Croatia Stuttering Symposium - day one

One of the absolute perks of doing research is being able to travel and attend conferences around the world. Listening to some of the the great researchers in our field there is always lots to learn and be inspirited by. Last week two of the EST projects researchers Åse, PhD-student, and Linn, post doc, was fortunate to attend the Croatia Stuttering Symposium.

The symposium is the fourth of its kind, held every third year since 2010, in Cavtat, an ancient small town not far from Dubrovnik. The symposium is a joint effort between Croatian SLP and European Fluency Specialist Suzana Jelčić Jakšić, researcher and clinician Robyn Lowe and foundation director Mark Onslow, both at the Australian Stuttering Research Centre at the University of Technology Sydney.

Focusing on stuttering treatment, the symposium program was set up to give clinical insight in problem-solving through video of clinical settings. There were many opportunities to discuss clinical questions in groups consisting of clinicians and researchers from many different parts of the world.

 

The topic on the conferences first day was treatment of adults who stutter. For someone who normally focuses on the treatment of pre-school children, shifting the focus to the experiences of people with a life- long experience of living with stuttering, is a very healthy exercise. The lecturers reminded us that for many adults who stutter, stuttering isn’t just an acoustic disorder but one that may impact emotional and social wellbeing. For many adults, avoiding sounds, words or even speaking situations, is a big part of the disorder. Consequently, 60 % of adults presenting for treatment are diagnosed with social anxiety (Menzies et al., 2008).

Hans-Georg Bosshardt highlighted a finding by Iverach and collegues (2018): adults how stutter with and without a social anxiety disorder did not differ in self-reported stuttering severity. However, more dissatisfaction with one’s own speech, avoidance of speaking situations and significant psychological problems were reported in the group of adults who were socially anxious. The message we took home with us from this is that efficacious treatment and psychological treatment are very important and that impact may occur regardless of stuttering severity.

Each day, different speech language psychologist gave master classes for the age group of focus by showing videos from different treatment sessions and commenting on treatment choices that were made and particular challenges. The clinical psychologist at the Australian Stuttering Research, Ross Menzies, gave master classes in psychology each of the days. On day one he presented and exemplified the use of cognitive behavioral therapy (CBT) in treatment of anxiety in adults who stutter. Menzies emphasized that SLPs, who are experts on stuttering, can use CBT in their treatment of people who stutter. Importantly, he stated that the worst thing for anxious people is the all of the opportunities that are robbed from them when they avoid life. With CBT, the clinician can work with changing the client’s negative thoughts and expectations before situations and challenging the client to expose him/herself for situations and cease the opportunities in his/her life.

Susan O’Brian gave a master class on speech pathology methods for adults who stutter. We felt very lucky when joining her for lunch one of the days.  

CBT requires changing the negative thoughts appearing in everyday situations, and exposure for challenging situations. The same can be said for speech therapy, which aims to change the way people speak, in order to decrease stuttering. In her masterclass, associate professor Sue O’Brian showed through video how SLPs can work with adults who stutter to facilitate that the clients continue the work that is done in the clinic when they are outside clinic. The two key components in the last generalization phase was practice and problem-solving. Practicing speech techniques outside clinic should involve a lot of complexity and variation. Development of problem solving skills involved both finding solutions for how to incorporate practice in daily life and also which activities and level of technique that should be used during practice. She emphasized that this work needs to be incorporated into the daily routine of the clients. The time and energy needed to go through with stuttering treatment is interesting to consider when thinking about treatments for preschool children and their busy families as well.

Special for the Croatia Stuttering Symposium is the emphasis that is placed on plenary and group discussions. During the group sessions we got the opportunity to discuss the issues raised by the presenters with other SLPs. We learned a lot from these discussions across SLPs with differing experiences. Also, the three plenary discussions with different prominent researchers and clinicians in the panel was very exciting.

A big thank you to Compros- our research group for sponsoring our trip!

 

From the EST- team, Linn and Åse

References:

Iverach, L., Jones, M., Lowe, R., O’Brian, S., Menzies, R. G., Packman, A., & Onslow, M. (2018). Comparison of adults who stutter with and without social anxiety disorder. Journal of fluency disorders, 56, 55-68.

Menzies, R. G., O’Brian, S., Onslow, M., Packman, A., St Clare, T., & Block, S. (2008). An experimental clinical trial of a cognitive-behavior therapy package for chronic stuttering. Journal of Speech, Language, and Hearing Research.