Checklist of parent Lidcombe Program administration

This article outlines the development of a checklist to document parent and child behaviours when implementing Lidcombe Program treatment during structured conversations. We present item development and reliability testing and instructions for use by speech pathologists. Finally, we present two case studies to demonstrate use of the checklist to aid clinical decision-making during Lidcombe Program treatment

Stuttering, disability and the higher education sector in Australia

The aim of this study was to ascertain the extent to which Australian public universities and their associated disability liaison services offer web-based information for current or prospective students who stutter. The disability pages of the websites of all 39 public universities in Australia were visited and the information about disability services assessed according to 12 criteria developed by the authors. Results indicate that there is a dearth of information on Australian university websites available for students or prospective students who stutter. Only 13% of the sites reported any form of alternative teaching and assessment procedures for speech-impaired students and only 51% of 39 disability liaison officers responded when contacted by email. Such a student could not make an informed choice to enrol in a university based upon the information on disability services available on public Australian university websites. © 2012 The Speech Pathology Association of Australia Limited

Natural History of Stuttering to 4 Years of Age: A Prospective Community-Based Study

These findings from a community-ascertained cohort refute long-held views suggesting that developmental stuttering is associated with a range of poorer outcomes. If anything, the reverse was true, with stuttering predicting subsequently better language,nonverbal skills, and psychosocial health-related quality of life at 4 years of age.Future research with this cohort will support a more complete longitudinal understanding of when and in whom recovery occurs. Current best practice recommends waiting for 12 monthsbefore commencing treatment, unlessthe child is distressed, there is parental concern, or the child becomes reluctant to communicate. It may be that for many children treatment could be deferred even longer. Treatment is efficacious15 but is both intensive (median of 15.4o ne-hour clinical sessions followedby 10 one-hour clinical maintenance sessions) and expensive; this "watchful waiting" recommendation would therefore help target allocation of scarce resources to the small number of children who do not resolve and experience adverse outcomes, secure in the knowledge that delaying treatment by a year or more has been shown not to compromise treatment efficac

A three-arm randomized controlled trial of Lidcombe Program and Westmead Program early stuttering interventions

Purpose: To compare two experimental Westmead Program treatments with a control Lidcombe Program treatment for early stuttering. Method: The design was a three-arm randomized controlled trial with blinded outcome assessments 9 months post-randomization. Participants were 91 pre-school children. Results: There was no evidence of difference in percentage syllables stuttered at 9 months among groups. Dropout rates were substantive and may have been connected with novel aspects of the trial design: the use of community clinicians, no exclusion criteria, and randomization of children younger than 3 years of age. Conclusion: The substantive dropout rate for all three arms in this trial means that any conclusions about the 9-month stuttering outcomes must be regarded as tentative. However, continued development of the Westmead Program is warranted, and we are currently constructing an internet version

"Spontaneous" late recovery from stuttering: Dimensions of reported techniques and causal attributions

Purpose: (1) To survey the employed techniques and the reasons/occasions which adults who had recovered from stuttering after age 11 without previous treatment reported as causal to overcome stuttering, (2) to investigate whether the techniques and causal attributions can be reduced to coherent (inherently consistent) dimensions, and (3) whether these dimensions reflect common therapy components.Methods: 124 recovered persons from 8 countries responded by SurveyMonkey or paper-and-pencil to rating scale questions about 49 possible techniques and 15 causal attributions.Results: A Principal Component Analysis of 110 questionnaires identified 6 components (dimensions) for self-assisted techniques (Speech Restructuring; Relaxed/Monitored Speech; Elocution; Stage Performance; Sought Speech Demands; Reassurance; 63.7% variance explained), and 3 components of perceived causal attributions of recovery (Life Change, Attitude Change, Social Support; 58.0% variance explained).Discussion: Two components for self-assisted techniques (Speech Restructuring; Elocution) reflect treatment methods. Another component (Relaxed/Monitored Speech) consists mainly of items that reflect a common, non-professional understanding of effective management of stuttering. The components of the various perceived reasons for recovery reflect differing implicit theories of causes for recovery from stuttering. These theories are considered susceptible to various biases. This identification of components of reported techniques and of causal attributions is novel compared to previous studies who just list techniques and attributions.Conclusion: The identified dimensions of self-assisted techniques and causal attributions to reduce stuttering as extracted from self-reports of a large, international sample of recovered formerly stuttering adults may guide the application of behavioral stuttering therapies.</p

“Spontaneous” late recovery from stuttering: Dimensions of reported techniques and causal attributions

Purpose: (1) To survey the employed techniques and the reasons/occasions which adults who had recovered from stuttering after age 11 without previous treatment reported as causal to overcome stuttering, (2) to investigate whether the techniques and causal attributions can be reduced to coherent (inherently consistent) dimensions, and (3) whether these dimensions reflect common therapy components. Methods: 124 recovered persons from 8 countries responded by SurveyMonkey or paper-and-pencil to rating scale questions about 49 possible techniques and 15 causal attributions. Results: A Principal Component Analysis of 110 questionnaires identified 6 components (dimensions) for self-assisted techniques (Speech Restructuring; Relaxed/Monitored Speech; Elocution; Stage Performance; Sought Speech Demands; Reassurance; 63.7% variance explained), and 3 components of perceived causal attributions of recovery (Life Change, Attitude Change, Social Support; 58.0% variance explained). Discussion: Two components for self-assisted techniques (Speech Restructuring; Elocution) reflect treatment methods. Another component (Relaxed/Monitored Speech) consists mainly of items that reflect a common, non-professional understanding of effective management of stuttering. The components of the various perceived reasons for recovery reflect differing implicit theories of causes for recovery from stuttering. These theories are considered susceptible to various biases. This identification of components of reported techniques and of causal attributions is novel compared to previous studies who just list techniques and attributions. Conclusion: The identified dimensions of self-assisted techniques and causal attributions to reduce stuttering as extracted from self-reports of a large, international sample of recovered formerly stuttering adults may guide the application of behavioral stuttering therapies

Looking at stuttering through the lens of complexity

In this theoretical paper, the disorder of stuttering is viewed through the lens of complexity. The complexity perspective is a way of understanding complex systems and it has been applied for this purpose across a range of domains, including architecture, economics, sociology, psychology and, most importantly in the present context, health. In this paper we apply some principles and metaphors of complexity to explain the disorder of stuttering. Through the complexity lens, stuttering comprises a number of complex systems, within both the person and the environment, that self-organize in response to a disturbance in the neural processing that is thought to underpin stuttering. The complexity perspective allows us to see this complex disorder in its entirety and provides a framework for integrating research and theory. The complexity perspective also highlights the importance of early intervention

Technology and the evolution of clinical methods for stuttering

The World Wide Web (WWW) was 20 years old last year. Enormous amounts of information about stuttering are now available to anyone who can access the Internet. Compared to 20 years ago, people who stutter and their families can now make more informed choices about speech-language interventions, from a distance. Blogs and chat rooms provide opportunities for people who stutter to share their experiences from a distance and to support one another. New technologies are also being adopted into speech-language pathology practice and service delivery. Telehealth is an exciting development as it means that treatment can now be made available to many rural and remotely located people who previously did not have access to it. Possible future technological developments for speech-language pathology practice include Internet based treatments and the use of Virtual Reality. Having speech and CBT treatments for stuttering available on the Internet would greatly increase their accessibility. Second Life also has exciting possibilities for people who stutter.Educational objectives: The reader will (1) explain how people who stutter and their families can get information about stuttering from the World Wide Web, (2) discuss how new technologies have been applied in speech-language pathology practice, and (3) summarize the principles and practice of telehealth delivery of services for people who stutter and their families. © 2011 Elsevier Inc