Effectiveness of intensive group therapy for children who stammer aged years: child and parent outcomes Karen Fenton Vicky Joffe

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Effectiveness of intensive group therapy for children who stammer aged 10-14

1 Effectiveness of intensive group therapy for children who stammer aged years: child and parent outcomes Karen Fenton Vicky Joffe The Michael Palin Centre

2 Overview Intensive course and aims Method Results Conclusion Next steps The Michael Palin Centre

3 Intensive course Groups are run every April and October Up to 10 children in each group Parent group runs alongside 4 follow up sessions The Michael Palin Centre

4 Aims of the course To help children: have more control and choice about how they manage moments of stammering; experience less negative impact associated with having a stammer experience less anxiety about speaking; make progress towards personal goals related to speaking, communication and confidence. To help parents: feel more knowledgeable about stammering and more confident in supporting their child. The Michael Palin Centre

5 METHOD The Michael Palin Centre

6 Participants 14 participants (10;2 14;9) 12 males, 2 females 25 parents (14 mothers, 11 fathers) 2 bilingual, 2 dyspraxia, 1 ASD diagnosis 50% had persistent family history of stuttering The Michael Palin Centre

7 Data Collection 4 time points used: 3 months pre- intervention immediately pre- intervention immediately post- intervention 12 months post intervention The Michael Palin Centre

8 Outcome measures CHILDREN Percentage of syllables stuttered (%SS) (reading and conversation) SSI-3 (Stuttering Severity Instrument-3) CAT (Communication Attitude Test) OASES-S (Overall Assessment of Speakers Experience of Stuttering) The Michael Palin Centre

9 PARENTS Outcome Measures Palin Parent Rating Scales (Palin PRS) Scales/pprs_connect (Millard & Davis, in review) The Michael Palin Centre

10 RESULTS The Michael Palin Centre

11 %SS Significant main effect for time (p = 0.019) Pairwise comparison showed significant differences between: T1 and T3 (p=0.014) T2 and T3 (p <= 0.05) The Michael Palin Centre

12 Mean percentage of stuttered syllables across time. The Michael Palin Centre

13 Immediately post course results 12/14 children reduced %SS score immediately post therapy. 7 children reduced %SS to below 3%SS at T3 9 children had mod-severe levels of stuttering at T2 which reduced to mild range at T3. The Michael Palin Centre

14 Results 12 months post course 9/13 children had lower %SS scores than at T2. 4 children achieved scores lower than 3%SS at T7. 6 children moved from moderate and severe levels of stuttering at T2 to mild levels at T7. 3 children remained in severe range at T7. The Michael Palin Centre

15 SSI-3 Significant effect for time (p= 0.01) Post hoc analysis showed difference between: T1 and T3 (p <= 0.01) T2 and T3 (p <= 0.01) The Michael Palin Centre

16 Mean SSI-3 score over time for all participants The Michael Palin Centre

17 OASES-S Significant effect for time (p = 0.001) Post hoc analysis showed difference between: T2 and T3 (p = 0.004) T2 and T7 (p = 0.001) The Michael Palin Centre

18 Mean OASES-S scores over time for all participants The Michael Palin Centre

19 Parent Data Palin-Parent Rating Scale No difference between mothers and fathers ratings so scores were combined. The Michael Palin Centre

20 Palin-PRS 4 factors: Perceived severity of stuttering Impact on the child Impact on the parents Parents level of knowledge and confidence Significant differences found over time for all four areas of the Palin PRS. (p=0.001). The Michael Palin Centre

21 Perceived severity of stuttering Mean rating for Factor 1, parents perceived severity over time The Michael Palin Centre

22 Impact of stuttering on the child 88% parents perceived the stuttering as having less of an impact on their child at T3 100% parents perceived the stuttering as having less of an impact on their child at T7 The Michael Palin Centre

23 Impact of stuttering on parents 92% of parents perceived the stutter as having less of an impact on themselves at T3 95% of parents perceived the stutter as having less of an impact on themselves at T7 The Michael Palin Centre

24 Parents knowledge and confidence 100% of parents reported increased levels of knowledge and confidence at T3 90% of parents reported increased levels of knowledge and confidence at T7 The Michael Palin Centre

25 Conclusion - children Immediate reduction in the amount of stuttering Less of an impact in everyday life Change is mostly maintained for a 12 month period. The Michael Palin Centre

26 Conclusion - Parents Increased knowledge and confidence. Perceived the severity of stuttering to be significantly reduced. Perceived a significant reduction of the impact that the stammer has on themselves and their child. The Michael Palin Centre

27 What next? Larger numbers Individual differences Investigate relapse and what helps The Michael Palin Centre

28 Acknowledgements Action for Stammering Children Whittington Health City University London The children and parents The Michael Palin Centre

How progress is assessed: The following assessments are used:

How progress is assessed: The following assessments are used: Band Four Group Programme for 10-14 year olds who Stammer Intensive integrated group therapy, follow up and individual therapy as required for one year for 10 to 14s who stammer and their parents/carers.