The EST-project

Norwegian speech pathologists’ treatment of young children who stutter

In June, Ane, Karoline and Kari-Anne and Linn published an article concerning Norwegian speech language pathologists’ (SLPs) treatment of young children (age 2-6) who stutter in the Norwegian journal Norsk tidsskrift for logopedi. Also, with the permission from the journal, the article was reprinted on the web page Utdanningsforskning.no. This blog post is a summary of the paper.

The majority of children who stutter will recover within school-age (Kefalianos et al., 2017; Månsson, 2000), however, few experience natural recovery within the first year after onset (Reilly m. fl., 2013). At present we are not able to predict who will experience natural recovery and who will persist to stutter and when natural recovery will occur (Clark, Tumanova, & Choi, 2017). Studies have shown treatment to be more efficacious in reducing stuttering in young children than no treatment (Harris, Onslow, Packman, Harrison, & Menzies, 2002; Lattermann, Euler, & Neumann, 2008). Given the abovementioned, treatment in young children is recommended. However, in Norway there are no national guidelines concerning stuttering treatment for young children.

Our study aimed at investigating how speech language pathologists in Norway treat young children who stutter. An electronic survey was carried out after approval by the Norwegian Centre for Research Data. Four main questions were asked in the survey. These concerned what kind of treatment approach SLPs used in treatment of young children who stutter (direct/ indirect/ a combination of direct and indirect/ other treatment), how often the different treatment approaches were given, the most often used indirect treatment (Palin PRS, Restart DCM, own developed of indirect direct strategies, other) and direct treatment (Westmead, Lidcombe program, fluency shaping techniques, stuttering modification techniques, other).

117 SLPs responded to the survey. The results indicate that the majority of SLPs use indirect treatment with young children who stutter. More specifically, the SLP’s own developed combination of different indirect strategies is used by most. Few report using indirect treatment programs such as Palin PCI (N=8) and Restart DCM (N=11) and direct treatment programs such as the Lidcombe program (N=2) and Westmead (N=0) most often. In summary, the results from our study highlight a discrepancy between the Norwegian SLPs practice and research evidence. Since there is no evidence for the treatment that is given most often by the majority of SLPs in the survey, future studies should target the effect of this treatment. Furthermore, to ensure efficacious treatment for young children who stutter in Norway, guidelines of stuttering treatment together with training in efficacious treatment programs should be implemented in Norwegian speech clinics.

References

Clark, C. E., Tumanova, V., & Choi, D. J. P. o. t. A. S. I. G. (2017). Evidence-Based Multifactorial Assessment of Preschool-Age Children Who Stutter. 2(4), 4-27.

Guttormsen, L.S., Melle, A.H., Hoff, K., & Næss, K-A.N (2019). Stammebehandling av barnehagebarn: norske logopeders praksis. Norsk tidsskrift for logopedi, 2, 6-13.

Harris, V., Onslow, M., Packman, A., Harrison, E., & Menzies, R. (2002). An experimental investigation of the impact of the Lidcombe Program on early stuttering. Journal of fluency disorders, 27(3), 203-214. doi:https://doi.org/10.1016/S0094-730X(02)00127-4

Kefalianos, E., Onslow, M., Packman, A., Vogel, A., Pezic, A., Mensah, F., . . . Reilly, S. (2017). The History of Stuttering by 7 Years of Age: Follow-Up of a Prospective Community Cohort. Journal of Speech, Language, and Hearing Research, 60(10), 2828-2839. doi:10.1044/2017_JSLHR-S-16-0205

Lattermann, C., Euler, H. A., & Neumann, K. (2008). A randomized control trial to investigate the impact of the Lidcombe Program on early stuttering in German-speaking preschoolers. Journal of fluency disorders, 33(1), 52-65. doi:https://doi.org/10.1016/j.jfludis.2007.12.002

Månsson, H. (2000). Childhood stuttering: Incidence and development. Journal of fluency disorders, 25(1), 47-57. doi:http://dx.doi.org/10.1016/S0094-730X(99)00023-6

Reilly, S., Onslow, M., Packman, A., Cini, E., Conway, L., Ukoumunne, O. C., . . . Block, S. (2013). Natural history of stuttering to 4 years of age: a prospective community-based study. Pediatrics, 132(3), 460-467. doi:http://dx.doi.org/10.1542/peds.2012-3067