Practice Based Evidence: An Integrated Therapy Approach for Children who Stutter

Abstract

This paper adds to the developing evidence base for an integrated therapy programme delivered at the Michael Palin Centre. A combination of data from a small cohort of children who attended the programme (Millard 2011) and a replicated single subject study (Fower, Harley & Millard, 2014) indicated that this programme can be effective in reducing the frequency and impact of stuttering and that these changes are maintained over time. This study seeks to add to the evidence base and increase the validity of the findings by exploring the effect of the therapy with larger participant numbers.Participants: All children (N=39; 32 boys and 7 girls) aged 10;0 – 14;11 who attended an intensive therapy programme over a period of four years were included. This is a longitudinal study which incorporates a pre-course baseline to establish whether change was occurring prior to the onset of therapy. Children completed assessments at seven time points:T1 = 2 months pre-courseT2 = 1st dayT3 = Last DayT4 = 6 weeks post courseT5 = 4-5 months post courseT6 = 8 months post courseT7 = 1 year post courseOutcome measuresa) A speech task – a conversation and reading sample recorded at home using a hand held video recording device (FLIP). These speech samples were later analysed by a trained researcher using the SSI-3 (Riley, 1994) to provide stuttering frequency and severity measures.b) The OASES-S/T (Yaruss & Quesal, 2010) to evaluate the impact of stuttering.c) Palin Parent Rating Scales (Millard, Edwards & Cook, 2009) to explore parents’ perspectives of the impact that the stuttering has on the child; the severity of the stuttering and the impact on the parent; and, the parents’ knowledge and confidence in managing it.This integrated therapy approach seeks to develop strengths in the areas of social communication skills; thoughts and feelings; and speech strategies. Regular follow up sessions take place throughout the remainder of the year and additional individual therapy sessions are available on the basis of need. Preliminary analysis of the data has been completed up to T4. The results indicate that there is no change in the two month pre-therapy baseline phase across the child measures. There are significant changes from T2 to T3 and from T2 to T4. There are no significant changes between T3 and T4. From this preliminary analysis we can conclude that the children were not undergoing a period of natural improvement prior to the start of the course. The frequency and severity of stuttering significantly reduced during the course and this was maintained until the first follow up session. Further the impact of the stuttering as measured by the OASES-S/T scores indicated a significant reduction in the impact of the stuttering in the short term.Further analysis will indicate whether these signs of progress are maintained over the long term and whether changes are observed by parents. These data will be ready for presentation at the conference.