Speech treatment and support group experiences of people who participate in the National Stuttering Association

Support groups are rapidly becoming an important part of the recovery process for many people who stutter, and a growing number of speech-language pathologists (SLPs) are encouraging their clients to participate in support groups. At present, however, little is known about the individuals who join stuttering support groups and the benefits they derive from their participation. This study surveyed members of the National Stuttering Association (NSA) to learn about their experiences in support groups, as well as their experiences in speech therapy. Respondents were 71 people who attended the 1999 NSA conference in Tacoma, WA. The majority of respondents had participated in treatment several times during their lives, using a variety of techniques. Respondents who had participated in fluency-shaping treatments were more likely to report that they had experienced a relapse than those who had participated in stuttering modification or combined treatments. Also, there was a strong positive correlation between respondents' satisfaction with treatment and their judgments of clinicians' competence, suggesting that improved training for SLPs should lead to improved treatment for people who stutter. Results will be used to provide a foundation for further evaluations of the benefits of support group participation for people who stutter. EDUCATIONAL OBJECTIVES: The reader will learn (a) that many people who participate in the NSA have had numerous and varied experiences with speech treatment throughout their lives, (b) which aspects of treatment and support group participation are seen as most beneficial for people who participate in the NSA.     

Enhancing treatment for school-age children who stutter II. Reducing bullying through role-playing and self-disclosure

This paper describes several treatment strategies that clinicians can use to help children who stutter who are experiencing bullying and other negative reactions from their peers. Specific strategies include problem-solving activities designed to help the child develop appropriate responses to bullying and a classroom presentation designed to educate peers about stuttering. To facilitate clinicians' application of these techniques, the strategies are presented in the context of a case study involving a 9-year-old boy who participated in a comprehensive treatment program for stuttering. Following treatment, the child exhibited an increased ability to respond to bullying experiences in a constructive fashion. In addition, negative comments by the child's peers diminished following the classroom presentation. Findings suggest that clinicians can help children overcome bullying and other negative reactions associated with stuttering through a number of well-supported treatment strategies that can be applied in a variety of clinical settings. Educational objectives: After reading this article, participants will be able to: (1) define bullying and teasing and explain the difference between the two experiences; (2) describe two strategies for helping children who stutter successfully manage bullying experiences at school and in other settings; and (3) explain two strategies for educating children about stuttering and about bullying.     

Enhancing treatment for school-age children who stutter I. Reducing negative reactions through desensitization and cognitive restructuring

This paper describes several treatment strategies that clinicians can use to address negative affective, behavioral, and cognitive reactions that school-age children who stutter may experience as part of their disorder. Specific strategies include desensitization to stuttering, cognitive restructuring, self-acceptance, purposeful self-disclosure, and a combination of both fluency enhancing and stuttering modification approaches. To facilitate clinicians' application of these techniques, the strategies are presented in the context of a case study involving a 9-year-old boy who participated in a comprehensive treatment program for stuttering. Following treatment, the child exhibited improved communication attitudes and a reduced frequency and severity of stuttering, combined with reduced concern about stuttering, as indicated through formal and informal assessments. Findings suggest that clinicians can help children overcome the negative reactions associated with stuttering through a number of treatment strategies that can be applied in a variety of clinical settings. Educational objectives: After reading this article, participants will be able to: (1) define desensitization and cognitive restructuring and provide two arguments in favor of using these strategies in treatment for school-age children who stutter; (2) describe two treatment strategies for helping school-age children achieve desensitization through stuttering therapy; (3) describe two treatment strategies for helping school-age children engage in cognitive restructuring in the context of therapy.     

Stutterers and others: A comparison of communication attitudes

The Erickson 39-item S-scale was administered to 24 persons who stutter, 24 persons with voice or articulation disorders, and 24 normal speakers. The purpose of the study was to determine if the three populations differed in communication attitude. The one-way analysis of variance showed that the three groups differed significantly. Normal speakers revealed the most desirable communication attitude; the communication attitude of the voice and articulation disorders population was less favorable than normals; the communication attitude of the stuttering population was least favorable.     

Academic and clinical education in fluency disorders: an update

This paper presents a survey of the academic and clinical education in fluency disorders provided by American Speech-Language-Hearing Association (ASHA)-accredited training programs. Respondents were 159 programs (out of 256, return rate = 67.4%) that completed a questionnaire seeking information about the courses and clinical experiences they require, the expertise of their faculty and supervisors, changes following the 1993 modification of training requirements for the ASHA certificate of clinical competence (CCC), and preliminary plans for changes in preparation for the 2005 standards. Results, which supplement findings from an earlier survey distributed in 1997 (Yaruss, 1999), indicated that nearly one-quarter of programs allow students to graduate without coursework in fluency disorders, and nearly two-thirds allow students to graduate without clinical practicum experiences. Findings suggest a trend toward fewer required classes taught by less experienced faculty, fewer clinical hours guided by less experienced supervisors, and a greater likelihood that students will graduate without any academic or clinical education in fluency disorders. Given the repeated finding that many speech-language pathologists are uncomfortable working with people who stutter, as well as ASHA's apparent de-emphasis of fluency disorders within the increasing scope of practice in the field of speech-language pathology, these results are a cause for concern about the future of fluency disorders. EDUCATIONAL OBJECTIVES: The reader will learn about (1) the coursework and clinical practicum experiences that are currently required for students in ASHA-accredited training programs; (2) trends indicating a reduction in training requirements for fluency disorders; and (3) ways of improving these requirements.     

Overall Assessment of the Speaker's Experience of Stuttering (OASES): documenting multiple outcomes in stuttering treatment

This paper describes a new instrument for evaluating the experience of the stuttering disorder from the perspective of individuals who stutter. Based on the World Health Organization's International Classification of Functioning, Disability, and Health [World Health Organization (2001). The International Classification of Functioning, Disability, & Health. Geneva: World Health Organization], the Overall Assessment of the Speaker's Experience of Stuttering (OASES) collects information about the totality of the stuttering disorder, including: (a) general perspectives about stuttering, (b) affective, behavioral, and cognitive reactions to stuttering, (c) functional communication difficulties, and (d) impact of stuttering on the speaker's quality of life. This paper summarizes scale development, reliability and validity assessment, and scoring procedures so clinicians and researchers can use the OASES to add to the available evidence about the outcomes of a variety of treatment approaches for adults who stutter. EDUCATIONAL OBJECTIVES: As a result of this activity, participants will be able to: (1) identify key issues related to the documentation of treatment outcomes in stuttering; (2) discuss the components of the international classification of functioning, disability, and health as they relate to the documentation of stuttering treatment outcomes; (3) evaluate and use a new measurement instrument for assessing the outcomes of stuttering treatment from the perspective of the person who stutters.     

National Stuttering Association members' opinions about stuttering treatment

As stuttering support groups, such as the National Stuttering Association (NSA), have gained prominence and visibility, it has become increasingly important for speech-language pathologists (SLPs) to learn about the people who participate in such groups. This article presents results of a brief survey completed by 200 members of the NSA to examine the opinions of support group members regarding the field of speech-language pathology and stuttering treatment options. Results indicate that NSA members hold a variety of opinions, both positive and negative, about the resources available to them. Findings highlight a number of ways in which SLPs can work with stuttering support groups, both to learn more about the needs of people who stutter and also to provide needed information about treatment options that are available for people who stutter. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to describe (1) the role of support groups in stuttering treatment; (2) the people who are members of the NSA; and (3) their opinions about various issues related to stuttering and its treatment.     

Training analysis in the dutch society for psychoanalytic psychotherapy: A survey of attitudes and feasibility

SUMMARY

As is the case in many training courses in psychoanalytic psychotherapy, one of the training requirements of the Dutch Society for Psychoanalytical Psychotherapy (NVPP) is a training analysis, currently a minimum duration of 700 hours. During the last few years, this requirement has become somewhat controversial. Because the NVPP does not have information about the current interest in NVPP membership, the Board of the NVPP decided to do a survey. Of 995 psychiatrists, clinical psychologists and psychotherapists, who had recently completed their training, or were still in training, 623 filled in a questionnaire. Of those who are interested in the NVPP training, 39 per cent judged the training analysis as not feasible in terms of time, and 61 per cent in terms of money. Forms of personal treatment thought desirable for anyone who wishes to become a psychoanalytic psychotherapist at a specialist level are, in descending order, psychoanalytic psychotherapy (63%), psychoanalysis (39%), psychoanalytic group psychotherapy (25%), and psychoanalytic marital or family therapy (6%). Respondents who judge personal analysis as not feasible, also tend to judge psychoanalysis to be equivalent to other forms of psychoanalytic psychotherapy, whereas those who judge personal analysis as feasible, tend to think that personal analysis is essential for a psychoanalytic psychotherapist at the specialist level.