Friday, August 14, 2009

A miracle has happened

Here is the first document on early intervention (from the NSA) that is not obviously wrong or over-hyped à la early Lidcombe claims. The website identifies as source Larry Molt. Congratulations.

Early intervention is important and effective. When a physician identifies stuttering in a young child, or is unsure if a disfluent speech pattern is indicative of stuttering or normal nonfluency, referral to a speech-language pathologist for an evaluation is appropriate and vital. The earlier that stuttering behavior can be identified and effective treatment strategy put into place, the less likely that the child will acquire the negative emotional reactions to stuttering and experience the ensuing complications and exacerbation.

I like this describtion, because there is no talk about brain plasticity and other scientific concepts used in a vague manner and no talk of treatment being able to change the brain. If genes or a neurological incident are involved, the brain will never recover per se but can only adapt to syptom-free speech at best. They focus on the clearly treatable emotional reactions and ensuing complications.

While the high recovery rate seen in children may tempt one to advise parents to wait and see if the child outgrows the problem, there is no assurance that the child will outgrow it. For the 20% to 40% of children for whom stuttering continues into gradeschool and adolescent years, the lost time during the early stages of the development of the disorder may significantly complicate the treatment picture. For young children, treatment by a speech-language pathologist often includes identification of risk factors, education of the parents, management of possible environmental influences, and adjustment of speech production patterns. These strategies typically have a positive effect on stuttering and can help return the child to a normal fluency pattern.

Again, they do not say that treatment will have an effect on fluency but that it can have an effect. And they argue well for treating children early.

For older children and adolescents, treatment strategies may also incorporate much more direct work on speech production and speech management techniques, such as slowing speech rate and simplifying linguistic and speech production patterns. Some professionals may also teach self-monitoring and self-management strategies, as well as acceptance and non-avoidance of stuttering and speaking situations. Similar treatment strategies are used with adults. Treatment strategies for adults may also include pharmaceutical management of some aspects of the disorder, and the use of assistive electronic feedback devices.

From time to time, radically different treatment strategies may appear in the literature or in the media. As with treatment of any other disorder, such strategies should be considered in light of empirical support. Speech-language professionals can often provide suggestions and guidance relative to new treatment approaches.


Anonymous said...

there seems to be a denial of the McGuire programme, a denial of the empirical evidence/facts/reality.

SLPs and professionals sees the McGuire programme as a threat and are afraid people will find out....a smear campaign.

Greedy SLPs?

Sure, the McGuire programme doesn't work for everyone all the time, but it works for some people, just like the SpeechEasy and the Lidcombe programme work for some. To tottally dismiss the McGuire programme based on emotions and prejudice is unprofession (and Speech language pathologists are supposed to be "professionals")

Tom Weidig said...

Why do you say this? How is it related to the text?

Anonymous said...

For Example:

"Thanks for providing the link. James Earl Jones is one of my favorites (loved him in Field of Dreams).

Although he says he is a stutterer I heard no real disfluencies. And I know he's one of the famous people who stutter (along with Marilyn Monroe, Johnny Damon and Tiger Woods). But here's what I dislike. I've heard Tiger
Woods speak many times. I have never heard a stutter. In fact with the
exception of Mel Tillis none of the NSA Famous People Who Stutter stutter publicly.

I think that gives the impression to the world that those of us who do stutter - we must be doing something wrong or just aren't trying hard enough.

Anonymous said...

The SFA and its therapists offer all of us who stutter the cure...Just ask the Queen!

You too can be like Tiger, Marilyn, Winston, Johnny, James, Julia, Bill, ETC....

And yes, we who continue to stutter are not practicing SFA therapy enough...Just ask the queen or any one on her court!