Thursday, February 02, 2012

TED Talk on Stuttering

TED is famous for interesting thought provoking speeches. Many side TEDs have developped over the years, for young talents and for regions for example. This TEDxNewy talk is on Lidcombe treatment by Sarita Koushik. I know her, because we meet at the Oxford Conference some years again, and were part of the happy party gang. She is a nice person, but I must say that she has unfortunately been indoctrinated by the Lidcombe way of doing research. Her talk is very much in-line with the highly doubtful statistical approach to evidence based practise. Her research involves finding the optimal treatment schedule, and very likely a fata morgana due to huge statistical fluctuations. You already need 100 kids to just test efficacy of treatment. So how do you compare between groups of different treatment length??? I am nearly convinced she is chasing a phantom...

And I am not sure I like her stuttering at the beginning, because she does not actually stutter. What is your opinion?


Thomas David Kehoe said...

Practice scheduling is an important subject that no one has studied with stuttering treatment. The classic practice scheduling study was done years ago by the United States Postal Service with the workers training to operate mail-sorting machines (similar to typewriters). All subjects received 60 hours of training. The scheduling varied among four groups. One group had two two-hour sessions per day, for 15 days. A second group had one two-hour session per day, for 30 days. A third group had two one-hour sessions per day, for 30 days. The fourth group had one one-hour session per day, for 60 days.

The first group (two two-hour sessions per day) learned fastest, but in the long run had the worst performance. The fourth group (one one-hour session per day) took the longest to get "up to speed," but eventually had the best performance.

Surprisingly, the postal workers preferred the two-hour/two-session schedule, even though they had the worst performance. People are impatient. They don't want to spend 60 days learning something, if they think there's a 15-day shortcut.

Stuttering therapy is usually done with one of two practice schedules. You either see your SLP for one hour twice a week for about six months, or you go to an intensive residential therapy program such as Hollins and practice ten hours per day for two weeks. The Postal Service study suggests that intensive therapy programs should make stutterers fluent quickly, but with poor long-term results.

On the other hand, two one-hour sessions per week may be too little practice. A difference between stuttering and mail sorting is that after training on a mail sorting machine you don't go out and sort mail with your friends. After you leave the speech clinic you talk to people. If you stutter during the time you're not in the speech clinic you may be reinforcing old speech motor programs and preventing your new, fluent speech motor programs from becoming habitual.

The Postal Service study suggests that the optimum practice schedule may be to do one hour of stuttering therapy per day, and then not talk the rest of the day, for 60 days.

Lidcombe therapy is one of the only stuttering therapy programs that may be close to this optimum practice schedule. The parents spend about an hour per day doing therapy with their child.

Tom Weidig said...

Excellent points.

But for those thoughts, you don't need to spend years on a PhD.

Especially because the outcome/performance is not that easily controlled, because stuttering involves dysfluencies, but also fears and avoidances and other learned speech patterns.

Ora said...

Tom - I'd be interested if you could clarify your opinion of the Lidcombe method, as I wrote in a comment on your earlier posting a few days ago:

Tom - I know that you've often criticized Lidcombe, sometimes in strong terms. However, I've never been sure whether you're critical of the method itself, or you're critical that the Lidcombe proponents make exaggerated and unsupported claims.

Can you clarify your opinion of the Lidcombe method itself? Do you believe that it's fundamentally beneficial, or not?

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Pam said...

I am not sure about her stuttering at the beginning either. It must be voluntary stuttering, as the majority of her speech does not contain any hesitations, partial word or sound repetitions, or blocking. But its pretty good voluntary stuttering.

Anonymous said...

This TED presentation on stuttering and owning a business is 10x [IMO] as good as the posted presentation. This is a real stutterer who is able to stand in front of a large audience and share her experiences; a really moving presentation which illustrates the importance of a positive attitude in life, regardless of impediment


Also I love the blog Tom, keep up the great work

Gert Reunes said...

the stuttering was SO FAKE... only the stuttering community has the right to do this!!!