDisfluency Frequency and TypesDisfluency LengthSpeech RateInterpreting Clinical DataDisfluency StatusStuttering SeverityBorderline CasesMaking PrognosisThe Illinois Prediction CriteriaConcluding Parent ConferenceDiagnosis, Prognosis, and RecommendationsParent CounselingSummaryStudy Questions and Discussion TopicsSuggested ReadingsChapter 10. Stuttering Therapy Overview: Issues and Directions IntroductionTheoretical ConsiderationsThe Objectives of TherapyIncreased FluencyManaged StutteringImproved Cognitive-Emotional AdjustmentGeneral Therapeutic ApproachesThe Client-Clinician RelationshipEmpathySelf-CongruenceUnconditional Positive RegardClinical ApplicationsDeveloping Appropriate Treatment ObjectivesIndividual Versus Group Therapy SessionsImplementing TreatmentSkill Maintenance and Prevention of RelapseEvidence-Based PracticeA Case Study to Illustrate the Steps in EBPClinical ResearchEvaluating EfficacyGroup StudiesSingle-Subject StudiesIssues Regarding Clinical EfficacyEthicsQuestions Concerning EthicsSummaryStudy Questions and Discussion TopicsSuggested ReadingsChapter 11. Therapy for Adults: Focus on Emotional Reactions Adults Who StutterTreatmentsPsychotherapy and RelaxationPsychoanalysisRational-Emotive TherapyRelaxationSummary of Psychotherapy and RelaxationDesensitizationSystematic DesensitizationDesensitization in VivoDesensitization to Stuttered SpeechDesensitization to ListenersSummary of DesensitizationMindfulness Therapy; Acceptance and Commitment TherapyAssertiveness Training and Group TherapyAssertiveness TrainingGroup TherapySummary of Assertiveness Training and Group TherapyAntianxiety DrugsWhy Drugs?Drugs for What?Studies of Pharmaceutical Treatments for StutteringSummary of Antianxiety DrugsSummaryStudy Questions and Discussion TopicsWebsitesSuggested ReadingsChapter 12. Therapy for Adults: Focus on Stuttering and Fluency IntroductionIdentificationRationalePhase I: AwarenessPhase II: AnalysisSummary of IdentificationModificationStep I: Post-Block ModificationStep II: In-Block ModificationStep III: Pre-Block ModificationSummary of ModificationFluency Oriented TherapiesFluency-Focused Therapy BasicsRhythmic SpeechSlow Stretched SpeechBehavioral ReinforcementSummary of Fluency-Focused TherapiesFluency-Inducing InstrumentsMetronome Pacing of SpeechAuditory MaskingAltered Auditory FeedbackBiofeedbackSummary of Fluency-Inducing InstrumentsIntegrated ApproachesInternet, Mass Media-Based and TeletherapySummaryStudy Questions and Discussion TopicsSuggested ReadingsChapter 13. Therapy for School-Age Children School-Age Children Who StutterAwareness and Emotional ReactionsOvert StutteringAcademic PerformanceThe School and Home FactorsThe Age FactorPrognosis and Objectives for TherapyWhy Is Stuttering in School-Age Children Difficult to Treat?Therapy Alternatives and ObjectivesHome and School EnvironmentsCounseling ParentsTeachers and PeersTherapy: Explaining StutteringThe Speech SystemWhat Can Go Wrong with the Speech System?ExperimentationTherapy: Focus on Emotional ReactionsAdapted Desensitization ActivitiesAssertiveness, Resilience, TeasingBullyingTherapy: Focus on Stuttering and FluencyIdentification and AnalysisChanging SpeechStuttering ModificationFluency Facilitating Speaking SkillsGeneralizationOther Therapy ProgramsConditioning Fluent SpeechFamily Stuttering ProgramsGroup TherapyClinical ResearchSummaryStudy Questions and Discussion TopicsWebsitesSuggested ReadingsChapter 14. Therapy for Preschool-Age Children General ConsiderationsA Brief Historical ReviewDirect TreatmentsIndirect TreatmentsWinds of ChangeCurrent Issues Concerning Early InterventionFactors Pertaining to StutteringFactors Pertaining to AgeWho Should Be Treated? When?Current TherapiesFocus on Learning PrinciplesFocus on Parent-Child InteractionFocus on Speech/Motor PatternsFocus on EmotionalityClinical ResearchPast and Current ResearchWeaknesses and Other Issues in ResearchGeneral ReflectionsSummaryStudy Questions and Discussion TopicsWebsitesSuggested ReadingsChapter 15. Other Fluency Disorders; Cultural and Bilingual IssuesIntroductionChildhood DisordersUnusual Breathing PatternsWord-Final DisfluencyLanguage DisordersClutteringAcquired StutteringNeurogenic StutteringPsychogenic StutteringMalingeringStuttering in Bilingual and Multicultural PopulationsIncidenceDiagnosisTreatmentSummaryStudy Questions and Discussion TopicsWebsitesSuggested ReadingsReferencesIndex