There have been quite a few advancements in the treatment of stuttering over the past several years. Included in these advances are improvements in treatment outcome measures (how well someone does in therapy), advancements in the pharmacological treatment of stuttering, advances in microelectronics that have had an impact on the use of devices for the treatment of stuttering, and improvements in imaging techniques that have allowed us to examine what is happening in the brain when stuttering occurs. In spite of these advances, the two types of basic therapy remain the same. That is, one type of treatment seeks to eliminate the stuttering (fluency shaping), while the other attempts to lessen the effects of stuttering on the individual (Stuttering modification). Plain and simple, the goal of fluency shaping is to eliminate or greatly reduce stuttering. Within this area, successful treatment outcomes provided by behavioral techniques employed by parents (such as the Lidcombe Program) are very promising. The Lidcombe Progran developed by Mark Onslow and his colleagues in Australia, has documented a very high percentage of success in young children who are developing stuttering. These children have been successfully treated without any long-term side effects. It is impressive to note that these children have maintained these levels of fluency over the long term. Keep in mind that these programs have been developed for young children and do not have the same levels of effectiveness on older children and adults. Somewhat related, are the epidemiological studies conducted by Dr. Ehud Yairi and his colleagues at the University of Illinois. They have shown that many children do recover from stuttering (even severe stuttering!) throughout their childhood years. In the course of their studies, they found that recovery can occur as long as four or five years beyond when stuttering had its onset. An important contribution from their work included the term “stuttering-like disfluencies”. The term “stuttering-like disfluencies” has been used by this research team to label speech behaviors that are the most indicative of stuttering. These include partword repetitions, prolongations, and blocks. The data from these studies can be used as active predictors as to whether stuttering will continue to develop or whether recovery is likely. A knowledgeable and skilled speech-language pathologist who treats stuttering should be well versed in the work of both of these research teams. Unfortunately, there is some debate between these two groups of researchers as to whether the impressive results of the Lidcombe Program are due to the effects of intervention, or are skewed by the early recovery data obtained from the University of Illinois studies. Once again, a knowledgeable and skilled clinician can help you interpret this important data. As a starting point, skilled clinicians in your area can be sought out through the Specialty Board in Fluency Disorders. Information on speech-language pathologists holding specialist credentials in fluency disorders can be obtained at the web site www.stutteringspecialists.org. In summary, these two groups of researchers have carefully added a great deal of information to our current knowledge base of stuttering. The future will weave these two theories together to give us a better picture of the course of early stuttering. In the next several issues, I will be reviewing our discussions and answering questions on important issues related to stuttering modification, the use of fluency enhancing devices, pharmacological treatments, brain imaging studies, and anything else that you may be interested in discussing. If you have any questions in addition to those we discussed at the 2008 conference.
John Tetnowski, Ph.D., CCC