Success in Changing Stuttering Attitudes: A Retrospective Analysis of 29 Intervention Studies (original) (raw)
Related papers
South African Journal of Communication Disorders
Background The purpose of this article was to demonstrate the effectiveness of a comprehensive stuttering intervention approach on an adult male participant who stutters based on multiple assessment measures. According to Bleek et al. (2012), stuttering is a multidimensional construct characterised by: (1) overt core behaviours, such as involuntary repetitions of syllables and words, prolongations of the sound(s) during the flow of speech and blocks of airflow, and (2) covert behaviours, a variety of behavioural, physiological, cognitive and emotional reactions to the speech disruptions. In essence, stuttering can be reduced to consisting of three components: (1) core speech behaviours, (2) secondary behaviours and (3) negative feelings and attitudes (Guitar, 2013). The interaction of these three components of stuttering often leads to debilitating effects. A person who stutters (PWS) may experience a variety of emotional challenges, which include sadness, shame, guilt, anger, resentment and fear (Yaruss, 2010; Yaruss & Quesal, 2006). This often leads to feelings of negative self-regard, such as self-blame and an overall sense of negative self-worth. These attitudes may cause further negative behavioural challenges such as avoidance of stuttering instances through secondary behaviours and avoidance of participation in activities that entail any communicative interactions (Yaruss, 2010; Bleek et al., 2012). 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 postintervention), 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.
2006
This paper reports the results of a three-week intensive program for 10 adult and adolescent stutterers. Measurements were made immediately before and after treatment and again during the follow-up period, 12 14 months post-treatment. The measures included percentage of stuttering, syllables spoken per minute and three self-report scales designed to measure changes in attitudes. perceptions and self-confidence. In the follow-up period, subjects completed a fourth scale in which they indicated their level of satisfaction with their speech performance. The results indicated that substantial positive changes occurred and were maintained in both speech performance and non-speech variables.
Five-year longitudinal treatment outcomes of the ISTAR Comprehensive Stuttering Program
Journal of Fluency Disorders, 2010
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.
Evidence-based treatment of stuttering: III. Evidence-based practice in a clinical setting
Journal of Fluency Disorders, 2003
At the heart of evidence-based practice in stuttering treatment are four issues: (1) the collection of data to inform treatment; (2) the long standing concern with maintenance of treatment gains; (3) the need to demonstrate accountability to clients, payers and our profession as service providers; and (4) the desire to advance theoretical knowledge. This article addresses the first three of these issues from a practical point of view, illustrating how data collection for stuttering treatment outcome research in a clinical setting is intimately blended with that required for clinical purposes and providing an example of a process of evaluating data for clinical and research purposes.
Current Issues in Stuttering Research and Practice
2014
Bridging the Gap, edited by Nan Ratner and E. Charles Healey. Like its predecessor, the current book is an edited collection of the presentations from the American Speech-Language-Hearing Association's Annual Leadership Conference in Fluency and Fluency Disorders. Among the topics covered are evidence-based practice, impact of the self-help and support groups, meta-analyses of selected assessment and intervention programs, current theories of stuttering, and the predicted path of stuttering intervention in the future. The authoritative representation of contributors offers the reader the most up to date presentation of fluency issues, with a special emphasis placed on the practical clinical implications of fluency assessment, treatment, and evolving theories of the disorder. The book is written for fluency specialists and graduate students in programs of fluency disorders. It will also be valuable for the clinicians who wish to upgrade their skills in treating fluency disorders.
Stuttering Treatment for Adults: An Update on Contemporary Approaches
Seminars in Speech and Language, 2010
This article provides a brief overview of historical and current approaches to stuttering treatment for adults. Treatment is discussed in terms of stuttering management approaches, fluency-shaping approaches, and combined approaches. The evidence base for these various approaches is outlined. Fluency-shaping approaches have the most robust outcome evidence. Stuttering management approaches are based more on theoretical models of stuttering, and the evidence base tends to be inferred from work using the approaches of cognitive behavior therapy and desensitization with other disorders such as anxiety. Finally, comprehensive approaches to treating stuttering are discussed, and several clinical methods are outlined. Comprehensive approaches target both improved speech fluency and stuttering management. Although it is presented that a comprehensive approach to stuttering treatment will provide the best results, no single approach to stuttering treatment can claim universal success with all adults who stutter.
Behavior therapy and stuttering: And the story grows
The contribution of behavioral approaches to the management of stuttering is reviewed. Subsequent to considering some features that distinguish behavior therapy procedures, this paper reviews some of the recent trends among reports of therapy programs for stutterers that are claimed to behaviorally manage treatment for this disorder. The therapy reports are grouped according to the principal procedure used to modify stuttering. It was concluded that the major contribution of behavior therapy to treatment of stuttering probably lies in its demand for the application of experimental methodology to treatment. However, several other important effects are also identified.