Speech Pathology Management of Chronic Refractory Cough and Related Disorders
Anne E. Vertigan, B.App.Sc.(Sp Path), M.B.A., Ph.D. Peter G. Gibson, MB.BS (Hons), FRACP

Contributions from Ken Altman, Max Haxer, Thomas Murry

 This is the first textbook worldwide on the speech pathology management of chronic refractory cough. It offers a comprehensive overview of the condition, outlines therapy in great detail and consolidates recent advances in this area.

  • It provides all materials needed for speech pathologists to assess and treat individuals with chronic refractory cough. All practical resources and tools needed to treat the condition are provided in one practical and accessible publication. Speech pathologists can access all the information from one single source thus saving time during busy caseloads.
  • The included extensive background material will be helpful for both novice and experienced clinicians. These materials are not available in any other format.
  • Resources include a CD with patient handouts and exercise sheets in printable pdf format, and excel spreadsheet files to help calculate symptom scores.
  • The book is written by people who currently specialize in the clinical assessment and management of patients with chronic refractory cough and who have an active research program.
  • By outlining laryngeal hypersensitivity, the book sets up the reader/practitioner to take advantage of upcoming developments in the field of chronic refractory cough.

Cough is such a common experience that it in fact accounts for the largest number of ambulatory health care visits internationally. Most cases of acute cough resolve spontaneously however Chronic Refractory Cough is another matter. This is defined as a cough that lasts for longer than eight weeks, and persists despite medical treatment; and it is a significant health problem for many people. Often lasting for months or even years, chronic refractory cough has debilitating side effects including stress urinary incontinence, depression, poor sleep, headaches and reduced quality of life. Some patients resign from work and many avoid social situations. Even simple activities such as conversing or using the telephone can become distressing because talking can trigger coughing episodes.

Although medical treatment is ineffective for Chronic Refractory Cough, speech pathology intervention can be effective in treating the condition. Understanding laryngeal function in chronic refractory cough has changed, and there are now effective treatment programs that can be used to help people with these problems. However while speech pathology intervention is effective in treating refractory chronic refractory cough, patients have difficulty accessing this intervention outside of specialist voice clinics.

Management of chronic refractory cough is an expanding area for speech pathologists, yet many have limited clinical exposure to the treatment of this condition and comprehensive details of the theory and treatment are not readily available in published form. This book, the result of a therapy program which is defined by the authors, who are both practicing clinicians as well as researchers, and based on evidence and background research, can be used by speech pathologists in all clinics.

Laryngeal hypersensitivity is emerging as the key concept in chronic refractory cough. It is the target of mechanisms studies, novel therapies and also novel pharmacological developments. This book will explain the importance of laryngeal hypersensitivity, how it can be recognized, and how it can be treated.

Speech pathologists, referring medical specialists and patients have expressed a need for more specialized speech pathology services for the management of chronic refractory cough. In particular, speech pathologists are requesting more comprehensive and cohesive information to guide their patient management.

Presently, there are no widespread education programs and material is generally disseminated through journal articles published in a wide array of literature and by word of mouth. This book fills the gap. It is the first manual available to speech pathologists to support their treatment of chronic refractory cough and to eliminate their reliance on conference presentations, infrequent journal articles and short textbook descriptions.

Presented here are a comprehensive overview of the conditions, detailed outlines of therapy options, and qualified guidance on recent advances in this area that speech pathologists need and are looking for when treating these patients.


Introduction, terminology definition and description A. Vertigan & P. Gibson

Physiology of cough. A. Vertigan & P. Gibson

Cough hypersensitivity A. Vertigan & P. Gibson

Laryngeal dysfunction in chronic cough A. Vertigan & P. Gibson

Associated medical conditions and patho-physiology of chronic cough A. Vertigan & P. Gibson

Medical management of chronic cough P. Gibson

Otolaryngology management of chronic cough K. Altman

Pulmonary function testing in patients with chronic cough A. Vertigan & P. Gibson

Evidence for behavioural management of chronic refractory cough A. Vertigan & P. Gibson

Speech pathology assessment of patients with chronic refractory cough A. Vertigan

Speech pathology treatment of patients with chronic refractory cough A. Vertigan

Speech pathology assessment and treatment of paradoxical vocal fold movement T. Murry & M. Haxer

Speech pathology assessment and treatment of globus pharyngeus. A. Vertigan

2016. 350 pages. ISBN 978-1-909082-17-5. Paperback. Color illustrations. 254x178mm (7x10")

Price £90 

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About the Authors

Anne Vertigan is the District Profession Director for Speech Pathology for Hunter New England Health and the Director of Speech Pathology at John Hunter Hospital, Australia. She has extensive clinical and research experience in the management of chronic refractory cough and completed her Ph.D. in the area of chronic cough and paradoxical vocal fold movement. She lectures in voice and dysphagia at the University of Newcastle, Australia.

Peter Gibson is one of the world leaders in asthma research and has published over 300 articles in peer reviewed journals. He is a senior staff specialist in Respiratory & Sleep Medicine at John Hunter Hospital and senior researcher for the Hunter Medical Research Institute and the Woolcock Institute of Medical Research in Australia. Prof Gibson specializes in the treatment of cough and asthma.