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Bridgman K, Erickson S. Perceptions and experiences of Australian speech-language pathologists who use the Lidcombe Program with children who stutter. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 26:611-622. [PMID: 37688534 DOI: 10.1080/17549507.2023.2241677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/11/2023]
Abstract
Purpose: Speech-language pathologists (SLPs) have varying levels of training and experience working with children who stutter (CWS). They often work in contexts and populations that require clinical management to take them beyond the borders of translating clinical trial protocols and evidence-based practice (EBP). This study sought to investigate the clinical experiences of Australian SLPs working with CWS, including their Lidcombe Program confidence and practices. Method: A cross-sectional online survey was completed by 215 Australian SLPs during 2017-2020. They were recruited prior to attending one of 14 workshops hosted by Speech Pathology Australia (SPA). Result: Participants worked in a range of contexts and were from all states and territories. The majority assessed and/or treated up to five CWS annually. Six predictor variables were considered for self-reported clinical confidence. The quantitative analysis identified that an SLP's previous training, reading the SPA stuttering management clinical guideline, and the annual number of CWS treated were found to significantly impact self-reported clinical confidence. Themes included: (1) client, family, service, and context factors that influence clinical decision-making; (2) SLP areas of clinical strength and aspects of paediatric stuttering management requiring further development; and (3) factors that impact Lidcombe Program success and modifications. Conclusion: This study has found that Australian SLPs working with CWS identify a range of important factors that impact their practice.
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Affiliation(s)
- Kate Bridgman
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - Shane Erickson
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
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Wiele B, Cook S, Raj EX, Heim S. Long-term evaluation of psychosocial impact and stuttering severity after intensive stuttering therapy. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-15. [PMID: 39219356 DOI: 10.1080/17549507.2024.2371869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
PURPOSE The purpose of this study was to assess the long-term stability of objective and subjective psychosocial improvements and fluency more than 10 years after participation in an intensive stuttering therapy camp. METHOD Ten former participants in intensive stuttering therapy (IST; mean age at time of intervention 14; 2 years) participated in this study. Outcomes of the IST at that time were assessed with the Stuttering Severity Instrument (SSI-3; Riley, 1994) and a questionnaire to measure the psychosocial impact of stuttering. A semi-structured video call and a general questionnaire for the long-term evaluation were used to gauge the participants' perceptions of the IST. These follow-up data were compared to the therapy outcomes reported by Cook (2011, 2013). RESULT Therapy effects on the severity of stuttering and psychosocial impact were stable over the follow-up period of more than 10 years. Moreover, scores for psychosocial impact and severity of stuttering further decreased from the end of the IST to the long-term evaluation. The intensive time and the periodically offered follow-up treatments were described as particularly positive by the participants. CONCLUSION Intensive stuttering therapy in childhood or adolescence can have a long-term positive effect on both internal and external stuttering symptoms.
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Affiliation(s)
- Birte Wiele
- Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Susanne Cook
- Stotterintensivtherapie Cook, Karlsruhe, Germany
| | - Erik X Raj
- Department of Speech-Language Pathology, Monmouth University, West Long Branch, NJ, USA
| | - Stefan Heim
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
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Coalson GA, Byrd CT, Werle D, Croft R, Mahometa M. Self-Perceived Communication Competence of Adults Who Stutter Following Communication-Centered Treatment. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1965-1985. [PMID: 38820237 DOI: 10.1044/2024_ajslp-23-00234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2024]
Abstract
PURPOSE The purpose of this study was to assess self-perceived communication competence of adults who stutter following participation in a non-ableist treatment for which one of the core components focuses on communication - with no direct or indirect goals designed to reduce or modify stuttered speech. METHOD Thirty-three adults who stutter completed the Self-Perceived Communication Competence scale (McCroskey & McCroskey, 1988) pre- and posttreatment. RESULTS Findings indicate significant gains in self-perceived communication competence posttreatment. Pre- to posttreatment changes in stuttering did not predict posttreatment gains in self-perceived communication competence. CONCLUSION The present study demonstrates that improvement in communication can be achieved independent of improvement in fluency, lending further support to the notion that stuttering and communication competence are distinct constructs.
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Theys C, Jaakkola E, Melzer TR, De Nil LF, Guenther FH, Cohen AL, Fox MD, Joutsa J. Localization of stuttering based on causal brain lesions. Brain 2024; 147:2203-2213. [PMID: 38797521 PMCID: PMC11146419 DOI: 10.1093/brain/awae059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 01/23/2024] [Accepted: 02/06/2024] [Indexed: 05/29/2024] Open
Abstract
Stuttering affects approximately 1 in 100 adults and can result in significant communication problems and social anxiety. It most often occurs as a developmental disorder but can also be caused by focal brain damage. These latter cases may lend unique insight into the brain regions causing stuttering. Here, we investigated the neuroanatomical substrate of stuttering using three independent datasets: (i) case reports from the published literature of acquired neurogenic stuttering following stroke (n = 20, 14 males/six females, 16-77 years); (ii) a clinical single study cohort with acquired neurogenic stuttering following stroke (n = 20, 13 males/seven females, 45-87 years); and (iii) adults with persistent developmental stuttering (n = 20, 14 males/six females, 18-43 years). We used the first two datasets and lesion network mapping to test whether lesions causing acquired stuttering map to a common brain network. We then used the third dataset to test whether this lesion-based network was relevant to developmental stuttering. In our literature dataset, we found that lesions causing stuttering occurred in multiple heterogeneous brain regions, but these lesion locations were all functionally connected to a common network centred around the left putamen, including the claustrum, amygdalostriatal transition area and other adjacent areas. This finding was shown to be specific for stuttering (PFWE < 0.05) and reproducible in our independent clinical cohort of patients with stroke-induced stuttering (PFWE < 0.05), resulting in a common acquired stuttering network across both stroke datasets. Within the common acquired stuttering network, we found a significant association between grey matter volume and stuttering impact for adults with persistent developmental stuttering in the left posteroventral putamen, extending into the adjacent claustrum and amygdalostriatal transition area (PFWE < 0.05). We conclude that lesions causing acquired neurogenic stuttering map to a common brain network, centred to the left putamen, claustrum and amygdalostriatal transition area. The association of this lesion-based network with symptom severity in developmental stuttering suggests a shared neuroanatomy across aetiologies.
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Affiliation(s)
- Catherine Theys
- School of Psychology, Speech and Hearing, University of Canterbury, 8140 Christchurch, New Zealand
- New Zealand Institute of Language, Brain and Behaviour, University of Canterbury, 8140 Christchurch, New Zealand
- New Zealand Brain Research Institute, 8011 Christchurch, New Zealand
| | - Elina Jaakkola
- Turku Brain and Mind Center, Clinical Neurosciences, University of Turku, 20014 Turku, Finland
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland
| | - Tracy R Melzer
- School of Psychology, Speech and Hearing, University of Canterbury, 8140 Christchurch, New Zealand
- New Zealand Brain Research Institute, 8011 Christchurch, New Zealand
- Department of Medicine, University of Otago, 8011 Christchurch, New Zealand
- RHCNZ—Pacific Radiology Canterbury, 8031 Christchurch, New Zealand
| | - Luc F De Nil
- Department of Speech-Language Pathology, University of Toronto, Toronto, ON M5G 1V7, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON M5G 1V7, Canada
| | - Frank H Guenther
- Departments of Speech, Language and Hearing Sciences and Biomedical Engineering, Boston University, Boston, MA 02215, USA
- The Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Alexander L Cohen
- Department of Neurology, Boston Children’s Hospital, Boston, MA 02115, USA
- Center for Brain Circuit Therapeutics, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
| | - Michael D Fox
- Center for Brain Circuit Therapeutics, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
| | - Juho Joutsa
- Turku Brain and Mind Center, Clinical Neurosciences, University of Turku, 20014 Turku, Finland
- Turku PET Centre, Neurocenter, Turku University Hospital, 20014 Turku, Finland
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Byrd CT, Coalson GA, Werle D. Observer-rated outcomes of communication-centered treatment for adults who stutter: A social validation study. PLoS One 2024; 19:e0303024. [PMID: 38753611 PMCID: PMC11098369 DOI: 10.1371/journal.pone.0303024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 04/02/2024] [Indexed: 05/18/2024] Open
Abstract
Previous studies have reported that adults who stutter demonstrate significant gains in communication competence, per self-ratings and clinician-ratings, upon completion of a communication-centered treatment, or CCT. The purpose of this social validation study was to determine whether communication competence ratings reported by untrained observers are consistent with client and clinician judgments of communication competence gains following CCT. Eighty-one untrained observers completed an online survey that required each to view one of two videos depicting an adult who stutters during a mock interview recorded prior to CCT or after CCT. Observers were then asked to rate the communication competence of the interviewee on a 100-point visual analog scale and provide additional demographic information. Communication competence of the adult who stutters who had completed CCT was rated significantly higher in their post-treatment video. Upon controlling for two demographic factors found to be associated with observer ratings (years of education, years the observers had known an adult who stutters), significantly higher ratings of communication competence for the post-treatment video were maintained. These preliminary findings provide social validity for CCT by demonstrating that the gains in communication competence reported in previous studies through clinician and client observations are also reported by untrained observers who are not familiar with CCT.
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Affiliation(s)
- Courtney T. Byrd
- Arthur M. Blank Center for Stuttering Education and Research (AMBCSER), The University of Texas at Austin, Austin, Texas, United States of America
| | - Geoffrey A. Coalson
- Arthur M. Blank Center for Stuttering Education and Research (AMBCSER), The University of Texas at Austin, Austin, Texas, United States of America
| | - Danielle Werle
- AMBCSER, Atlanta Satellite, Atlanta, Georgia, United States of America
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Johnson G, Onslow M, Horton S, Kefalianos E. Reduced stuttering for school-age children: A systematic review. JOURNAL OF FLUENCY DISORDERS 2023; 78:106015. [PMID: 37776613 DOI: 10.1016/j.jfludis.2023.106015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/09/2023] [Accepted: 09/19/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Treatment of school-age children (6-12 years of age) who stutter is a public health priority. Their clinical needs include a psychosocial focus and stuttering reduction. For the latter clinical need, there is a critical window of opportunity for these children warranting research attention. PURPOSE The purpose of the review is to guide future clinical research by establishing (a) what interventions are associated with stuttering reduction for school-age children (b) the reported immediate and longer-term effects of those interventions, and (c) the level of evidence for these interventions in terms of study design. METHODS Fourteen databases and three conference proceedings were searched for interventions used to reduce stuttering in school-age children. Primary outcomes were mean stuttering reductions pre-treatment, immediately post-treatment, and any follow-up assessments. RESULTS Of the 4305 studies identified from the databases, 67 studies met inclusion criteria. Five different treatment approaches were reported in the literature that might reduce stuttering for a school-age child, but with varying effect sizes. These include (a) operant methods, (b) speech restructuring, (c) combined operant methods and speech restructuring, (d) machine-driven treatments, and (e) treatments with a cognitive behaviour therapy component. CONCLUSIONS Operant methods warrant investigation in future clinical trial research, as do variants of speech restructuring. Hybrid approaches showed encouraging results, including speech restructuring variants combined with operant methods or with cognitive behaviour therapy. However, evidence is preliminary only at Phase I and II trials. Several treatments with reported clinical promise have been overlooked for decades and require further investigation.
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Affiliation(s)
- Georgina Johnson
- University of Melbourne, Department of Audiology & Speech Pathology, VIC, Australia.
| | - Mark Onslow
- University of Technology Sydney, Australian Stuttering Research Centre, NSW, Australia
| | - Sarah Horton
- University of Melbourne, Department of Audiology & Speech Pathology, VIC, Australia; Murdoch Children's Research Institute, Speech and Language Group, VIC, Australia
| | - Elaina Kefalianos
- University of Melbourne, Department of Audiology & Speech Pathology, VIC, Australia; Murdoch Children's Research Institute, Speech and Language Group, VIC, Australia
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Johnson G, Onslow M, Horton S, Kefalianos E. Psychosocial features of stuttering for school-age children: A systematic review. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:1829-1845. [PMID: 37132231 DOI: 10.1111/1460-6984.12887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 04/03/2023] [Indexed: 05/04/2023]
Abstract
BACKGROUND Contemporary clinical and empirical perspectives indicate that management of the psychosocial features of stuttering is fundamental for effective treatment. Interventions that improve psychosocial outcomes for school-age children who stutter are, therefore, needed. AIMS This systematic review identifies what psychosocial outcomes have been explored in existing school-age clinical research, the measures used and the potential treatment effects. This will provide guidance for developing interventions that reflect contemporary perspectives of stuttering management. METHODS & PROCEDURES A total of 14 databases and three conference proceedings were searched for clinical reports of psychosocial outcomes of children aged 6-12 years. The review did not include pharmacological interventions. Psychosocial measures and outcomes were analysed in each study based on data recorded pre-treatment, immediately post-treatment and for any follow-up assessments. MAIN CONTRIBUTIONS Of the 4051 studies identified from the databases, a total of 22 studies met criteria for inclusion in the review. From these 22 studies, the review identified four prominent psychosocial domains that have been explored in school-age clinical research to date: Impact of stuttering, communication attitude, anxiety and speech satisfaction. These domains vary in measurement and effect sizes. Two behavioural treatments were associated with anxiety reduction, even though they did not contain anxiolytic procedures. No evidence of potential treatment effects emerged for communication attitudes. Quality of life-an important psychosocial domain pertinent to health economics-did not feature in school-age clinical reports. CONCLUSIONS & IMPLICATIONS The psychosocial features of stuttering need to be managed during the school years. Three psychosocial domains-impact of stuttering, anxiety and speech satisfaction-show evidence of potential treatment effects. This review provides direction for future clinical research so that speech-language pathologists can effectively and holistically manage school-age children who stutter. WHAT THIS PAPER ADDS What is already known on the subject Elevated levels of anxiety are apparent for children and adolescents who stutter. Therefore, the need to assess and manage psychosocial features of stuttering are expertly regarded as clinical priorities. Clinical trials of such psychosocial features of stuttering for children aged 6-12 years are not well advanced and, therefore, do not reflect current best practice management of this disorder. What this study adds to existing knowledge This systematic review identifies four different psychosocial domains measured and reported in the literature for school-age stuttering management. For three psychosocial domains, some evidence of potential treatment effects emerged with participant numbers greater than 10: Impact of stuttering, anxiety and speech satisfaction. Though treatment effect sizes varied, there is a suggestion that cognitive behaviour therapy can improve anxiety of school-age children who stutter. There is also suggestion that two other behavioural treatments can improve anxiety of school-age children who stutter. What are the potential or actual clinical implications of this work? Given the essential need for school-age children who stutter to receive management of any speech-related anxiety they may experience, it would be productive to discover in future clinical research what interventions could contribute to that goal-behavioural or psychosocial, or both. This review reveals that cognitive behaviour therapy, and other behavioural treatments, are associated with anxiety reductions. Such approaches should be considered for future clinical trial research to help advance the evidence base for managing school-age stuttering.
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Affiliation(s)
- Georgina Johnson
- Department of Audiology & Speech Pathology, University of Melbourne, Melbourne, VIC, Australia
| | - Mark Onslow
- Australian Stuttering Research Centre, University of Technology Sydney, Sydney, NSW, Australia
| | - Sarah Horton
- Department of Audiology & Speech Pathology, University of Melbourne, Melbourne, VIC, Australia
- Murdoch Children's Research Institute, Speech and Language Group, Melbourne, VIC, Australia
| | - Elaina Kefalianos
- Department of Audiology & Speech Pathology, University of Melbourne, Melbourne, VIC, Australia
- Murdoch Children's Research Institute, Speech and Language Group, Melbourne, VIC, Australia
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Erickson S, Bridgman K, Furlong L. Australian speech-language pathologists' experiences and perceptions of working with children who stutter: A qualitative study. JOURNAL OF FLUENCY DISORDERS 2023; 75:105944. [PMID: 36434976 DOI: 10.1016/j.jfludis.2022.105944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/11/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Effective early intervention is recommended to ameliorate the potential long term negative effects of stuttering. Efficacious treatments are available, but speech-language pathologists (SLPs) report finding implementation to be challenging due to a range of clinician, client and clinical context factors. Previous survey-based research has found that SLPs lack self-efficacy working with CWS, however the reasons contributing to this are not well understood. This study presents the first in-depth analysis of the current practices and perceptions of SLPs working with children who stutter (CWS). METHODS In this qualitative study 18 Australian SLPs who provide services to CWS were interviewed using a semi-structured interview approach. Data were analysed using reflexive thematic analysis. RESULTS The thematic analysis identified four themes: (1) A stronger sense of self-efficacy is needed in stuttering management compared to other areas of clinical practice; 2) SLPs' sense of self-efficacy in stuttering management is influenced by early career experiences, client factors and the practice context; 3) Professional development and collaboration strengthen self-efficacy; and 4) Parental involvement and engagement are crucial to treatment success. CONCLUSION SLP self-efficacy for working with CWS appears a critical factor in the provision of effective management for this population. This study provides an in-depth analysis of the role of SLP self-efficacy and the factors that influence it.
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Affiliation(s)
| | | | - Lisa Furlong
- La Trobe University, Bundoora, Australia; University of Canterbury, Christchurch, New Zealand
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Boyce JO, Jackson VE, van Reyk O, Parker R, Vogel AP, Eising E, Horton SE, Gillespie NA, Scheffer IE, Amor DJ, Hildebrand MS, Fisher SE, Martin NG, Reilly S, Bahlo M, Morgan AT. Self-reported impact of developmental stuttering across the lifespan. Dev Med Child Neurol 2022; 64:1297-1306. [PMID: 35307825 DOI: 10.1111/dmcn.15211] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 02/24/2022] [Accepted: 02/28/2022] [Indexed: 02/05/2023]
Abstract
AIM To examine the phenomenology of stuttering across the lifespan in the largest prospective cohort to date. METHOD Participants aged 7 years and older with a history of developmental stuttering were recruited. Self-reported phenotypic data were collected online including stuttering symptomatology, co-occurring phenotypes, genetic predisposition, factors associated with stuttering severity, and impact on anxiety, education, and employment. RESULTS A total of 987 participants (852 adults: 590 males, 262 females, mean age 49 years [SD = 17 years 10 months; range = 18-93 years] and 135 children: 97 males, 38 females, mean age 11 years 4 months [SD = 3 years; range = 7-17 years]) were recruited. Stuttering onset occurred at age 3 to 6 years in 64.0%. Blocking (73.2%) was the most frequent phenotype; 75.9% had sought stuttering therapy and 15.5% identified as having recovered. Half (49.9%) reported a family history. There was a significant negative correlation with age for both stuttering frequency and severity in adults. Most were anxious due to stuttering (90.4%) and perceived stuttering as a barrier to education and employment outcomes (80.7%). INTERPRETATION The frequent persistence of stuttering and the high proportion with a family history suggest that stuttering is a complex trait that does not often resolve, even with therapy. These data provide new insights into the phenotype and prognosis of stuttering, information that is critically needed to encourage the development of more effective speech therapies. WHAT THIS PAPER ADDS Half of the study cohort had a family history of stuttering. While 75.9% of participants had sought stuttering therapy, only 15.5% identified as having recovered. There was a significant negative correlation between age and stuttering frequency and severity in adults.
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Affiliation(s)
- Jessica O Boyce
- Speech and Language, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Audiology and Speech Pathology, University of Melbourne, Parkville, VIC, Australia
| | - Victoria E Jackson
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia
| | - Olivia van Reyk
- Speech and Language, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Richard Parker
- Queensland Institute for Medical Research, Berghofer Medical Research Institute, Brisbane, Australia
| | - Adam P Vogel
- Department of Audiology and Speech Pathology, University of Melbourne, Parkville, VIC, Australia.,Centre for Neuroscience of Speech, University of Melbourne, Parkville, VIC, Australia.,Redenlab Inc, Melbourne, VIC, Australia
| | - Else Eising
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, the Netherlands
| | - Sarah E Horton
- Speech and Language, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Audiology and Speech Pathology, University of Melbourne, Parkville, VIC, Australia
| | - Nathan A Gillespie
- Queensland Institute for Medical Research, Berghofer Medical Research Institute, Brisbane, Australia.,Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, VA, USA
| | - Ingrid E Scheffer
- Epilepsy Research Centre, Department of Medicine, University of Melbourne, Heidelberg, VIC, Australia.,Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
| | - David J Amor
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia.,Royal Children's Hospital
| | - Michael S Hildebrand
- Epilepsy Research Centre, Department of Medicine, University of Melbourne, Heidelberg, VIC, Australia
| | - Simon E Fisher
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, the Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
| | - Nicholas G Martin
- Queensland Institute for Medical Research, Berghofer Medical Research Institute, Brisbane, Australia
| | - Sheena Reilly
- Menzies Health Institute Queensland, Griffith University, Southport, Australia
| | - Melanie Bahlo
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia
| | - Angela T Morgan
- Speech and Language, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Audiology and Speech Pathology, University of Melbourne, Parkville, VIC, Australia.,Royal Children's Hospital
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Laiho A, Elovaara H, Kaisamatti K, Luhtalampi K, Talaskivi L, Pohja S, Routamo-Jaatela K, Vuorio E. Stuttering interventions for children, adolescents, and adults: a systematic review as a part of clinical guidelines. JOURNAL OF COMMUNICATION DISORDERS 2022; 99:106242. [PMID: 35751980 DOI: 10.1016/j.jcomdis.2022.106242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 05/01/2022] [Accepted: 06/15/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Stuttering may have a holistic effect on the quality of life of a person who stutters by limiting participation in social situations, resulting in feelings of isolation and frustration, leading to difficulties in education and employment and increasing the likelihood of mental health problems. Even young children who stutter may have negative experiences of speaking. Therefore, it is important to treat stuttering behavior effectively in both children and adults. The purpose of this paper was to systematically review group and case studies about the effectiveness of behavioral stuttering interventions to provide evidence-based guidelines for clinicians. METHODS Systematic data retrieval was conducted in four electronic databases (PsycINFO, CINAHL, PubMed, Cochrane). The assessment of search results was conducted according to predetermined inclusion and exclusion criteria by two independent judges. The methodological quality of each paper was assessed using strict criteria to include only high-quality research. RESULTS The search revealed 2293 results, and 38 papers (systematic reviews N=3, group design studies N=21 and case studies N=14) with acceptable methodological quality were included. The data show that there is most evidence about the treatment of early childhood stuttering, very little evidence about school-aged children and some evidence about adults. The most convincing evidence is about the Lidcombe Program in the treatment of young children who stutter, but also other methods have promising evidence. Our data imply that in the treatment of adults who stutter, holistic treatments may influence speech fluency and overall experience of stuttering behavior. Speech restructuring treatments may have a positive effect on overt characteristics of stuttering, but not on covert stuttering behavior. CONCLUSIONS The results of this review agree with earlier reviews about the treatment of young children. However, due to different inclusion criteria, this review also shows the benefits of holistic treatment approaches with adults and adolescents.
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Affiliation(s)
- Auli Laiho
- Finnish Association of Speech and Language Therapists; Voimavarakeskus Tempo Oy, Tempo - Stuttering Resource Center.
| | - Heli Elovaara
- Finnish Association of Speech and Language Therapists; Salon kaupunki, City of Salo.
| | - Kirsi Kaisamatti
- Finnish Association of Speech and Language Therapists; Coronaria Terapeija Oy.
| | - Katri Luhtalampi
- Finnish Association of Speech and Language Therapists; Logopedica.
| | - Liisa Talaskivi
- Finnish Association of Speech and Language Therapists; Kommunikointikeskus Kipinä Oy.
| | - Salla Pohja
- Finnish Association of Speech and Language Therapists; Voimavarakeskus Tempo Oy, Tempo - Stuttering Resource Center.
| | | | - Elsa Vuorio
- Finnish Association of Speech and Language Therapists; Private Practice.
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11
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Iimura D, Kakuta K, Oe T, Kobayashi H, Sakai N, Miyamoto S. Treatment for School-Age Children Who Stutter: A Systematic Review of Japanese Literature. Lang Speech Hear Serv Sch 2022; 53:561-583. [PMID: 35157506 DOI: 10.1044/2021_lshss-21-00044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE This systematic review identified and synthesized published research articles, written in Japanese, on the clinical effectiveness of a broad range of nonpharmacological interventions for school-age children who stutter. METHOD A systematic review of Japanese literature published between January 1, 1980, and July 7, 2020, reporting interventions for school-age children who stutter, was carried out through a search of two databases (CiNii Article database and Japan Medical Abstract Society database) using the key words "stuttering" and "school-age" or "child" or "primary school students" or "children" or "school child" in Japanese. To be included in the review, the articles must report studies where data were subjectively reported by clinicians, where school-age participants were treated for developmental stuttering, where participants received interventions conducted by clinicians, and where quantitative outcomes (pre- and/or posttreatment) were measured; and they must be published in Japanese. RESULTS Forty articles met all the inclusion criteria. Most articles adopted a case series or single-case study design. A total of 179 intervention programs were identified from all the articles and broadly classified into speech therapy, psychological therapy, interventions for modifying the child's environment, and others. CONCLUSIONS Our systematic review provided a broad overview of the treatments used for school-age children who stutter in Japan. Future research should focus on gathering more reliable, systematic, and rigorous evidence to establish the effectiveness of stuttering treatments for school-age children and thereby develop evidence-based practices.
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Affiliation(s)
- Daichi Iimura
- Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Okayama, Japan.,Graduate School of Comprehensive Human Sciences,University of Tsukuba, Japan
| | - Kohei Kakuta
- Department of Rehabilitation, Hospital, National Rehabilitation Center for Persons with Disabilities, Saitama, Japan
| | - Takuya Oe
- Graduate School of Comprehensive Human Sciences,University of Tsukuba, Japan
| | - Hiroaki Kobayashi
- School of Teacher Education, College of Human and Social Science, Kanazawa University, Japan.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Naomi Sakai
- Research Institute, National Rehabilitation Center for Persons with Disabilities, Saitama, Japan
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12
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Bernard R, Hofslundsengen H, Frazier Norbury C. Anxiety and Depression Symptoms in Children and Adolescents Who Stutter: A Systematic Review and Meta-Analysis. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:624-644. [PMID: 35084999 DOI: 10.1044/2021_jslhr-21-00236] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE The purpose of this study was to investigate whether there are elevated symptoms of anxiety or depression in children and adolescents (aged 2-18 years) who stutter, and to identify potential moderators of increased symptom severity. METHOD We conducted a preregistered systematic review of databases and gray literature; 13 articles met criteria for inclusion. A meta-analysis using robust variance estimation was conducted with 11 cohort studies comparing symptoms of anxiety in children and adolescents who do and do not stutter. Twenty-six effect sizes from 11 studies contributed to the summary effect size for anxiety symptoms (851 participants). Meta-analysis of depression outcomes was not possible due to the small number of studies. RESULTS The summary effect size indicates that children and adolescents who stutter present with increased anxiety symptoms (g = 0.42) compared with nonstuttering peers. There were insufficient studies to robustly analyze depression symptoms, and qualitative review is provided. No significant between-groups differences were reported in any of the depression studies. CONCLUSIONS Preliminary evidence indicates elevated symptoms of anxiety in some children and adolescents who stutter relative to peers. There was a tendency toward higher depression scores in this population, although reported between-groups differences did not reach statistical significance. These findings require replication in larger, preferably longitudinal studies that consider factors that may moderate risk. Nevertheless, our findings highlight a need for careful monitoring of mental health and well-being in young people who stutter. Supplemental Materials: http://osf.io/5m6zv.
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Affiliation(s)
- Ria Bernard
- Language and Cognition, Division of Psychology and Language Sciences, University College London, United Kingdom
| | - Hilde Hofslundsengen
- Department of Language, Literature, Mathematics and Interpreting, Western Norway University of Applied Sciences, Bergen
| | - Courtenay Frazier Norbury
- Language and Cognition, Division of Psychology and Language Sciences, University College London, United Kingdom
- Language & Cognition, UCL and Department of Special Needs Education, University of Oslo, Norway
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Rojas Contreras D, Saavedra Rojas P, Aravena Gallardo SL. Intervención de la tartamudez en niños: una revisión integrativa de la literatura. REVISTA CEFAC 2022. [DOI: 10.1590/1982-0216/20222427521s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMEN Objetivo: describir las metodologías de intervención implementadas durante los últimos años en niños con tartamudez Métodos: se realizó la búsqueda de artículos empíricos de tratamiento en niños con tartamudez entre los 2.5 a 7 años. Se consideraron artículos publicados entre enero del año 2014 a junio del año 2020. La búsqueda se realizó en las bases de datos Embase, WOS, Pubmed y Scopus. Junto a lo anterior se realizó un análisis de las referencias de los artículos seleccionados. Revisión de la Literatura: se seleccionaron 11 artículos de 1.099 revisados. Se observaron distintas propuestas de intervención de las cuales el Programa Lidcombe es el que mayor evidencia presenta. La mayoría de las investigaciones fueron realizadas en hablantes de lengua inglesa. Los participantes son evaluados tanto en aspectos lingüísticos como no lingüísticos. Todos consideraron la participación de los padres en la intervención. No hubo investigaciones con mediciones a más de 24 meses. Predomina la modalidad de intervención individual. Conclusión: se evidencian buenos resultados terapéuticos en todas las intervenciones revisadas. En las investigaciones que compararon dos tipos de tratamiento no se observó la superioridad de uno por sobre otro.
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Rojas Contreras D, Saavedra Rojas P, Aravena Gallardo SL. Stuttering intervention in children: an integrative literature review. REVISTA CEFAC 2022. [DOI: 10.1590/1982-0216/20222427521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Purpose: to describe intervention methodologies implemented in recent years in stuttering children. Methods: a search was performed for empirical articles on interventions in stuttering children aged 2.5 to 7 years. The search was carried out in Embase, WOS, Pubmed, and Scopus, considering articles published between January 2014 and June 2020. Literature Review: 11 articles were selected out of the 1,099 retrieved. Different approaches were observed, of which the Lidcombe program showed the most evidence. Most studies were conducted on English-speaking children and participants were assessed regarding linguistic and non-linguistic aspects. All studies considered parental involvement in the intervention. No investigation took measurements for more than 24 months. Individual interventions predominated. Conclusion: good therapeutic results were found in all reviewed interventions. Research comparing two types of treatments did not find one to be superior to the other.
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Prince A, Marsden J, Wren Y, Hayhow R, Harding S. The Fluency Trust Residential Course for young people who stutter: A pragmatic feasibility study. JOURNAL OF COMMUNICATION DISORDERS 2022; 95:106181. [PMID: 35051833 DOI: 10.1016/j.jcomdis.2021.106181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 11/24/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION A feasibility study of The Fluency Trust Residential Course (FTRC) for adolescents who stutter was conducted. The study aimed to measure key areas of a feasibility trial, for example, recruitment and retention, outcome measure completion, outcome measure reliability, and acceptability of the intervention to inform future research into the FTRC. METHODS Quantitative and qualitative methods were used. Participants were 23 adolescents (12-17 years), 23 parents and 2 Speech-Language Pathologists (SLPs) from the FTRC. Data collection included: outcome measure collection via a pre-test post-test quasi-experimental design (including two baseline measures), intervention fidelity checklists, semi-structured interviews with adolescents to explore acceptability of the intervention and semi-structured interviews with SLPs to explore their experiences of research participation and views on a future trial. RESULTS Recruitment, retention and outcome measure completion levels were all 100%. Intervention fidelity was 95% and there were no adverse events. Outcome measures showed good test- re-test reliability: Progress Questionnaire Child Intraclass Correlation Coefficient (ICC) = 0.87 (95% CI = 0.69-0.94 sig< 0.001) and Progress Questionnaire Parent ICC = 0.88 (95% CI = 0.70-0.95 sig< 0.001). Descriptive statistics showed that group medians and means of all outcome measures shifted in a positive direction between pre and post-tests (9 weeks follow-up). Twenty-five percent of young people showed changes on the Progress Questionnaire Child that were above the minimal important difference. Seventy-five percent of parents showed changes on the Progress Questionnaire Parent that were above the minimal important difference. Acceptability of the intervention by adolescents was high. SLPs reported participation was manageable and they were pleased to be part of the research. CONCLUSION Quantitative and qualitative data suggest that a future definitive trial of the FTRC is indicated after additional development work and feasibility testing. Recommendations for further research are included.
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Affiliation(s)
- Anna Prince
- Sirona care and health, Speech and Language Therapy Department, Community Children's Health Partnership, Unit 9 Eastgate Office Centre, Unit 9 Eastgate Office Centre, Eastgate Road, Bristol BS5 6XX, United Kingdom; University of Plymouth, School of Health Professions, FF20 Peninsular Allied Health Centre, College of St Mark and St John, PL6 8BH, United Kingdom.
| | - Jonathan Marsden
- University of Plymouth, School of Health Professions, FF20 Peninsular Allied Health Centre, College of St Mark and St John, PL6 8BH, United Kingdom
| | - Yvonne Wren
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, Pines and Steps, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, United Kingdom; Bristol Dental School, Upper Maudlin Street, University of Bristol, BS1 2LY UK, United Kingdom
| | - Rosemarie Hayhow
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, Pines and Steps, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, United Kingdom
| | - Sam Harding
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, Pines and Steps, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, United Kingdom
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Brignell A, Krahe M, Downes M, Kefalianos E, Reilly S, Morgan A. Interventions for children and adolescents who stutter: A systematic review, meta-analysis, and evidence map. JOURNAL OF FLUENCY DISORDERS 2021; 70:105843. [PMID: 33743406 DOI: 10.1016/j.jfludis.2021.105843] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 03/09/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE This systematic review critically appraises and maps the evidence for stuttering interventions in childhood and adolescence. We examine the effectiveness of speech-focused treatments, the efficacy of alternative treatment delivery methods and identify gaps in the research evidence. METHODS Nine electronic databases and three clinical trial registries were searched for systematic reviews, randomised controlled trials (RCTs) and studies that applied an intervention with children (2-18 years) who stutter. Pharmacological interventions were excluded. Primary outcomes were a measure of stuttering severity and quality assessments were conducted on all included studies. RESULTS Eight RCTs met inclusion criteria and were analysed. Intervention approaches included direct (i.e. Lidcombe Program; LP) and indirect treatments (e.g. Demands and Capacities Model; DCM). All studies had moderate risk of bias. Treatment delivery methods included individual face-to-face, telehealth and group-based therapy. Both LP and DCM approaches were effective in reducing stuttering in preschool aged children. LP had the highest level of evidence (pooled effect size=-3.8, CI -7.3 to -0.3 for LP). There was no high-level evidence for interventions with school-aged children or adolescents. Alternative methods of delivery were as effective as individual face-to-face intervention. CONCLUSION The findings of this systematic review and evidence mapping are useful for clinicians, researchers and service providers seeking to understand the existing research to support the advancement of interventions for children and adolescence who stutter. Findings could be used to inform further research and support clinical decision-making.
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Affiliation(s)
- Amanda Brignell
- Speech and Language Group, Murdoch Children's Research Institute, Parkville, Victoria, 3052, Australia
| | - Michelle Krahe
- Health Group, Griffith University, Southport, Queensland, 4222, Australia
| | - Martin Downes
- Centre for Applied Health Economics, School of Medicine, Griffith University, Nathan, Queensland, 4111, Australia
| | - Elaina Kefalianos
- Department of Audiology and Speech Pathology, University of Melbourne, Parkville, Victoria, 3052, Australia
| | - Sheena Reilly
- Health Group, Griffith University, Southport, Queensland, 4222, Australia
| | - Angela Morgan
- Speech and Language Group, Murdoch Children's Research Institute, Parkville, Victoria, 3052, Australia.
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Seitz SR, Choo AL. Stuttering: Stigma and perspectives of (dis)ability in organizational communication. HUMAN RESOURCE MANAGEMENT REVIEW 2021. [DOI: 10.1016/j.hrmr.2021.100875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Irani F, Rojas R. Intensive Stuttering Therapy with Telepractice Follow-Up: Longitudinal Outcomes. Folia Phoniatr Logop 2021; 74:254-270. [PMID: 34583350 DOI: 10.1159/000519866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 09/19/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE This study estimated the treatment outcomes of a behavioral stuttering therapy program that blended a combination of intensive face-to-face therapy with telepractice-based follow-up therapy. METHOD A total of 17 participants (mean age = 22 years) who stutter participated in the program, preceded by an extended baseline period. The participants completed a series of assessments conducted over multiple time points, spanning a total of 42 weeks. Growth curve modeling was used to analyze the changes participants experienced in the frequency of stuttering, stuttering severity, communication attitudes, and quality of life. RESULTS The participants demonstrated stability throughout the extended baseline period, and experienced positive outcomes from the intensive program and the gains in communication attitudes and quality of life were largely maintained with weekly follow-up telepractice sessions. However, stuttering frequency and severity increased when the telepractice follow-up session frequency transitioned to a biweekly basis. Neither gender nor age group predicted the treatment outcomes for frequency or severity of stuttering. Gender-based differences were found for the treatment outcomes of specific self-report measures, with male participants having demonstrated a greater proportional decline on their standard scores, relative to female participants. Outcomes were similar for both adolescents and adults. CONCLUSIONS Participants attending the intensive stuttering therapy program experienced positive and significant changes in their speech, attitudes toward communication, and overall quality of life, which were maintained over time with structured, weekly telepractice follow-up sessions.
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Affiliation(s)
- Farzan Irani
- Department of Communication Disorders, Texas State University, Round Rock, Texas, USA
| | - Raúl Rojas
- Department of Speech, Language and Hearing, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
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Moïse-Richard A, Ménard L, Bouchard S, Leclercq AL. Real and virtual classrooms can trigger the same levels of stuttering severity ratings and anxiety in school-age children and adolescents who stutter. JOURNAL OF FLUENCY DISORDERS 2021; 68:105830. [PMID: 33662867 DOI: 10.1016/j.jfludis.2021.105830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 01/30/2021] [Accepted: 02/09/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE Many school-age children and adolescents who stutter experience the fear of public speaking. Treatment implications include the need to address this problem. However, it is not always possible to train repeatedly in front of a real audience. The present study aimed to assess the relevance of using a virtual classroom in clinical practice with school-age children and adolescents who stutter. METHODS Ten children and adolescents who stutter (aged 9-17 years old) had to speak in three different situations: in front of a real audience, in front of a virtual class and in an empty virtual apartment using a head-mounted display. We aimed to assess whether the self-rated levels of anxiety while speaking in front of a virtual audience reflect the levels of anxiety reported while speaking in front of a live audience, and if the stuttering level while speaking to a virtual class reflects the stuttering level while speaking in real conditions. RESULTS Results show that the real audience creates higher anticipatory anxiety than the virtual class. However, both the self-reported anxiety levels and the stuttering severity ratings when talking in front of a virtual class did not differ from those observed when talking to a real audience, and were significantly higher than when talking in an empty virtual apartment. CONCLUSION Our results support the feasibility and relevance of using a virtual classroom to expose school-age children and adolescents who stutter to a feared situation during cognitive behavioral therapy targeting the fear of public speaking.
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Affiliation(s)
- Anne Moïse-Richard
- Marie Enfant Rehabilitation Centre of Sainte-Justine University Hospital Centre, Montreal, Canada; University of Montreal, Canada
| | - Lucie Ménard
- Marie Enfant Rehabilitation Centre of Sainte-Justine University Hospital Centre, Montreal, Canada; Laboratoire de Phonétique, Université du Québec à Montréal, Canada
| | - Stéphane Bouchard
- Université du Québec en Outaouais et Centre Intégré de Santé et de Services Sociaux de l'Outaouais, Canada
| | - Anne-Lise Leclercq
- Research Unit on Childhood, Speech and Language Therapy Department, and Clinique Psychologique et Logopédique de l'Université de Liège, Belgium.
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Karani TF, Mupawose A. A descriptive analysis of assessment measures on the effectiveness of a comprehensive stuttering intervention approach: A single case study. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2020; 67:e1-e9. [PMID: 32370524 PMCID: PMC7203267 DOI: 10.4102/sajcd.v67i1.648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/10/2019] [Accepted: 02/23/2020] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND For effective client outcomes, stuttering assessment and intervention approaches need to be aligned. This encompasses using assessment and intervention approaches that address the three multidimensional constructs of stuttering, namely core behaviours, secondary behaviours and negative feelings and attitudes. OBJECTIVE The study aimed to explore whether multiple assessment measures could be used to describe the effectiveness of a comprehensive stuttering intervention approach, undergirded by the International Classification of Functioning, Disability and Health (ICF) framework. METHOD A single-subject case design was employed with one male adult who stutters. Data was collected by administering the Stuttering Severity Instrument-Fourth Edition (SSI-4) and Overall Assessment of the Speaker's Experience of Stuttering-Adults (OASES-A) at three testing periods (pre-intervention, immediately post-intervention and 7 months post-intervention), and a semi-structured interview schedule immediately post-intervention. Descriptive statistics was used to analyse the SSI-4 and OASES-A, and thematic analysis was conducted to evaluate the participant's interview schedule responses. RESULTS The participant's total scores, impact scores and severity ratings of both the SSI-4 and OASES decreased across the three testing periods. The main theme of effectiveness of the comprehensive stuttering intervention to reduce aspects of disability emerged from the participant's responses. CONCLUSION Evaluation of the results from the assessment measures revealed that the comprehensive stuttering intervention approach was effective in reducing the participant's core behaviours, secondary behaviours and negative feelings and attitudes. Assessment and management of fluency disorders should promote a client-specific multidimensional approach that extends beyond the core behaviours and secondary behaviours, by addressing the underlying social and emotional facets of fluency disorders.
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Affiliation(s)
- Tasneem F Karani
- Department of Speech Pathology and Audiology, Faculty of Humanities, University of the Witwatersrand, Johannesburg.
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Frigerio-Domingues CE, Gkalitsiou Z, Zezinka A, Sainz E, Gutierrez J, Byrd C, Webster R, Drayna D. Genetic factors and therapy outcomes in persistent developmental stuttering. JOURNAL OF COMMUNICATION DISORDERS 2019; 80:11-17. [PMID: 31003007 DOI: 10.1016/j.jcomdis.2019.03.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 03/18/2019] [Accepted: 03/31/2019] [Indexed: 06/09/2023]
Abstract
PURPOSE We investigated whether outcomes of therapy for persistent developmental stuttering differ in individuals who carry a mutation in one of the known genes associated with stuttering compared to individuals without such mutations. METHOD We studied outcomes of an intensive fluency shaping-based therapy program in individuals with persistent developmental stuttering. We evaluated a cohort of 51 stuttering individuals with who carried a mutation in either the GNPTAB, GNPTG, NAGPA, or AP4E1 gene. We compared therapy outcomes in these individuals with outcomes in 51 individuals matched for age, gender, and ethnicity, who stutter and underwent the same therapy program, and did not carry a mutation in any of these genes. Fluency pre- and post-therapy was evaluated using blinded observer-based quantitative stuttering dysfluency measures (Dysfluent Words Score, DWS), and by subjects' self-reported measures of struggle, avoidance and expectancy behavior associated with speaking (Perceptions of Stuttering Inventory, PSI). The difference between pre- and post-therapy fluency scores was taken as the measure of near-term therapy efficacy. RESULTS Comparison of fluency measures showed a strong effect of therapy overall. Mutation carriers achieved significantly less resolution in PSI following therapy, with PSI scores showing significantly less improvement in individuals who carry a mutation (p = 0.0157, RR = 1.75, OR = 2.92) while the group difference in DWS between carriers and non-carriers was statistically not significant in the present study, the trend observed in the results warrants further research focused on this important issue. CONCLUSIONS These results suggest stuttering is more resistant to therapy in individuals who carry a mutation in one of the genes known to be associated with stuttering.
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Affiliation(s)
- Carlos E Frigerio-Domingues
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, 35A Convent Drive, Bethesda, MD 20892, USA
| | - Zoi Gkalitsiou
- Lang Stuttering Institute and Moody College of Communication, 300 W. Dean Keeton (A0900), University of Texas, Austin, TX 78712, USA
| | - Alexandra Zezinka
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, 35A Convent Drive, Bethesda, MD 20892, USA
| | - Eduardo Sainz
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, 35A Convent Drive, Bethesda, MD 20892, USA
| | - Joanne Gutierrez
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, 35A Convent Drive, Bethesda, MD 20892, USA
| | - Courtney Byrd
- Lang Stuttering Institute and Moody College of Communication, 300 W. Dean Keeton (A0900), University of Texas, Austin, TX 78712, USA
| | - Ronald Webster
- Hollins Communications Research Institute, 6851 Enon Drive, Roanoke, VA 24019, USA
| | - Dennis Drayna
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, 35A Convent Drive, Bethesda, MD 20892, USA.
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Connery A, McCurtin A, Robinson K. The lived experience of stuttering: a synthesis of qualitative studies with implications for rehabilitation. Disabil Rehabil 2019; 42:2232-2242. [DOI: 10.1080/09638288.2018.1555623] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Amy Connery
- School of Allied Health, University of Limerick, Limerick, Ireland
- HSE Dublin South West, Dublin, Ireland
| | - Arlene McCurtin
- School of Allied Health, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Katie Robinson
- School of Allied Health, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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Georgieva D, Stoilova R. A clinical training model for students: intensive treatment of stuttering using prolonged speech. Codas 2018; 30:e20170259. [PMID: 30365650 DOI: 10.1590/2317-1782/20182017259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/30/2018] [Indexed: 11/21/2022] Open
Abstract
PURPOSE This study describes a practical model for improving the quality of Speech-Language Pathology (SLP) education on a clinical setting in a Bulgarian University. During this study, adults who stutter (AWS) received intensive treatment (IT) to increase fluent speech. The intensive treatment was delivered by students trained in the SLP Master's degree program "Logopedics Management in Fluency and Voice Disorders". METHODS The La Trobe University intensive program of prolonged speech was implemented. SLP students were trained and delivered the IT for AWS, under supervision in all stages. The treatment followed a clinical modeling pattern. RESULTS The primary outcomes were measured according to (i) percent of syllables stuttered (%SS) within and outside the stuttering research center of the university; (ii) self-reported inventory scores; and (iii) speech naturalness score evaluations from pre-treatment, immediately following treatment, 11 months post-treatment, and 18 months after the intensive treatment using stutter-free speech samples. The outcomes were reported for the overall IT program delivered by the SLP Master students. CONCLUSION The treatment delivered by students can ensure objective speech outcomes. The evidence-based practice model allowed students to develop and master specific clinical skills in establishing fluent speech by applying a prolonged speech technique. During the IT experience, students began to incorporate elements of evidence-based practice (EBP), clinical expertise, and consider values held by AWS. After four outcome-sessions, the AWS developed self-consciousness about the quality of their prolonged speech during controlled fluent patterns. The participants produced objective speech fluency data and statistically significant differences before and immediately after the IT regarding %SS and overall speech naturalness.
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Affiliation(s)
- Dobrinka Georgieva
- South-West University "N. Rilski" - Blagoevgrad, Bulgaria.,Hospital Lozenetz, Medical Faculty, Sofia University "St. Kliment Ohridski" - Sofia, Bulgaria
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Keilmann A, Neumann K, Zöller D, Freude C. Clinical trial of the D.E.L.P.H.I.N. speech treatment for children and adolescents who stutter. LOGOP PHONIATR VOCO 2018; 43:155-168. [DOI: 10.1080/14015439.2018.1498917] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Annerose Keilmann
- Division of Communication Disorders, The University Medical Center Mainz, Mainz, Germany
- Voice Care Center Bad Rappenau, Bad Rappenau, Germany
| | - Kirsten Neumann
- Division of Communication Disorders, The University Medical Center Mainz, Mainz, Germany
| | - Daniela Zöller
- Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), Mainz, Germany
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Christina Freude
- Division of Communication Disorders, The University Medical Center Mainz, Mainz, Germany
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