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Uysal HT, Incebay Ö, Köse A. Speech-language therapists' approach towards adults who stutter in Turkey: which components are important for therapeutic alliance and comprehensive assessment? REVISTA DE INVESTIGACIÓN EN LOGOPEDIA 2023. [DOI: 10.5209/rlog.81706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Speech-Language Therapists (SLT) may have negative approaches toward Adults Who Stutter (AWS). There is no consensus about the SLT perspectives on AWS. This study aimed to investigate the SLT approach to AWS and assessment-therapy components in their practices. SLT (N=209) were included in the study. The survey consisted of four sections: demographic information, assessment-therapy components, and attitudes. The results are reported through boxplot graphics. The majority of the SLT were female (86.6%) and aged in the young group (20-29 years) (81.2%). SLT noted that they frequently used non-standard tools in the assessments and traditional or contemporary methods are preferred in the therapy components. The participants mentioned that important to AWS's quality of life, resilience, and psychosocial characteristics. SLT are more likely to utilize non-standard approaches while evaluating AWS. Traditional methods, as well as current approaches, are preferred by the SLT. SLT cares about AWS's resilience and temperament differences.
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Lowe R, Menzies R, Onslow M, Packman A, O'Brian S. Speech and Anxiety Management With Persistent Stuttering: Current Status and Essential Research. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:59-74. [PMID: 33400555 PMCID: PMC8608149 DOI: 10.1044/2020_jslhr-20-00144] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 08/16/2020] [Accepted: 10/22/2020] [Indexed: 06/12/2023]
Abstract
Purpose The purpose of this review article is to provide an overview of the current evidence base for the behavioral management of stuttering and associated social anxiety. Method We overview recent research about stuttering and social anxiety in the context of contemporary cognitive models of social anxiety disorder. That emerging evidence for self-focused attention and safety behavior use with those who stutter is considered in relation to current treatment approaches for stuttering: speech restructuring and social anxiety management. Results The emerging information about social anxiety and stuttering suggests a conflict between the two clinical approaches. For those clients who wish to control their stuttering and where speech restructuring is deemed the most suitable approach, it is possible that speech restructuring may (a) induce or increase self-focused attention, (b) promote the use of safety behaviors, and (c) become a safety behavior itself. This conflict needs to be explored further within clinical and research contexts. Conclusions The issues raised in this review article are complex. It appears that evidence-based speech treatment procedures are in conflict with current best-practice treatment procedures that deal with social anxiety. In this review article, we propose directions for future research to inform the development of improved treatments for those who stutter and recommendations for interim clinical management of stuttering.
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Affiliation(s)
- Robyn Lowe
- Australian Stuttering Research Centre, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Ross Menzies
- Australian Stuttering Research Centre, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Mark Onslow
- Australian Stuttering Research Centre, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Ann Packman
- Australian Stuttering Research Centre, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Sue O'Brian
- Australian Stuttering Research Centre, University of Technology Sydney, Ultimo, New South Wales, Australia
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Scheurich JA, Beidel DC, Vanryckeghem M. Exposure therapy for social anxiety disorder in people who stutter: An exploratory multiple baseline design. JOURNAL OF FLUENCY DISORDERS 2019; 59:21-32. [PMID: 30578977 DOI: 10.1016/j.jfludis.2018.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/21/2018] [Accepted: 12/11/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND & OBJECTIVES Social anxiety disorder (SAD) is a debilitating condition, and approximately half of adults who stutter have SAD. Cognitive-behavioral therapy (CBT) has shown promise in decreasing social anxiety symptoms among adults who stutter, but exposure, arguably the essential component for successful CBT for SAD, has been understudied and underemphasized. Aims of this study were to develop an exposure therapy protocol designed specifically for people who stutter and have SAD and evaluate its potential efficacy in reducing social anxiety and stuttering severity using a multiple baseline design. METHODS Six participants received ten sessions of exposure therapy. Participants reported daily social anxiety, and social distress and stuttering severity were evaluated at major assessment points. RESULTS There were substantial reductions in social anxiety and considerable improvements in affective, behavioral, and cognitive experiences of stuttering. No consistent change was observed for stuttering frequency. Gains were mostly maintained after six-months. CONCLUSIONS Results suggest that the novel exposure approach may decrease social distress, but not necessarily influence speech fluency. These findings underscore the importance of the assessment and treatment of SAD among adults who stutter and suggest that the integration of care between clinical psychologists and speech-language pathologists may prove beneficial for this population.
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Affiliation(s)
- Jennifer A Scheurich
- Department of Psychology, University of Central Florida, 4111 Pictor Lane, Orlando, FL 32816-1390, United States.
| | - Deborah C Beidel
- Department of Psychology, University of Central Florida, 4111 Pictor Lane, Orlando, FL 32816-1390, United States
| | - Martine Vanryckeghem
- School of Communication Sciences and Disorders, University of Central Florida, 4111 Pictor Lane, Orlando, FL 32816-1390, United States
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Baxter S, Johnson M, Blank L, Cantrell A, Brumfitt S, Enderby P, Goyder E. Non-pharmacological treatments for stuttering in children and adults: a systematic review and evaluation of clinical effectiveness, and exploration of barriers to successful outcomes. Health Technol Assess 2016; 20:1-302, v-vi. [PMID: 26767317 DOI: 10.3310/hta20020] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Despite many years of research, there is no certainty regarding the cause of stuttering. Although numerous interventions have been developed, a broad-based systematic review across all forms of intervention for adults and children was needed including views and perceptions of people who stutter. OBJECTIVE The aims of the study were to report the clinical effectiveness of interventions for people who stutter (or clutter), to examine evidence regarding the views of people who stutter and the views of professionals regarding interventions. DATA SOURCES A systematic review of quantitative and qualitative literature was carried out between August 2013 and April 2014. The following electronic databases were searched: (1) MEDLINE, (2) EMBASE, (3) The Cochrane Library (including The Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, Health Technology Assessment Database and NHS Economic Evaluations Database), (4) PsycINFO, (5) Science Citation Index, (6) Social Science Citation Index, (7) Cumulative Index to Nursing and Allied Health Literature, (8) ASSIA, (9) Linguistics and Language Behavior Abstracts, (10) Sociological Abstracts and (11) the EPPI Centre. Reference lists of included papers and other reviews were screened and also key journals in the subject area were hand-searched. REVIEW METHODS The searches aimed to identify (1) evidence of clinical effectiveness in populations of pre-school children, school-aged children, adolescents and adults, and (2) data relating to perceptions of barriers and facilitators to intervention clinical effectiveness among staff and people who stutter. A metasynthesis of the two linked elements via development of a conceptual model was also carried out to provide further interpretation of the review findings. RESULTS A systematic search of the literature identified a large number of potentially relevant studies. Of these, 111 studies examining the clinical effectiveness of interventions, 25 qualitative papers and one mixed-methods paper met the criteria for inclusion in this review. Review of the effectiveness literature indicated evidence of positive outcomes across all types of interventions. Virtually all evidence we identified reported at least some positive effect for some participants. However, there was evidence of considerable individual variation in outcome for study participants. The qualitative literature highlighted the need for programmes to be tailored to individual need with variation at the levels of the intervention, the individual and interpersonal/social elements. Metasynthesis of the data highlighted the complexity of elements that need to be considered in evaluation of long-term impacts following stuttering interventions. LIMITATIONS Around two-thirds of the studies were considered to be at higher risk of bias. The heterogeneous nature and variability in outcomes meant that we were unable to complete a meta-analysis. CONCLUSIONS Although much of the evidence we identified was from studies at risk of bias, it is suggested that most available interventions for stuttering may be of benefit to at least some people who stutter. There is a requirement for greater clarity regarding what the core outcomes following stuttering intervention should be and also enhanced understanding of the process whereby interventions effect change. Further analysis of those for whom interventions have not produced a significant benefit may provide additional insights into the complex intervention-outcomes pathway. STUDY REGISTRATION This study is registered as PROSPERO CRD42013004861.
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Affiliation(s)
- Susan Baxter
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Maxine Johnson
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Lindsay Blank
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Anna Cantrell
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Shelagh Brumfitt
- Department of Human Communication Sciences, University of Sheffield, Sheffield, UK
| | - Pamela Enderby
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Elizabeth Goyder
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Menzies R, O'Brian S, Lowe R, Packman A, Onslow M. International Phase II clinical trial of CBTPsych: A standalone Internet social anxiety treatment for adults who stutter. JOURNAL OF FLUENCY DISORDERS 2016; 48:35-43. [PMID: 27498893 DOI: 10.1016/j.jfludis.2016.06.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 05/31/2016] [Accepted: 06/27/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE CBTPsych is an individualized, fully automated, standalone Internet treatment program that requires no clinical contact or support. It is designed specifically for those who stutter. Two preliminary trials demonstrated that it may be efficacious for treating the social anxiety commonly associated with stuttering. However, both trials involved pre- and post-treatment assessment at a speech clinic. This contact may have increased compliance, commitment and adherence with the program. The present study sought to establish the effectiveness of CBTPsych in a large international trial with no contact of any kind from researchers or clinicians. METHOD Participants were 267 adults with a reported history of stuttering who were given a maximum of 5 months access to CBTPsych. Pre- and post-treatment functioning was assessed within the online program with a range of psychometric measures. RESULTS Forty-nine participants (18.4%) completed all seven modules of CBTPsych and completed the post-treatment online assessments. That compliance rate was far superior to similar community trials of self-directed Internet mental health programs. Completion of the program was associated with large, statistically and clinically significant reductions for all measures. The reductions were similar to those obtained in earlier trials of CBTPsych, and those obtained in trials of in-clinic CBT with an expert clinician. CONCLUSIONS CBTPsych is a promising individualized treatment for social anxiety for a proportion of adults who stutter, which requires no health care costs in terms of clinician contact or support. EDUCATIONAL OBJECTIVES The reader will be able to: (a) discuss the reasons for investigating CBTPsych without any clinical contact; (b) describe the main components of the CBTPsych treatment; (c) summarize the results of this clinical trial; (d) describe how the results might affect clinical practice, if at all.
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Affiliation(s)
- Ross Menzies
- Australian Stuttering Research Centre, The University of Sydney, Australia.
| | - Sue O'Brian
- Australian Stuttering Research Centre, The University of Sydney, Australia.
| | - Robyn Lowe
- Australian Stuttering Research Centre, The University of Sydney, Australia.
| | - Ann Packman
- Australian Stuttering Research Centre, The University of Sydney, Australia.
| | - Mark Onslow
- Australian Stuttering Research Centre, The University of Sydney, Australia.
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Baxter S, Johnson M, Blank L, Cantrell A, Brumfitt S, Enderby P, Goyder E. The state of the art in non-pharmacological interventions for developmental stuttering. Part 1: a systematic review of effectiveness. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2015; 50:676-718. [PMID: 26123259 PMCID: PMC4755200 DOI: 10.1111/1460-6984.12171] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 02/13/2015] [Accepted: 02/16/2015] [Indexed: 05/13/2023]
Abstract
BACKGROUND The growing range of available treatment options for people who stutter presents a challenge for clinicians, service managers and commissioners, who need to have access to the best available treatment evidence to guide them in providing the most appropriate interventions. While a number of reviews of interventions for specific populations or a specific type of intervention have been carried out, a broad-based systematic review across all forms of intervention for adults and children was needed to provide evidence to underpin future guidelines, inform the implementation of effective treatments and identify future research priorities. AIMS To identify and synthesize the published research evidence on the clinical effectiveness of the broad range of non-pharmacological interventions for the management of developmental stuttering. METHODS & PROCEDURES A systematic review of the literature reporting interventions for developmental stuttering was carried out between August 2013 and April 2014. Searches were not limited by language or location, but were restricted by date to studies published from 1990 onwards. Methods for the identification of relevant studies included electronic database searching, reference list checking, citation searching and hand searching of key journals. Appraisal of study quality was performed using a tool based on established criteria for considering risk of bias. Due to heterogeneity in intervention content and outcomes, a narrative synthesis was completed. MAIN CONTRIBUTION The review included all available types of intervention and found that most may be of benefit to at least some people who stutter. There was evidence, however, of considerable individual variation in response to these interventions. The review indicated that effects could be maintained following all types of interventions (although this was weakest with regard to feedback and technology interventions). CONCLUSIONS This review highlights a need for greater consensus with regard to the key outcomes used to evaluate stuttering interventions, and also a need for enhanced understanding of the process whereby interventions effect change. Further analysis of the variation in effectiveness for different individuals or groups is needed in order to identify who may benefit most from which intervention.
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Affiliation(s)
- Susan Baxter
- School of Health
and Related ResearchUniversity of SheffieldSheffieldUK
| | - Maxine Johnson
- School of Health
and Related ResearchUniversity of SheffieldSheffieldUK
| | - Lindsay Blank
- School of Health
and Related ResearchUniversity of SheffieldSheffieldUK
| | - Anna Cantrell
- School of Health
and Related ResearchUniversity of SheffieldSheffieldUK
| | - Shelagh Brumfitt
- Department of
Human Communication SciencesUniversity of SheffieldSheffieldUK
| | - Pam Enderby
- School of Health
and Related ResearchUniversity of SheffieldSheffieldUK
| | - Elizabeth Goyder
- School of Health
and Related ResearchUniversity of SheffieldSheffieldUK
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Yaruss JS, Coleman CE, Quesal RW. Stuttering in School-Age Children: A Comprehensive Approach to Treatment. Lang Speech Hear Serv Sch 2012; 43:536-48. [DOI: 10.1044/0161-1461(2012/11-0044)] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose
This letter, prepared through a close collaboration between the authors and more than 100 colleagues, responds to a paper by the editor of
Language, Speech, and Hearing Services in Schools
that highlighted the need for research on treatment for stuttering in school-age children.
Method
Our response addresses 3 themes: First, we offer agreement with the editor’s call for research because more evidence about treatment for children who stutter is certainly needed. Second, we provide an overview of recent literature, demonstrating that the majority of current treatments include strategies for helping children improve speech fluency
in addition to
helping them increase acceptance of their stuttering and diminish the negative consequences of the disorder. Third, we present several strategies designed to help clinicians respond to the individual needs of children who stutter in a data-based, comprehensive manner that focuses on minimizing the adverse impact of stuttering on children’s educational endeavors, and on their lives as a whole.
Conclusion
Much has been learned about the factors that contribute to the successful treatment of stuttering in school-age children, and evidence will continue to accumulate. Meanwhile, speech-language pathologists can help children increase their fluency while simultaneously minimizing the adverse impact of their speaking difficulties and helping them improve their overall communication.
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Kaya Y, Alladin A. Hypnotically assisted diaphragmatic exercises in the treatment of stuttering: a preliminary investigation. Int J Clin Exp Hypn 2012; 60:175-205. [PMID: 22443525 DOI: 10.1080/00207144.2012.648063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This preliminary study investigates the combined effect of intensive hypnotherapy and diaphragmatic exercises in the management of stuttering. Fifty-nine clients with stuttering were trained to practice abdominal weightlifting to strengthen their respiratory muscles and to improve their diaphragmatic movements. The weightlifting exercises involved lifting a dumbbell (2.0-4.0 kg) with the abdomen for 2 hours daily for 8 consecutive days. Hypnotherapy was utilized to alleviate anxiety, to boost self-confidence, and to increase motivation for weightlifting exercise. The pre- and postmeasures were statistically significant (p < .001). Results of the study provide support for the effectiveness of hypnotically assisted diaphragmatic training in the management of stuttering but should be further studied in controlled trials.
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Affiliation(s)
- Yalcin Kaya
- Department of Sports, Physical Exercises and Kinesiology, Institute of Health Sciences, University of Selcuk, Konya, Turkey.
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Langevin M, Kully D, Teshima S, Hagler P, Narasimha Prasad NG. Five-year longitudinal treatment outcomes of the ISTAR Comprehensive Stuttering Program. JOURNAL OF FLUENCY DISORDERS 2010; 35:123-140. [PMID: 20609333 DOI: 10.1016/j.jfludis.2010.04.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2009] [Revised: 04/15/2010] [Accepted: 04/16/2010] [Indexed: 05/29/2023]
Abstract
UNLABELLED Replicated evidence of satisfactory 1- and 2-year post-treatment outcomes has been reported for the Comprehensive Stuttering Program (CSP). However, little is known about longer term outcomes of the CSP. Yearly follow-up measures were obtained from 18 participants for 5 consecutive years. At 5-year follow-up, participants were maintaining clinically and statistically significant reductions in stuttering and increases in rates of speech relative to pre-treatment measures. Standardized effect sizes were large. There were no significant differences among the immediate post-treatment and five follow-up measures, indicating that speech gains achieved by the end of the treatment program were stable over the 5-year follow-up period. Insufficient return rates for self-report data for the third to fifth follow-up measurement occasions prohibited analyzing these data. However, non-significant differences among the immediate post-treatment and two follow-up measures indicated that improvements achieved by the end of treatment in speech-related confidence, and perceptions of struggle, avoidance, and expectancy to stutter were stable over the 2-year follow-up period. Significant differences among the speech-related communication attitudes scores indicated that improvements in attitudes made at the end of the treatment program were less stable. Taken together, these results provide further and longer term evidence of the effectiveness of the CSP. EDUCATIONAL OBJECTIVES Readers will be able to: (1) describe the main components of the Comprehensive Stuttering Program (2) describe a methodology for determining clinically meaningful maintenance of stuttering reductions, and (3) describe the durability and stability of improvements in speech and self-report measures across time.
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Affiliation(s)
- Marilyn Langevin
- Institute for Stuttering Treatment & Research (ISTAR), Faculty of Rehabilitation Medicine, 1500, 8215 - 112 Street, Edmonton, Alberta, Canada T6G 2C8.
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Bricker-Katz G, Lincoln M, McCabe P. A life-time of stuttering: How emotional reactions to stuttering impact activities and participation in older people. Disabil Rehabil 2009; 31:1742-52. [DOI: 10.1080/09638280902738672] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Venkatagiri HS. What do people who stutter want--fluency or freedom? JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2009; 52:500-515. [PMID: 18695024 DOI: 10.1044/1092-4388(2008/07-0019)] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE In this study, the author examined the following questions: What proportion of adult persons who stutter (PWS) choose fluency and what proportion choose to be free from a need to be fluent in managing their stuttering? What demographic and stuttering-related variables influence their choice, and how consistent are they in their choice? METHOD A survey instrument administered over the Internet was used to collect the data. RESULTS Overall, 8% more of the 216 respondents opted for fluency than freedom. A larger proportion of male PWS and PWS under the age of 30 years preferred fluency. Neither nationality nor language background influenced their preference. Those who received no therapy overwhelmingly chose fluency, and a slight majority of those with fewer than 5 years of therapy preferred fluency. Those with more than 5 years of therapy were evenly divided between the 2 choices. Those who preferred freedom were more consistent in their responses across items than were those who opted for fluency. Based on the consistency of responses, 20% and 23% of the sample decisively opted for fluency and freedom, respectively, and 34% in the fluency group and 23% in the freedom group were ambivalent. CONCLUSION A majority of PWS appear to benefit from flexible treatment programs with cafeteria-style choices.
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Iverach L, Jones M, O'Brian S, Block S, Lincoln M, Harrison E, Hewat S, Cream A, Menzies RG, Packman A, Onslow M. The relationship between mental health disorders and treatment outcomes among adults who stutter. JOURNAL OF FLUENCY DISORDERS 2009; 34:29-43. [PMID: 19500713 DOI: 10.1016/j.jfludis.2009.02.002] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2008] [Revised: 02/19/2009] [Accepted: 02/19/2009] [Indexed: 05/27/2023]
Abstract
UNLABELLED The ability to reduce stuttering in everyday speaking situations is the core component of the management plan of many who stutter. However, the ability to maintain the benefits of speech-restructuring treatment is known to be compromised, with only around a third of clients achieving this [Craig, A. R., & Hancock, K. (1995). Self-reported factors related to relapse following treatment for stuttering. Australian Journal of Human Communication Disorders, 23, 48-60; Martin, R. (1981). Introduction and perspective: Review of published research. In E. Boberg (Ed.), Maintenance of fluency. New York: Elsevier]. The aim of this study was to determine whether the presence of mental health disorders contributes to this failure to maintain fluency after treatment. Assessments for mental health disorders were conducted with 64 adults seeking speech-restructuring treatment for their stuttering. Stuttering frequency, self-rated stuttering severity and self-reported avoidance were measured before treatment, immediately after treatment and 6 months after treatment. Stuttering frequency and situation avoidance were significantly worse for those participants who had been identified as having mental health disorders. The only subgroup that maintained the benefits of the treatment for 6 months was the third of the participants without a mental health disorder. These results suggest that prognosis for the ability to maintain fluency after speech restructuring should be guarded for clients with mental health disorders. Further research is needed to determine the benefits of treating such disorders prior to, or in combination with, speech-restructuring. EDUCATIONAL OBJECTIVES The reader will (1) evaluate the impact of one or more mental health disorders on medium-term outcomes from speech-restructuring treatment for stuttering, (2) describe how this finding affects prognosis for certain groups of stuttering clients, (3) evaluate how these finding are consistent with estimates of post-treatment relapse after speech-restructuring treatment, (4) describe two test instruments for detecting mental health disorders, and (5) outline the findings about the relation between pre-treatment stuttering severity and mental health disorders.
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Affiliation(s)
- Lisa Iverach
- Australian Stuttering Research Centre, The University of Sydney, NSW 2141, Australia
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Rousseau I, Onslow M, Packman A, Jones M. Comparisons of audio and audiovisual measures of stuttering frequency and severity in preschool-age children. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2008; 17:173-178. [PMID: 18448604 DOI: 10.1044/1058-0360(2008/017)] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE To determine whether measures of stuttering frequency and measures of overall stuttering severity in preschoolers differ when made from audio-only recordings compared with audiovisual recordings. METHOD Four blinded speech-language pathologists who had extensive experience with preschoolers who stutter measured stuttering frequency and rated overall severity from audio-only and audiovisual recordings of 36 preschool children who were stuttering. Stuttering frequency (percentage of syllables stuttered [%SS]) was based on counts of perceptually unambiguous stutterings, made in real time, and overall severity was measured using a 9-point rating scale. RESULTS Stuttering frequency was statistically significantly lower by around 20% when made from audio-only recordings. This was found to be directly attributable to differences in the counts of stuttered syllables, rather than to differences in the total numbers of syllables spoken. No significant differences were found between recording modalities for the ratings of overall severity. Correlations between %SS scores in the 2 modalities and severity rating scores in the 2 modalities were high, indicating that observers agreed on data trends across speech samples. CONCLUSIONS Measures of %SS made from audio-only recordings may underestimate stuttering frequency in preschoolers. Although audio-only %SS measures may underestimate stuttering frequency at the start of a clinical trial to a clinically significant extent, posttreatment scores at or below 1.0%SS are likely to underestimate by 0.2%SS or less, which is clinically insignificant.
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Affiliation(s)
- Isabelle Rousseau
- Australian Stuttering Research Centre, The University of Sydney, Australia
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Floyd J, Zebrowski PM, Flamme GA. Stages of change and stuttering: a preliminary view. JOURNAL OF FLUENCY DISORDERS 2007; 32:95-120. [PMID: 17499124 DOI: 10.1016/j.jfludis.2007.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2006] [Revised: 03/07/2007] [Accepted: 03/09/2007] [Indexed: 05/15/2023]
Abstract
UNLABELLED As a way to better understand the process of change that occurs in stuttering, Craig [Craig, A. (1998). Relapse following treatment for stuttering: a critical review and correlative data. Journal of Fluency Disorders, 23, 1-30] compared the behavioral changes that people who stutter often experience with and without treatment to those that have been observed for certain (non)addictive behavior disorders such as smoking, overeating, phobia and anxiety disorder. The process underlying these behavioral changes has been described by the transtheoretical or "stages of change" model, which is a model of behavior change that can illuminate "where" a person is in the process of change, and how this may relate to the outcome of either treatment or self-change attempts [Prochaska, J. O., & DiClemente, C. C. (1986). The transtheoretical approach. In J. C. Norcross (Ed.), Handbook of eclectic psychotherapy. New York: Brunner/Mazel]. The purpose of the present study was to analyze the extent to which the responses of adults who stutter on a modified Stages of Change Questionnaire yield interrelations among questionnaire items that are consistent with a stage-based interpretation. Results of both confirmatory and exploratory factor analyses indicated that while the modified questionnaire was a relatively good fit for participant responses, the structure derived from the exploratory analysis provided a significantly better fit to the observed data. Results suggest that a questionnaire incorporating items that better reflect the unique behavioral, cognitive and affective variables that characterize stuttering may better discriminate stages of change in people who stutter as they move through therapy, or are engaged in self-directed change. EDUCATIONAL OBJECTIVES After reading this paper, the learner will be able to: (1) describe the transtheoretical or "stages of change" model; (2) describe the various processes that are associated with different stages of change; (3) summarize research findings in stages of change as they apply to a variety of clinical populations; (4) discuss the applicability of the findings from the present study to stuttering treatment, and (5) relate conventional strategies and techniques used in stuttering therapy to different stages in the process of change.
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