The association between atypical speech development and adolescent self-harm

Background: Adolescent self-harm is a major public health issue internationally. Various factors associated with adolescent self-harm have been identified, including being bullied and experiencing mental health problems. Stuttering and speech sound disorder are associated with both of these factors. It was hypothesised that both stuttering and speech sound disorder would be associated with self-harm. This is the first study to explore the relationship between communication disorders and adolescent self-harm. Method: Secondary analysis of a large, longitudinal, prospective, community sample, the Avon Longitudinal Study of Parents and Children, was carried out. Clinicians identified children who stuttered or exhibited speech sound disorder at age 8. When the cohort members were 16 years old, they were asked to complete a questionnaire about self-harm. Multinomial logistic regression was used to examine the associations between stuttering and speech sound disorder and the self-harm outcomes, adjusting for other relevant factors. Results: Of 3824 participants with data for both speech status and self-harm, 94 (2.5%; 95% CI 2.0% to 3.0%) stuttered at age 8 and 127 (3.3%; 95% CI 2.8% to 3.9%) displayed speech sound disorder. Speech sound disorder at age 8 was associated with self-harm with suicidal intent in both unadjusted and adjusted models. Differences between the adjusted and unadjusted models were small, suggesting that speech sound disorder is largely an independent risk factor for self-harm with suicidal intent. Stuttering at age 8 was not associated with adolescent self-harm, and there was no association between speech sound disorder and self-harm without suicidal intent. Conclusions: Compared with individuals without speech sound disorder, adolescents with speech sound disorder at age 8 have twice the risk of reporting self-harm with suicidal intent, even when other important predictors are taken into account

The Fluency Trust Residential Course for Young People who Stutter:A Pragmatic Feasibility Study

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

Weighing the arguments

Six researchers at the Speech and Language Therapy Research Unit pause among their protocols to reflect on their research. All practising clinicians in a previous or parallel life, they describe what impact their research has had on their approach to practice. Interviews with the parents of speech/language delayed children and with clients with aphasia have altered approaches to treatment for two of the researchers. The need to motivate cooperation and commitment when working in partnership with primary schools is emphasised, as well as the difficulties in adhering to research protocols are described as well as the overuse of feedback in clinical practice