Stuttering: An Integrated Approach to Its Nature and Treatment (3rd edition)
Barry Guitar
Lippincott Williams & Wilkins

Review: Liz O'Connell (Yorkhill NHS Trust, Glasgow)

This book is intended for speech and language therapists, and undergraduate and post graduate students. The intention is to teach them to become more effective therapists in the field of stuttering.

I have my own copy of the 2nd edition of this book so was delighted to review this new edition. I have compared the two books in order to describe what has changed and what has been added.

The 3rd edition of this book is very comprehensive with some obvious additions from the previous edition. The book is divided into two sections. Section one focuses on the nature of stuttering and section two focuses on assessment and treatment of stuttering.

Section one has five chapters devoted to the nature and development of stuttering. Guitar presents several theories of stuttering as well as his own attempt to integrate research and clinical findings. Obvious additions include a complete update on research, which incorporates genetics, brain imaging, language and emotion.

Section two of the book focuses on assessment and treatment of stuttering. There are eight chapters within this section and these have been re-organised into the developmental treatment levels of the disorder, e.g. from borderline to advanced stuttering. The reordering of the chapters has produced a much more logical sequence.

In the chapters focusing on assessment Guitar has included some very useful information for clinicians to consider during assessment and treatment in relation to the differing cultures within our societies. For instance, he highlights how the use of praise in some of the treatment approaches can be difficult for some cultures and he discusses how he managed this. Other cultural considerations include examples such as eye contact and how some approaches encourage clients to improve their eye contact and in some cultures loss of eye contact may be appropriate.

Chapter 7 looks at assessment procedures. These are organised by age level, e.g. pre-school, school-age and adolescent/adult. This makes it easier for the reader to go to the specific age level they are interested in. Within each age level, Guitar has provided samples of case history/questionnaires and described the tasks you should undertake in assessment for each age level. This chapter is very useful for the student or developing clinician as the examples will help ensure that they have all the relevant information in order to make a diagnosis and plan an evaluation.

Chapter 8 focuses on preliminaries to treatment and the author discusses evidence based practice and how many stuttering treatment approaches have very little data to support their effectiveness. In the following treatment chapters, each chapter contains a detailed description of the approach he uses followed by a brief description of other approaches. He makes suggestions on how to measure changes in the behaviours that are to be targeted in order to contribute to the evidence base.

The final chapter (chapter 13) is new and it focuses on related disorders of fluency, in particular, neurogenic acquired stuttering, psychogenic stuttering and cluttering. Guitar explains how developmental stuttering can be differentiated from these conditions.

My second edition of this book has been well thumbed not only by myself but by my students and developing specialists within my department. This edition has a clearer layout, it is very well referenced and useful website information has been added. It is an excellent teaching book and each chapter has useful summaries with study questions and study projects and suggested readings for students/developing therapists. Barry Guitar's style of writing makes this book very easy to read and understand and he is able to describe his approach to assessment and therapy in a way that encourages you to 'give it a go' but with a certain level of confidence.

This new edition has some very interesting and welcome chapters for those who enjoyed the 2nd edition. I'd recommend that every department should have at least one book - I can guarantee it won't gather dust!

From the Winter 2006 issue of 'Speaking Out', page 16

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