Tuesday, April 16, 2013

Journal Review: Stuttering in School-Age Children: A Call for Treatment Research.

This evening I read Stuttering in School-Age Children: A Call for Treatment Research by Marilyn A. Nippold, PhD, and Editor. 2011

http://lshss.asha.org/cgi/content/full/42/2/99

This article is short, sweet, informative and basically hands out a research idea for dysfluency on a silver platter! In a nutshell this article discusses the need for research on therapy intervention for fluency for school-age children. I cannot agree more!

Since starting in an outpatient facility I have had just a hand full of school-age fluency clients. I feel that there are so many different techniques to target fluency that it would be nice to have some solid evidence-based practice to present to parents and the students to collaboratively make a great plan of care.

The author discusses the need and the benefit research would give this area of speech-language pathology. She further discusses two common methods in targeting fluency - the Lidcombe Program and the Gradual Increase in Length and Complexity of Utterance program. These two programs are very different - the first more child-directed and the second more structured and clinician-driven. The author feels that comparing these two methods in research for school-age children would be beneficial. Of course the difficult part in this would be the carry-over in the home environment for the patient's parents with the Lidcombe Program - but hey I think that this can at times be typical in the school and outpatient setting!

I would highly recommend reading this article - especially if you have a new fluency patient and are looking for a quick review of some therapeutic interventions. Before I go I wanted to pose a question. The author stated in her article that "Ms. Blake (an SLP) detected a trend in the literature toward counseling children to accept their stuttering and to learn to cope with its negative side effects instead of working directly on the stuttered speech, as if to say that we are throwing the towel on the effort to achieve fluency in school-age children." How do you all feel about this? Do you feel by school-age treatment is less focused on decreasing dysfluencies? I feel that learning to accept yourself is apart of the process though it is only a portion of the big picture in my therapy.

5 comments:

  1. Somehow I have yet to have a fluency student on my caseload, so I should definitely read this article just to brush up. In response to the question, I will be vague, but honest - I think it depends on the child and the specifics of their environment, severity of stuttering, etc. I have known of some parents who were behaving towards their child in a way that was not supportive of the child accepting his stuttering, and that child and his family needed quite of bit of counseling by the SLP about how negative attitudes toward the stuttering have adverse affects on progress, and the child's self-esteem, etc. I think strategies to increase fluency would almost always be appropriate in combination with any counseling to accept themselves. Stuttering may never "go away" in some people, so that shouldn't necessarily be the focus. So I guess my bottom line is depending on the individual circumstances, therapy should target a combination of decreasing stuttering moments, learning strategies to deal with stuttering when it occurs, and child and family counseling. Sorry for the long post, I'm typing while I'm thinking! Thanks for getting me to think about this!

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  2. Nadine - you took the words right out of my mouth! Thanks for sharing your insights!

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  3. I strongly encourage everyone who reads this article to also read the response from MANY members of the stuttering community (BRS-FD SLPs, people who stutter, NSA members, etc.). Yaruss, J.S., Coleman, C.E., & Quesal, R.W. (2012) "Stuttering in school-age children: A comprehensive approach to treatment" LSHSS, 43, 536-548. This letter to the editor covers your concerns about not addressing acceptance of stuttering in therapy and also provides an outline for providing treatment for school-age CWS.

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  4. NSA NC Triad Chapter thank you so much for passing along this article! I am very excited to read it! The more education and collaboration the better! Thank you thank you!

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  5. Thanks for the informative article. There are few well-known Speech Language Therapy Clinic in Kolkata who provide Speech Therapy For Stammering In Kolkata. Looking forward to more informative articles from you.

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