Category Archives: Common Questions

Common stuttering treatment and assessment questions, and my responses.

Why visit The Stuttering Clinic?

The Stuttering Clinic is probably not located behind your corner shops. Inconvenient! So why trek across town to see me at The Stuttering Clinic?

Speech pathologists are health professionals trained to assess and treat communication and swallowing disorders. Some speech pathologists, like myself, have a particular interest in certain disorders and considerably more experience in assessing and treating them. My caseload solely comprises of people who stutter.

Speech pathology practice, like other areas of medical science, is changing at an increasingly rapid rate. Working in one area allows me to keep up to date in it. This is important because even though stuttering is a well known communication disorder, ineffective treatment can have lifelong consequences.

Did you know that living with stuttering increases the risk of psychological disorders? Many adults who stutter also live with a social anxiety disorder. General anxiety and mood disorders are more likely after years of living with stuttering. School children can be bullied or choose to marginalise themselves owing to the stuttering, both of which can lead to these psychological difficulties.

Did you know that stuttering can be treated effectively during the preschool years? The same treatments are less successful with school-age children. By adolescence and adulthood stuttering can be managed only.

Many children I treat have seen another speech pathologist for stuttering and not made progress. Treatment is so much more straightforward if I can start with you. If you come to me down the track we often need to undo what wasn’t working. This is particularly tricky when clients have been sensitised to components of the treatment. Even when this hasn’t happened many children aren’t happy to start treatment again because they’re tired of it already.

It’s best to do treatment properly from the outset. Make sure the speech pathologist you see has tangible expertise in stuttering. Any Certified Practising Speech Pathologist can list an interest in any communication disorder; they are qualified to treat it. But, I recommend asking whether they’ve used the treatment before, how often and with what ages. Ask them about their treatment outcomes.  

Treatment for stuttering is a lengthy process. Do it right, from the start, for the best possible outcome.

Contact me if you’d like to discuss whether I can help you. If Edgecliff is not handy to you I also see clients using telehealth (Skype).

What will happen to my child after they complete Stage 1 of the Lidcombe Program stuttering treatment?

The Lidcombe Program has two stages. Stage 1 is about eliminating stuttering; Stage 2 is for the maintenance of stutter-free speech. We have Stage 2 because relapse (stuttering again) is common and most likely soon after entering Stage 2.

Continue reading What will happen to my child after they complete Stage 1 of the Lidcombe Program stuttering treatment?

Should I treat my preschooler’s stuttering?

I often hear clients ask whether now is the right time to treat their preschooler’s stuttering. There has been much media misinformation around this issue.

Parents need to know that not all children grow out of stuttering and that for those who do not grow out of it, treatment with the Lidcombe Program during the preschool years is their best treatment option.

Below I have reproduced a letter from researchers at the Australian Stuttering Research Centre which was written to address this.

Publicity regarding the recent article by Reilly et al., “Natural history of stuttering to 4 years of age: A prospective community-based study”:

Response from the Australian Stuttering Research Centre

Australian Stuttering Research Centre, October 2013

A recent report in the journal Pediatrics on the epidemiology of stuttering (1), published by Australian researchers, including two from the Australian Stuttering Research Centre, has attracted a lot of interest worldwide.

Unfortunately, much of the publicity and discussion about the article in the press, in the social media and even in the professional literature has been
misleading. The Reilly et al. study is part of a larger community study of children in three areas of Melbourne, Australia. Children and their parents were recruited to
the study at their universal visit to maternal and child health nurses at age 8 months. Recruitment occurred over a 6 month period. The children were then assessed regularly by researchers to identify the natural course of language development and to document the onset (incidence) of stuttering.

The Reilly et al. article reports the findings for those children who had started to stutter by age 4 years. The most important finding is that many more
children started to stutter than previously thought. This is likely because children were first assessed prior to the onset of stuttering, meaning that all
(or nearly all) children in the community who started to stutter were identified.

The second finding is that at 4 years of age the group of children who had started to stutter did not score lower that the rest of the children when
assessed for language development and quality of life. Again, this is likely because the study captured all children who had started to stutter, not just
those who presented at a clinic. This is the finding that has been so widely misrepresented. It has been reported that the authors have said that this
means that treatment for early stuttering should be withheld. This is not the case.

In their report, Reilly and colleagues endorse the evidence based guidelines for the Lidcombe Program about when to start
treatment (2). The Lidcombe Program was developed in Australia and is the only treatment for stuttering in preschoolers that is supported by clinical
trials.  The guidelines clearly state that (a) delaying the program for a year after the onset of stuttering is unlikely to jeopardize a child’s responsiveness,
but (b) the program should be instigated earlier than this if “the child is distressed, there is parental concern, or the child becomes reluctant to
communicate” (see Reilly et al., page 446).

In summary, while epidemiological studies provide information about the incidence and course of disorders or conditions in the community, in clinical
practice the welfare of the individual is always of prime concern. A child who starts to stutter should be assessed by a speech pathologist, who can advise on the best
course of action, taking into account the individual circumstances of the child and family.

References 
(1) Reilly, S., Onslow, M., Packman, A. et al. (2013). Natural history of stuttering to 4 years of age: A prospective community based study. Pediatrics 132, 460-467.
(2) Packman A, Onslow M, Attanasio, J. The timing of early intervention with the Lidcombe Program. In M. Onslow, A. Packman, & E. Harrison (Eds.) The Lidcombe
Program of early stuttering intervention: A clinician’s guide (pp. 41-55). Austin, TX:Pro-Ed.

 

Common Questions: What options are available for my child who has started stuttering?

Here’s a question I often receive from parents concerned about stuttering and their child:

“Hi, my daughter turned 3 in Jan this year. We have noticed over the last few months that she has begun to stutter. Her father suffered quite badly from stuttering when he was younger so I want to be proactive in this situation. Can you please tell me what options are available?”

It is good that you are proactive because there is an effective, evidence-based treatment for stuttering during the preschool years called the Lidcombe Program.

The aim of the Lidcombe Program is to completely resolve the stuttering. Many of the children who have completed the program do not remember stuttering; some are not ever aware they did it.

Your child’s stuttering behaviours have started at the typical age. Speech dysfluencies are common in preschool-age children; without treatment some of these children will go on to stutter throughout life whereas others will stop being dysfluent by themselves.

See a speech pathologist who works with children who stutter. The speech pathologist will be able to advise you on how to respond to the stuttering and discuss treatment timing.