More Than Fluency: The Social, Emotional, and Cognitive Dimensions of Stuttering

First Edition

Barbara J. Amster, Evelyn R. Klein

Details: 242 pages, B&W, Softcover, 7" x 10"

ISBN13: 978-1-59756-995-8

© 2018 | Available

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More Than Fluency: The Social, Emotional, and Cognitive Dimensions of Stutteringprovides a thoughtful and contemporary framework for speech-language pathologists and others working with people who stutter. The text focuses on the social, emotional, and cognitive realms of stuttering and offers new insights and applications based on research in the field. It guides the reader through theoretical discussions about the social experiences, emotional complications, and cognitive interpretations that often influence the person who stutters. The text also offers practical strategies for intervention from contributing authors who are prominent theorists, researchers, and practitioners in the field of fluency and stuttering.

In line with the current multifactorial view of stuttering, More Than Fluency emphasizes the social, emotional, and cognitive aspects of stuttering, drawing important connections between them. The authors present a variety of therapeutic interventions and techniques along with practical guidelines that have been designed to alleviate distress in those who stutter. Although these interventions differ in approach, each offers their own roadmap to support and empower people who stutter.

The idea for this book grew out of the insights gained from listening to both clients and graduate students. Clients wanted to talk about their life experiences as a person who stutters. Graduate students often described their worry and uncertainty when dealing with the emotional and social issues of their clients who stutter. Similarly, many practicing speech-language pathologists also have concerns about treating people who stutter, especially regarding the social, emotional, and cognitive aspects of the disorder, areas not typically taught in traditional coursework.

More Than Fluency was developed for practicing speech-language pathologists and other professionals who evaluate and treat people who stutter. It is also intended to be an academic textbook used in graduate courses on fluency and stuttering. This text provides a collection of well-thought-out programs and approaches that help treat the whole person, not just his or her stuttering. The authors believe that this is best practice because successfully treating a person who stutters encompasses treating more than fluency.


"The central theme of this book and much of the contents captures a niche area in stuttering that has been void. Several of the chapters present relatable poignant examples and guide the reader through practical applications of the generally framed psychologically-focused approaches targeting the social, emotional, and cognitive dimensions of stuttering, as stated in the book’s title. Many of the book’s chapters begin with an introductory theoretical framing, used as a referent throughout the chapter, that continues to a brief 'state of the literature section', which is then followed by the lived experiences of stuttering from PWS with statements supporting the framing and evidence. Many chapter authors then present an easily accessible guided practical application of the concepts before summarizing the content. This thoughtfully sequenced presentation further enhances the accessibility of an engaging and readable text typically written in an informal dialogue-like style. For example, the text is written at a level that undergraduate students through introductory SLPs not specializing in stuttering can easily gain insight into the lived experience of stuttering as well as glean general framing of certain approaches and practical strategies for evidence-based functionally-focused holistic therapy. The approaches are presented through a general practical framework that isn’t overly obtrusive or laden with high densities of intense content. Similarly, intermediate-level clinicians, who are generally knowledgeable about stuttering from clinical and evidence standpoints, may find benefit from the text through the relatable examples and client statements envisioned through the applied framings. Such professionals may find added benefit from the text by integrating their foundational and advanced clinical knowledge with the presented concepts. Instructors of fluency disorder courses and clinicians with advanced expertise in stuttering, again who are up to date on the corpus of literature within the field, should be able to connect the dots with many of the statements and concepts provided that elude to the more nuanced details not explicitly presented in the book. Again, most of the content covered in the book could be of use to a wide array of people interested in stuttering."
—Dan Hudock, PhD, CCC-SLP, Idaho State University, in Journal of Fluency Disorders (September 2019)

"This book is comprised of 12 chapters – 10 content chapters bookended by an introductory first and concluding last chapter written by the editors – that span theoretical and clinical accounts of various social, emotional, and cognitive issues that affect people who stutter. [...] It leans towards a practice-based text as each chapter presents ways to augment therapeutic interventions for people who stutter. In this way, I believe this book would be well-suited as a supplemental resource for an advanced stuttering course for graduate student clinicians or for more seasoned clinicians who might be seeking a newfound spring in their therapeutic step. The editors and authors who contributed to this book are commended for their efforts to provide clincians with an insider’s view of the thoughts and feelings that are so often experienced by people who stutter, and the ways in which they can facilitate the change that leads to positive outcomes in therapy."
—Naomi H. Rodgers, PhD, CCC-SLP, University of Iowa, in Journal of Fluency Disorders (September 2019)

Foreword by John A. Tetnowski, PhD

Chapter 1. Introduction: The Importance of the Social, Emotional, and Cognitive Dimensions of Stuttering
Barbara J. Amster and Evelyn R. Klein

Chapter 2. How the Brain Influences the Cognitive, Emotional, and Motor Aspects of Stuttering
Jennifer Kleinow

Chapter 3. The Importance of Self-Efficacy for Individuals Who Stutter
Michael P. Boyle

Chapter 4. A Perspective on Stuttering in the Social Context
James M. Mancinelli

Chapter 5. The Impact of Perfectionism on Stuttering
Barbara J. Amster and Evelyn R. Klein

Chapter 6. Cognitive Behavioral Therapy (CBT) for People Who Stutter
Evelyn R. Klein and Barbara J. Amster

Chapter 7. Acceptance and Commitment Therapy for Stuttering Disorders
Janet M. Beilby and J. Scott Yaruss

Chapter 8. Experiential Therapy for Adults Who Stutter: Principles and Methods
C. Woodruff Starkweather and Janet Givens

Chapter 9. Avoidance Reduction Therapy for Stuttering (ARTS®)
Vivian Sisskin

Chapter 10. Peer Support for People Who Stutter: History, Benefits, and Accessibility
Mitchell Trichon and Erik X. Raj

Chapter 11. Community-Centered Assessment and Treatment: Targeting the Social, Emotional, and Cognitive Aspects of Stuttering in Children
Craig Coleman

Chapter 12. Final Thoughts
Barbara J. Amster and Evelyn R. Klein


Barbara J. Amster

Barbara J. Amster, PhD, CCC-SLP, BCS-F, is founding Chair, founding Graduate Director, and Professor in the Department of Communication Sciences and Disorders at La Salle University, where she teaches the graduate course in stuttering. She is a licensed and certified speech-language pathologist. She holds Board Specialty Certification in Fluency Disorders from the American Speech-Language-Hearing Association (ASHA). She is an ASHA Fellow and received Honors of the Pennsylvania Speech-Language-Hearing Association, where she served as Vice President for Professional Preparation and Continuing Education. She was Pennsylvania's representative to the ASHA Advisory Council and served as Associate Coordinator for ASHA's Special Interest Group 4: Fluency and Fluency Disorders. Dr. Amster has investigated perfectionism in people who stutter (PWS) and has presented and published articles on perfectionism and the therapeutic use of cognitive behavioral therapy with PWS. She is also an editor and author of a book on children in the child welfare system.

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Evelyn R. Klein

Evelyn R. Klein, PhD, CCC-SLP, BCS-CL, ASHA Fellow, is a Full Professor at La Salle University in the Department of Communication Sciences and Disorders where she teaches, supervises, and advises students pursuing degrees in speech-language pathology. She also co-directs the CASTLE Assessment Center at La Salle. Dr. Klein is a certified and licensedspeech-language pathologist and a licensed psychologist with postdoctoral training in clinical neuropsychology and cognitive behavioral therapy. She is a Board-Certified Specialist in Child Language and Language Disorders affiliated with ASHA. Dr. Klein received the Lindback Distinguished Teaching Award in 2011 and Faculty Distinguished Scholarship Award in 2018. She is also engaged in private practice. Her areas of specialization include selective mutism, autism spectrum disorders, fluency disorders, language disorders, and counseling. Dr. Klein is an editor and author of textbooks and treatment programs including EXPRESS (Expanding Receptive and Expressive Skills through Stories), More Than Fluency: The Social, Emotional, and Cognitive Dimensions of Stuttering, and Acquired Language Disorders: A Case-Based Approach, Third Edition (all published by Plural Publishing). She is on the Scientific Advisory Board of the Selective Mutism Association.

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