Observer-rated outcomes of communication-centered treatment for adults who stutter: A social validation study.

Previous studies have reported that adults who stutter demonstrate significant gains in communication competence, per self-ratings and clinician-ratings, upon completion of a communication-centered treatment, or CCT. The purpose of this social validation study was to determine whether communication competence ratings reported by untrained observers are consistent with client and clinician judgments of communication competence gains following CCT. Eighty-one untrained observers completed an online survey that required each to view one of two videos depicting an adult who stutters during a mock interview recorded prior to CCT or after CCT. Observers were then asked to rate the communication competence of the interviewee on a 100-point visual analog scale and provide additional demographic information. Communication competence of the adult who stutters who had completed CCT was rated significantly higher in their post-treatment video. Upon controlling for two demographic factors found to be associated with observer ratings (years of education, years the observers had known an adult who stutters), significantly higher ratings of communication competence for the post-treatment video were maintained. These preliminary findings provide social validity for CCT by demonstrating that the gains in communication competence reported in previous studies through clinician and client observations are also reported by untrained observers who are not familiar with CCT.

Self-Perceived Communication Competence of Adults Who Stutter Following Communication-Centered Treatment.

PURPOSE: The purpose of this study was to assess self-perceived communication competence of adults who stutter following participation in a non-ableist treatment for which one of the core components focuses on communication - with no direct or indirect goals designed to reduce or modify stuttered speech. METHOD: Thirty-three adults who stutter completed the Self-Perceived Communication Competence scale (McCroskey & McCroskey, 1988) pre- and posttreatment. RESULTS: Findings indicate significant gains in self-perceived communication competence posttreatment. Pre- to posttreatment changes in stuttering did not predict posttreatment gains in self-perceived communication competence. CONCLUSION: The present study demonstrates that improvement in communication can be achieved independent of improvement in fluency, lending further support to the notion that stuttering and communication competence are distinct constructs.

Treatment for Stuttering in Preschool-Age Children: A Qualitative Document Analysis of Treatment Programs.

PURPOSE: The purpose of this study was to identify commonalities and differences between content components in stuttering treatment programs for preschool-age children. METHOD: In this document analysis, a thematic analysis of the content was conducted of handbooks and manuals describing Early Childhood Stuttering Therapy, the Lidcombe Program, Mini-KIDS, Palin Parent-Child Interaction Therapy, RESTART Demands and Capacities Model Method, and the Westmead Program. First, a theoretical framework defining a content component in treatment was developed. Second, we coded and categorized the data following the procedure of reflexive thematic analysis. In addition, the first authors of the treatment documents have reviewed the findings in this study, and their feedback has been analyzed and taken into consideration. RESULTS: Sixty-one content components within the seven themes-interaction, coping, reactions, everyday life, information, language, and speech-were identified across the treatment programs. The content component SLP providing information about the child's stuttering was identified across all treatment programs. All programs are multithematic, and no treatment program has a single focus on speech, language, or parent-child interaction. A comparison of the programs with equal treatment goals highlighted more commonalities in content components across the programs. The differences between the treatment programs were evident in both the number of content components that varied from seven to 39 and the content included in each treatment program. CONCLUSIONS: Only one common content component was identified across programs, and the number and types of components vary widely. The role that the common content component plays in treatment effects is discussed, alongside implications for research and clinical practice. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25457929.

Communicative practices and perceptions towards stuttering people in South Africa.

BACKGROUND:  A few studies have explored the life experiences of people who stutter. Research has shown that stuttering affects a significant number of people in the population. OBJECTIVES:  The study was designed to explore the experiences of people who stutter and the perception of stuttering in South Africa. METHOD:  Four people who identified as South Africans who stutter participated in this study. The primary investigator conducted semi-structured interviews with each of the participants. In addition, a questionnaire was administered to 20 acquaintances of all the participants. Transcriptions of interviews and results of questionnaires were analysed for major and minor themes. RESULTS:  Results of this study suggest different perceptions by those who stutter and those acquainted with them. The findings of the study show that people who stutter experience communication barriers, so they adopt certain strategies to manage and cope with their speech disorder. The findings showed that stuttering has a pervasive impact on the lives of people who stutter and how they view themselves, considering negative societal views. CONCLUSION:  Evaluation of the results from the study reveals that although stuttering is a common speech disorder, many people who are less informed about it harbour various stereotypes and myths that stigmatise stuttering. This study concludes by outlining recommendations for creating awareness of stuttering. It suggests vigorous campaigns aiming at promoting a multilevel approach that extends beyond the mere social and professional understanding of stuttering but addresses the inherent perceptions, myths, and stereotypes around stuttering.Contribution: Experiences of people who stutter and perceptions towards stuttering can help to better understand the speech disorder and overcome myths and stereotyping of stuttering.

Lidcombe Program telehealth treatment for children 6-12 years of age: A Phase II trial.

BACKGROUND: For children older than 6 years who stutter, there is a gap in clinical research. This is an issue for speech-language pathologists because the tractability of stuttering decreases and the risk of long-term psychological consequences increase with age. PURPOSE: To report a Phase II trial of a telehealth version of the Lidcombe Program with school-age children. METHODS: Participants were 37 children who stuttered, 6-12 years of age, from Australia, New Zealand, Hong Kong, and Singapore. Parents were trained by video telehealth how to deliver the Lidcombe Program to their child. Primary and secondary outcomes were stuttering severity and psychosocial functioning measured pre-treatment and at 6 months and 12 months after starting treatment. Parents submitted two 10-minute recordings of their child speaking in conversation, and three measures of anxiety, impact of stuttering, and communication attitude. RESULTS: Six months after starting treatment, seven children (18.9%) attained Lidcombe Program Stage 2 criteria, 25 children (67.6%) showed a partial response to treatment, and five children (13.5%) showed no response. By 12 months, 12 children (32.4%) had reached Stage 2 criteria. Psychosocial improvements were observed 6 and 12 months after starting treatment. CONCLUSIONS: The Lidcombe Program may eliminate or nearly eliminate stuttering for about one third of children 6-12 years of age. Randomized controlled trials with this age group involving the Lidcombe Program are warranted. In the interim, the Lidcombe Program is a clinical option clinicians can implement with this age group to reduce stuttering and its psychosocial impacts.

Designing a Module on Stuttering and Cluttering: A Guide for Speech-Language Pathology Educators.

PURPOSE: Due to the scope of practice of speech-language pathology (SLP) expanding considerably in recent times, there is reduced emphasis on certain communication conditions within the curricula of SLP university programs. Stuttering and cluttering are neglected components of such curricula, despite the complex clinical skill set required to work with these client groups. Evaluation of the content and quality of modules on stuttering and cluttering is warranted to ensure that SLP students are graduating with adequate competence and confidence for supporting people with these conditions. This tutorial, based on a review of the literature, aims to provide guidance to educators who are designing or revising such modules. METHOD: The All Ireland Society for Higher Education (AISHE) model for module design provides a practical and theoretically underpinned guide to educators in higher education on the design of a new module or the review of an existing one. The model's seven key components are discussed, and their application to a module on stuttering and cluttering is outlined. RESULTS: The AISHE model provides a systematic and user-friendly approach to module design in SLP university programs. It supports educators who are designing a new module or revising a module currently being taught on stuttering and cluttering. CONCLUSIONS: Educators are encouraged to familiarize themselves with the seven components of the AISHE model and to use it as a tool to design or revise modules on stuttering and cluttering. This will ensure that SLP students are graduating with increased competence and confidence in working with these client groups.

Evaluation of an Integrated Fluency and Acceptance and Commitment Therapy Intervention for Adolescents and Adults Who Stutter.

PURPOSE: Developmental stuttering is a complex and multifaceted neurodevelopmental disorder that may cause pervasive negative consequences for adults who stutter (AWS). Historically, intervention for AWS has primarily addressed speech fluency, with less focus on the covert psychosocial aspects of the disorder. The purpose of this article is to report on a feasibility trial evaluating a novel integrated intervention that combines traditional stuttering management techniques with Acceptance and Commitment Therapy (ACT) for AWS. METHOD: Twenty-nine AWS participated in the feasibility trial. All participants successfully completed a combined fluency and ACT intervention, titled the fluency and Acceptance and Commitment Therapy for Stuttering (fACTS) Program. As this was a feasibility study, no control group was included. Intervention was administered by two certified practicing speech-language pathologists, over eight 60- to 90-min sessions. RESULTS: Generalized linear mixed modeling was used to determine change from pre- to post-intervention and follow-up. Significant pre- and post-intervention improvements in self-efficacy, psychosocial functioning, and psychological flexibility were observed, along with significant reductions in observable stuttering behaviors (i.e., stuttered speech frequency). Intervention gains for all variables of interest were maintained 3 and 6 months post-intervention. CONCLUSIONS: The fACTS Program was created to be a holistic and flexible intervention to promote self-efficacy beliefs and address stuttering-related psychosocial impacts and speech fluency goals of AWS. Preliminary results indicated positive improvement in all psychosocial outcomes (i.e., self-efficacy, psychosocial impact, and psychological flexibility) and observable speech fluency following completion of the program. Future clinical trials of the fACTS Program with an included control group will further investigate the mechanisms of change for the positive effects observed.

Mothers' and fathers' attitudes toward stuttering in the Middle East compared to Europe and North America.

BACKGROUND: Parents play a central role in the treatment of childhood stuttering. Addressing parental attitudes toward stuttering is helpful therapeutically. The extent to which differences in attitudes toward stuttering exist on the basis of sex, geographical region and parental status (e.g., parent of a stuttering child, parent of a nonstuttering child, nonparent) is unclear. Many studies investigating such factors have used the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) questionnaire. A large POSHA-S database has collected responses from over 20 000 people from 49 countries. AIMS: The aim of this study was to use the POSHA-S database to examine the extent to which the following variables influence attitudes toward stuttering: (a) parents' sex (mothers vs. fathers), (b) geographic region (Middle East vs. Europe and North America), (c) parents' children (stuttering vs. nonstuttering) and (d) parental status (parents versus nonparents). METHODS & PROCEDURES: Data used in this study were extracted from selected, relevant studies that administered the POSHA-S to respondents. The Overall Stuttering Scores were compared on the basis of sex and parent status (i.e., mothers and fathers; nonparent women and men) and were then compared within and across the two geographical areas. Group comparisons were performed using analysis of variance followed by independent t tests, and Cohen's d was calculated to determine effect sizes. OUTCOMES & RESULTS: Statistically significant differences were observed upon the basis of geographical region. In general, male parents and nonparents tend to have more positive stuttering attitudes among the Middle Eastern samples while female parents and nonparents tend to show more positive attitudes in European and North American samples in the POSHA-S database. Effect sizes were small for all comparisons. CONCLUSIONS & IMPLICATIONS: The effect of geographic region and culture may predict sex-based differences among mothers' and fathers' attitudes toward stuttering; however, the clinical significance is unclear. Additional research is needed to better understand how children who stutter are affected by their parents' attitudes toward stuttering. WHAT THIS PAPER ADDS: What is already known on this subject The research clearly indicates that attitudes toward stuttering vary according to geographical region. Less clear is whether mothers and fathers from geographically diverse backgrounds hold different attitudes toward stuttering and the extent to which parental status (being a parent, parent of a child who stutters or nonparent) affects attitudes toward stuttering. What this study adds This study's findings confirm that geographical differences do influence attitudes toward stuttering. Male parents and nonparents tend to have equal or more positive attitudes toward stuttering in Middle Eastern samples, whereas non-Middle Eastern female parents and nonparents tend to show hold more positive attitudes. What are the clinical implications of this work? In addition to being culturally sensitive when working with parents of children who stutter, clinicians should also consider that mothers and fathers may have some differences in attitudes and behaviours toward their child's stuttering. These differences should be considered when designing treatment plans. It should also be noted that, despite statistical significance, the effect sizes in this study were low, suggesting that further research as well as close collaboration with parents of children who stutter is warranted.

Effectiveness of speech therapy in treating vocal blocking tics in children with Tourette syndrome: Two case reports.

Tourette syndrome is characterized by at least two motor tics and one vocal tic, which persist for over a year. Infrequently, tics can manifest as blocking tics in speech when they prevent a person from starting to speak or interrupt their speech flow. Vocal blocking tics (VBTs) resemble stuttering, and they can be difficult to differentiate from each other. A previous report described two patients with severe VBTs who did not benefit from stuttering-therapy-based speech therapy and were treated effectively with cannabis-based medicine. Here, we present the cases of two patients, seven- and nine-year-old boys, who benefited from speech therapy in which stuttering therapy techniques were used. Detailed descriptions of the interventions are included. Further research is needed to test the effectiveness of speech therapy in treating VBTs in a larger group of children with Tourette syndrome.

The Fifth Croatia Stuttering Symposium: Part I. Treatments for early stuttering.

PURPOSE: The Fifth Croatia Stuttering Symposium in 2022 continued the Fourth Croatia Stuttering Symposium 2019 theme of the connection between research and clinical practice. At the 2022 Symposium, there were 145 delegates from 21 countries. This paper documents the contents of the first of three Symposium modules. METHODS: The module topic was that three treatments for early childhood stuttering are supported by randomized controlled trial evidence. A clinical situation was considered where a parent of a 3-year-old child asked what results to expect of stuttering treatment. RESULTS: A distinguished scholar presented a 5-minute video interpretation of the research concerning the randomized controlled trial evidence for the three treatments. Three master clinicians then each presented a 2-minute video demonstration of how those research findings might be applied in a clinical situation. Following that, the convenors moderated a discussion between the distinguished scholar, master clinicians, and delegates regarding the research and how it applies to clinical practice.

Expectations from stuttering therapy: Qualitative content analysis of client's perspective in Kannada-speaking adults who stutter.

PURPOSE: The current study was carried out to explore clients' expectations from stuttering therapy using the qualitative content method in the Indian context. METHOD: Twenty-one Kannada-speaking adults who stutter between the age range of 18-33 years participated in the study. The procedure involved three phases, including the formulation of semi-structured interview questions, data collection and analysis. Inductive content analysis was used to determine the categories and sub-categories arising from the participants verbatim. The frequency count of emerging sub-categories was completed, and the data was interpreted. RESULTS: The overall analysis of the data obtained from 21 participants generated three categories under the theme of expectations from speech therapy. The categories generated included beliefs and understanding of stuttering, stuttering and related behaviours, and goals and outcome of therapy. CONCLUSION: Selecting personalised goals and techniques during therapy is necessary to improve client satisfaction. This study helps clinicians to understand the anticipatory beliefs of Kannada-speaking adults who stutter and educate them about achievable and realistic goals, leading to shared decision-making to ensure better quality of life and satisfaction in everyday speaking situations.

Evolución percibida por los padres de preescolares que tartamudean que recibieron tratamiento preventivo / Perceived evolution by parents of preschoolers who stutter and received preventive treatment

Objetivo: I) Describir los resultados preliminares de un estudio sobre la evolución percibida por los padres de los niños entre los 2.11 y 5.11 años que tartamudeaban, después de recibir tratamiento preventivo de tartamudez con apoyo de los progenitores, II) conocer los recursos comunicativos aprendidos por los niños y sus padres respecto al tartamudeo y III) descubrir el grado de satisfacción de los padres con el tratamiento. El estudio se realizó en ILD, centro especializado en trastornos de fluidez. Método: Se administró un cuestionario a 18 padres, cuyos hijos habían sido dados de alta después de la terapia. El 77.8% (n=14) de los participantes fueron niños y el 22.2% (n=4) niñas. Los niños seleccionados que participaron en el estudio tenían una edad comprendida entre cuatro y ocho años (M=5.90, DT=1.25). Resultados: En las respuestas cabe destacar que: I) El 88.9% de los niños mantuvieron un habla fluida, II) y el 72.2% no presentó ni tuvo bloqueos, el 82.3% no experimentó tensión en la garganta, III) los niños mostraron disfluencias cuando estaban cansados (n=6) o estresados (n=5), IV) los niños mejoraron en el habla, en la conducta y adoptaron buenas estrategias ante las disfluencias o los bloqueos, V) tanto los niños como los padres utilizaron los recursos aprendidos durante el tratamiento, VI) se realizaron sesiones individuales de padres y de seguimiento y la mayoría de ellos recibió pautas a seguir en caso de recaídas, y VII) el 94.4% de los padres, quedaron satisfechos con los resultados del tratamiento. Conclusión: Los resultados preliminares indican que el tratamiento realizado con los niños preescolares con apoyo de sus padres ayudó a mejorar la fluidez del habla, su conducta, las actitudes positivas en la conversación y las habilidades de comunicación padres-hijo.(AU)

Aim: The aim of this article is (a) to describe the progress perceived by parents of children between the ages of 2.11 and 5.11 who stuttered, after receiving preventive treatment for stuttering with parental support; (b) to assess the communicative resources learned by the children and their parents regarding stuttering and (c) to find out their level of satisfaction with treatment. The study was carried out at ILD, a specialized centre for fluency disorders. Methods: A questionnaire was administered to 18 parents, whose children had been discharged after therapy. Of the sample, 77.8% (n=14) were boys and 22.2% (n=4) girls. The selected children participating in the study were aged between 4 and 8 years (M=5.90, SD=1.25). Results: From the responses it was noted that: (I) 88.9% of the children maintained fluent speech; (II) and 72.2% did not present or have blocks, 82.3% did not experience throat tension; (III) the children continued to present disfluencies when they were tired (n=6) or stressed (n=5); (IV) the children improved in speaking, behavior and had adopted good strategies in dealing with disfluencies or blocks; (V) both children and parents frequently used the resources learned during treatment; (VI) individual parent and follow-up sessions were conducted and most of them received guidelines to follow in case of relapses; and (VII) 94.4% of parents were satisfied with treatment outcomes.Conclusion: Results indicate that the treatment conducted with the preschool children, with support from their parents, contributed to improvements in speech fluency, behavior, positive conversational attitudes, and parent–child communication skills.(AU)

Tratamiento psicológico de la tartamudez crónica: estudio descriptivo de cinco casos clínicos / Psychological treatment of persistent stuttering: Descriptive study of five clinical cases

La tartamudez persistente se define por la permanencia de las disfluencias y la presencia de factores cognitivos, conductuales y comunicativos que contribuyen a mantenerla y agravarla. Por tanto, su tratamiento clínico debe centrarse en mejorar la fluidez del habla, asegurar la generalización del nuevo patrón prosódico y manejar los pensamientos disfuncionales y las conductas de evitación social y comunicativa que ayudan a mantener el problema y provocan una pérdida significativa de calidad de vida. Objetivo: Medir la eficacia de un tratamiento estandarizado para pacientes adultos con tartamudez persistente centrado en la fluidez de habla y en los aspectos psicológicos implicados. Material y métodos: Estudio clínico analítico de los resultados de la intervención. Se realizó una evaluación de todos los aspectos implicados en la tartamudez persistente mediante instrumentos validados y registro de habla. Se aplicó el protocolo de un tratamiento para tartamudez crónica. Resultados: Se evaluó la fluidez del habla en muestras de habla espontánea y lectura y las subescalas del cuestionario OASES de cinco pacientes con tartamudez de entre 21 y 25años. El tratamiento redujo el porcentaje de sílabas tartamudeadas en todos los casos, tanto en habla como en lectura, así como una reducción de las puntuaciones en todas las subescalas del OASES. Conclusión: Los resultados clínicos obtenidos indican eficacia del protocolo empleado para la modificación de la frecuencia de tartamudeos y de otros fenómenos asociados. Se exponen algunas consideraciones de interés para los terapeutas de la tartamudez crónica.(AU)

Persistent stuttering is defined by the permanence of disfluencies and the presence of cognitive, behavioral, and communication factors that contribute to maintaining and aggravating it. Therefore, clinical treatment should focus on improving speech fluency, ensuring generalization of the new prosodic pattern, and managing dysfunctional thoughts and social and communicative avoidance behaviors that help maintain the problem and cause significant loss of quality of life in patients. Objective: The main objective is to measure the efficacy of a standardized treatment focused on speech fluency and psychological aspects for adult patients with persistent stuttering. Material and methods: Analytical clinical study of the results of the psychological intervention. An evaluation of all aspects involved in persistent stuttering was carried out using validated instruments and speech recording. The protocol of a clinical treatment for chronic stuttering was applied. Results: Speech fluency in spontaneous speech and reading samples and the OASES questionnaire subscales from five stuttering patients aged 21-25years were assessed. The treatment reduced the percentage of stuttered syllables in all cases, both in speaking and reading, as well as a reduction in scores on all OASES subscales. Conclusion: Clinical results obtained indicate the efficacy of the protocol used to modify the frequency of stuttering and other associated behaviors. Some considerations of interest for therapists of chronic stuttering are exposed.(AU)

Stuttering on Instagram: What is the focus of stuttering-related Instagram posts and how do users engage with them?

PURPOSE: Instagram has become a popular platform for sharing and seeking health-related information, including stuttering. However, concerns have been raised about the accuracy, confidentiality, and potential negative impact of such information. This study aims to examine how stuttering is defined and understood on Instagram, and how users engage with related content. METHODS: We analyzed highly engaged Instagram posts with the hashtag "#Stuttering" published within a year and their corresponding comments using thematic analysis. RESULTS: The results revealed four main themes and nine sub-themes that highlighted different understandings of stuttering on Instagram, including the need for intervention, emotional impact on people who stutter, positive meanings, and mental health implications. User engagement varied based on the nature of the post, with users showing appreciation, objections, seeking advice, celebrating success stories, mocking, or advocating for people who stutter. CONCLUSION: Although Instagram can serve as a means of normalizing stuttering and highlighting success stories, it raises concerns about the promotion of non-evidence-based treatments and the use of stuttering for political or entertainment purposes. This study emphasizes the need to critically evaluate health-related information presented on social media platforms. To provide reliable information to PWS and their families who seek information on social media, it is recommended to promote evidence-based information on stuttering through trustworthy organizations such as the National Stuttering Association or the Stuttering Foundation, particularly on special occasions like International Stuttering Awareness Day.

The Fifth Croatia Stuttering Symposium: Part II. Natural recovery from early stuttering.

PURPOSE: The Fifth Croatia Stuttering Symposium of 2022 continued the Fourth Croatia Stuttering Symposium 2019 theme of the connection between research and clinical practice. At the 2022 Symposium, there were 145 delegates from 21 countries. This paper documents the contents of the second of three Symposium modules. METHODS: The module topic was that some children with early stuttering will recover naturally. A clinical situation was considered where a parent of a 3-year-old child asked if a clinician can predict whether their child will recover from stuttering without treatment. RESULTS: A distinguished scholar presented a 5-minute video interpretation of research about this topic. Three master clinicians then each presented a 2-minute video demonstration of how that research might be applied in a clinical situation. Following that, the convenors moderated a discussion between the distinguished scholar, master clinicians, and delegates regarding the research and how it applies to clinical practice.

Why do people who stutter attend stuttering support groups?

BACKGROUND:  Stuttering support groups (SSGs) have been a long-standing invaluable resource for people who stutter (PWS) but research into SSGs is only emerging. Speech-language therapists (SLTs) need further insight to successfully facilitate SSGs. OBJECTIVES:  To determine PWS' perspectives regarding why they attend SSGs in South Africa. METHOD:  Thirteen PWS who attend SSGs, between 20 and 58 years old, were a part of this qualitative study. Purposive sampling was utilised. Semi-structured telephonic interviews were used and data was analysed thematically. RESULTS:  Four themes, namely, 'altered perceptions', 'increased sense of community', 'support group reciprocity', and 'support group environment, participants and topics', were identified. The results yielded clinical implications which included SLTs encouraging: (1) improved perceptions of being a PWS through education and self-empowerment, (2) PWS' connections between meetings to increase the sense of community, (3) reciprocity in meetings, (4) sharing personal stories to promote learning and general self-management and (5) support, praise and education to empower and encourage PWS. This study's findings show that SSGs helped PWS accept their stutter and gain confidence. This study showcased how SSGs can help PWS manage their fluency and gain confidence. Additionally, this study supports current research which suggests that dysfluency and social-emotional well-being should be equally addressed. CONCLUSION:  Recommendations were generated from PWS' perspectives and included focusing discussions on fluency, emotions and sharing personal stories. Insights from PWS helped better inform SLTs of their role within SSGs including guiding and facilitating conversations.Contribution: People who stutters' perspectives can be used in clinical practice to help SLTs meet the needs of PWS and guide best practice when facilitating SSGs.

Eye movement as a simple, cost-effective tool for people who stutter: A case study.

BACKGROUND:  Access to services remains the biggest barrier to helping the most vulnerable in the South African Stuttering Community. This novel stuttering therapy, harnessing an unconscious link between eye and tongue movement, may provide a new therapeutic approach, easily communicated and deliverable online. OBJECTIVES:  This study provides both objective and subjective assessments of the feasibility of this intervention. Assessment tools holistically address all components of stuttering in line with comprehensive treatment approaches: core behaviours, secondary behaviours, anticipation and reactions. METHOD:  On receipt of ethical approval, this single-subject case design recruited one adult (21-year-old) male with a developmental stutter (DS). The participant gave informed consent and completed four scheduled assessments: baseline, after 5-week training, 3 months post-intervention and 24 months post-completion. The study used objective assessment tools: Stuttering Severity Instrument-4 (SSI-4); Subjective-assessment tools: SSI-4 clinical use self-report tool (CUSR); Overall Assessment of Speaker's Experience of Stuttering (OASES-A); Premonitory Awareness in Stuttering (PAiS) and Self-Report Stuttering Severity* (SRSS) (*final assessment). RESULTS:  The participant's scores improved across all assessment measures, which may reflect a holistic improvement. The participant reported that the tool was very useful. There were no negative consequences. CONCLUSION:  This case report indicates that this innovative treatment may be feasible. No adverse effects were experienced, and the treatment only benefited the participant. The results justify the design of a pilot randomised feasibility clinical trial.Contribution: The results indicate that this is a needed breakthrough in stuttering therapy as the instructions can be easily translated into any language. It can also be delivered remotely reducing accessibility barriers.

Effectiveness of Stuttering Modification Treatment in School-Age Children Who Stutter: A Randomized Clinical Trial.

PURPOSE: This study investigated the effectiveness of the stuttering modification intervention Kinder Dürfen Stottern (KIDS) in school-age children who stutter. METHOD: Seventy-three children who stutter were included in this multicenter, two-group parallel, randomized, wait-list controlled trial with a follow-up of 12 months. Children aged 7-11 years were recruited from 34 centers for speech therapy and randomized to either the immediate-treatment group or the 3 months delayed-treatment group. KIDS was provided by 26 clinicians who followed a treatment manual. Although the primary outcome measure was the impact of stuttering (Overall Assessment of the Speaker's Experience of Stuttering-School-Age [OASES-S]), the secondary outcomes included objective and subjective data on stuttering severity. RESULTS: At 3 months postrandomization, the mean score changes of the OASES-S differed significantly between the experimental (n = 33) and control group (n = 29; p = .026). Furthermore, treatment outcomes up to 12 months were analyzed (n = 59), indicating large effects of time on the OASES-S score (p < .001, partial η2 = .324). This was paralleled by significant improvements in parental ratings and objective ratings (stuttering severity, frequency, and physical concomitants). CONCLUSIONS: The significant short-term treatment effects in the OASES-S are in line with the (initial) focus of KIDS on cognitive and affective aspects of stuttering. Over 12 months, these changes were maintained and accompanied by behavioral improvements. The results suggest that individual treatment with KIDS is an adequate treatment option for this age group. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.24207864.

Reduced stuttering for school-age children: A systematic review.

BACKGROUND: Treatment of school-age children (6-12 years of age) who stutter is a public health priority. Their clinical needs include a psychosocial focus and stuttering reduction. For the latter clinical need, there is a critical window of opportunity for these children warranting research attention. PURPOSE: The purpose of the review is to guide future clinical research by establishing (a) what interventions are associated with stuttering reduction for school-age children (b) the reported immediate and longer-term effects of those interventions, and (c) the level of evidence for these interventions in terms of study design. METHODS: Fourteen databases and three conference proceedings were searched for interventions used to reduce stuttering in school-age children. Primary outcomes were mean stuttering reductions pre-treatment, immediately post-treatment, and any follow-up assessments. RESULTS: Of the 4305 studies identified from the databases, 67 studies met inclusion criteria. Five different treatment approaches were reported in the literature that might reduce stuttering for a school-age child, but with varying effect sizes. These include (a) operant methods, (b) speech restructuring, (c) combined operant methods and speech restructuring, (d) machine-driven treatments, and (e) treatments with a cognitive behaviour therapy component. CONCLUSIONS: Operant methods warrant investigation in future clinical trial research, as do variants of speech restructuring. Hybrid approaches showed encouraging results, including speech restructuring variants combined with operant methods or with cognitive behaviour therapy. However, evidence is preliminary only at Phase I and II trials. Several treatments with reported clinical promise have been overlooked for decades and require further investigation.