Clinical Management of Stuttering in Older Children and Adults. (1999). By Richard E. Ham. Aspen Publishers, Inc., 200 Orchard Ridge Drive, Suite 200, Gaithersburg, MD 20878. 377 pages, $46. Reviewed by Judith V. Butler, Franklin, MA.

This is the cookbook to beat all cookbooks. If you need a reference text for nearly all the fluency-enhancing techniques known to man, this is the book for you. In Clinical Management of Stuttering in Older Children and Adults, Richard E. Ham devotes only one chapter to diagnosis. The remaining eight chapters are devoted to management, dense with lists, charts, definitions, and rationales. The prose is easy to read and sometimes conversational.

In the preface, Ham prepares the reader by saying that his text "is not 'about' stuttering." Rather it is about treatment options. In teaching for more than 40 years, he found that he needed to develop a syllabus of class projects in various evaluation and management procedures. Then it dawned on him to put them all together to "construct this resource book." While the material refers to disorders of fluency, the techniques therein "apply to a wide range of communication problems."

At this point in my own professional development, I am practicing psuedo-stuttering. Since I found what some call "voluntary stuttering" to be fairly difficult, I was delighted that Ham provided a sequence of steps for learning how to "fake" stuttering. He also encouraged me to keep at it by writing, "A clinician who cannot fake is a person who has failed to acquire a useful therapy device, has failed to deal with their own fears and anxiety, and has shown minimal tolerance for disfluency, but expects the client to achieve in all of these areas" (p. 93).

This book was made even more interesting for me because I had just finished reading a book by Carl Rogers. Talk about opposite ends of the therapeutic spectrum! Rogers teaches nothing. Instead, a therapist employs very careful listening in order to understand the client as fully as possible. It is this process of understanding that promotes change in the client. Of course, Rogers' topic was not stuttering, but psychotherapy. However, it seems to me that those of us in this confusing field of stuttering management need a very broad base of knowledge. We need to be aware of the techniques so thoroughly compiled by Ham, as well as the sensitivity to humanity promoted by Rogers. While this is a huge task, it is what makes this field so wildly interesting us fluency geeks.

This is a terrific reference text. I am happy to have it in my personal library. While I enjoy theoretical debate, it is helpful to have a book like this one to bring me back to the concrete aspects of speech behavior. One note-this is not a cookbook for the uninformed. An experienced chef can create a masterpiece from the same recipe from which a beginner can create a mess. And so it is that a speech-language pathologist needs a broad knowledge base to treat persons who stutter. For the educated, this is a wonderful reference.