Lincolnshire Knowledge and Resource Service

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1 Lincolnshire Knowledge and Resource Service This search summary contains the results of a literature search undertaken by the Lincolnshire Knowledge and Resource Service librarians in; September 2013 All of the literature searches we complete are tailored to the specific needs of the individual requester. If you would like this search re-run with a different focus, or updated to accommodate papers published since the search was completed, please let us know. We hope that you find the information useful. If you would like the full text of any of the abstracts listed, please let us know. Alison Price Janet Badcock Alison.price@lincolnshire.gov.uk janet.badcock@lincolnshire.gov.uk Librarians, Lincolnshire Knowledge and Resource Service Lexicon House Stephenson Road North Hykeham Lincoln LN6 3QU

2 Lincolnshire Knowledge and Resource Service Please find below the results of your literature search request. If you would like the full text of any of the abstracts included, or would like a further search completed on this topic, please let us know. Google can bring you back 100,000 answers, a librarian can bring you back the right one. Neil Gaiman Literature Search Results Search completion date: 7 th September 2013 Search completed by: Jan Badcock Enquiry Details therapy approaches in stammering therapy/ dysfluency treatment for adults (not children) Block Modification Therapy Vocal Fold Management relaxation therapy solution focused therapy

3 Disclaimer Every effort has been made to ensure that this information is accurate, up-to-date, and complete. However it is possible that it is not representative of the whole body of evidence available. No responsibility can be accepted for any action taken on the basis of this information. It is the responsibility of the requester to determine the accuracy, validity and interpretation of the search results. All links from this resource are provided for information only. A link does not imply endorsement of that site and the Lincolnshire Knowledge and Resource Service does not accept responsibility for the information displayed there, or for the wording, content and accuracy of the information supplied which has been extracted in good faith from reputable sources. Opening Internet Links The links to internet sites in this document are live and can be opened by holding down the CTRL key on your keyboard while clicking on the web address with your mouse Full Text Papers Links are given to full text resources where available. For some of the papers, you will need a free NHS Athens Account. If you do not have an account you can register by following the steps at: You can then access the papers by simply entering your username and password. If you do not have easy access to the internet to gain access, please let us know and we can download the papers for you. Guidance on Searching within Online Documents Links are provided to the full text of each of these documents. Relevant extracts have been copied and pasted into these Search Results. Rather than browse through often lengthy documents, you can search for specific words and phrases as follows: Portable Document Format / pdf. / Adobe Click on the Search button (illustrated with binoculars). This will open up a search window. Type in the term you need to find and links to all of the references to that term within the document will be displayed in the window. You can jump to each reference by clicking it. You can search for more terms by pressing search again. Word documents Select Edit from the menu, the Find and type in your term in the search box which is presented. The search function will locate the first use of the term in the document. By pressing next you will jump to further references.

4 Guidelines Resource Manual for Commissioning and Planning Services for SLCN Royal College of Speech Therapists 2009 There is a large section discussing all forms of treatment for Stammering page 9. Evidence Systematic Reviews / Summaries The efficacy of habit reversal therapy for tics, habit disorders, and stuttering: a metaanalytic review Database of Abstracts of Reviews of Effects Centre for Reviews and Dissemination 16 Sep 2013 Description: Bibliographic details Bate KS, Malouff JM, Thorsteinsson ET, Bhullar N. The efficacy of habit reversal therapy for tics, habit disorders, and stuttering: a meta-analytic review. Clinical Psychology Review 2011; 31(5): CRD summary This review concluded that there was substantial support for the efficacy of habit reversal therapy for the disorders it was commonly used to treat. Given the uncertainties surrounding the review process, the small number of participants, and the apparently poor quality of the studies and substantial variability across them, the authors' conclusions seem overly strong and their applicability uncertain. Indexing status Systematic studies of modified vocalization: speech production changes during a variation of metronomic speech in persons who do and do not stutter 31 May 2011 Systematic Reviews Davidow JH, Bothe AK, Ye J. Systematic studies of modified vocalization: speech production changes during a variation of metronomic speech in persons who do and do not stutter. J Fluency Disord Jun;36(2): This article has been selected for inclusion in NHS Evidence because it meets the NHS Evidence definition of a reliable systematic review. This is a systematic review in the Cochrane Database of Systematic Reviews and those published by a journal which conforms to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard. If not published by one of these journals, a systematic review is deemed reliable if the abstract reports the inclusion/exclusion criteria, confirms two or more sources have been searched, and incorporates a synthesis of included studies. A systematic review may also be deemed reliable if it has been appraised and selected by a group of experts for inclusion in an Evidence Update. Systematic reviews listed as supporting references in Evidence Updates are also included. Request form LKRS

5 SpeechEasy (Janus Development Group Inc.) for treatment of stuttering SpeechEasy (Janus Development Group Inc.) for treatment of stuttering Lansdale: HAYES, Inc Authors' objectives Stuttering is a disorder in which certain sounds, syllables, or words are repeated or prolonged, disrupting the normal flow of speech. Symptoms are generally worse in stressful situations such as talking in public or on the telephone, while talking or singing in unison may temporarily alleviate symptoms, a phenomenon known as the choral effect. Stuttering usually develops in young children as they are learning to speak and may occur in 2% to 5% of children at some stage. In the United States, approximately 3 million people or 1% of the adult population stutter. Usual treatment for stuttering includes various behavioral vocal techniques to assist speakers with generating difficult words or sounds and with actively monitoring their own speech. Stuttering treatment research I: Systematic review incorporating trial quality assessment of behavioral, cognitive, and related approaches Database of Abstracts of Reviews of Effects Centre for Reviews and Dissemination 30 Sep 2008 Systematic reviews Bibliographic details Bothe A K, Davidow J H, Bramlett R E, Ingham R J. Stuttering treatment research I: Systematic review incorporating trial quality assessment of behavioral, cognitive, and related approaches. American Journal of Speech-Language Pathology 2006; 15(4): CRD summary This review concluded that some non-pharmacological therapies may help patients to reduce stuttering and/or improve social, emotional or cognitive variables. The authors? conclusions are in line with the evidence presented, but should be treated with caution in view of the small sample sizes and non-comparative design of many of the included studies. Outcomes of treatments for stuttering Cuerva Carvajal A, Marquez Calderon S, Sarmiento Gonzulez-Nieto V Citation Cuerva Carvajal A, Marquez Calderon S, Sarmiento Gonzulez-Nieto V. Resultados de los tratamientos de la tartamudez. [Outcomes of treatments for stuttering] Seville: Andalusian Agency for Health Technology Assessment (AETSA). Informe 5/ Authors' objectives The main aim of this review was compare the efficacy of different interventions against stuttering with each other, or as opposed to no intervention. Authors' conclusions No intervention for stuttering was found that was clearly effective in terms of results related either objectively or subjectively to speech. Effects really happening could be left undetected since all studies have a low statistical power, as well as problems related to internal validity. In children, there are two studies comparing Lidcombe Programme as opposed to control. One of them shows improvement in the percentage of stuttered syllables after intervention; and in the other one, a tendency towards better outcomes is observed with the programme, although the latter did not reach statistical significance. The rest of studies with comparisons among different interventions did not present clear differences in favour of one or another. In adults, olanzapine was superior to placebo in the only study with a control group that was found. The studies without control group showed improvements in stuttering which were not

6 maintained till the end of the follow-ups. Furthermore the results from these studies cannot be considered due to their methodological weakness. No studies were found with results related to the impact of stuttering on the individuals' lives. Effectiveness of behavioral stuttering treatment: a systematic review and metaanalysis Contemporary Issues in Communication Science and Disorders 02 Jan 2006 Systematic Reviews Herder C, Howard C, Nye C et al. Effectiveness of behavioral stuttering treatment: a systematic review and meta-analysis. Effectiveness of behavioral stuttering treatment: a systematic review and meta-analysis 2006;33: urces%2fhub%2f6436&q=stuttering&returnurl=%2fsearch%3fq%3dstuttering Research See database search below Service Examples Adult therapy and courses Rachel Everard - from the Speech Therapy City Lit team

7 Table of Contents Search Results Search History... page 2 1. Integrating Functional Measures With Treatment: A Tactic for Enhancing Personally Significant Change in the Treatment of Adults and Adolescents Who Stutter.... page 3 2. Evidence-based treatment of stuttering: III. Evidence-based practice in a clinical setting.... page 3 3. Evidence-based treatment of stuttering: II. Clinical significance of behavioral stuttering treatments.... page 3 4. Evidence-based treatment of stuttering: I. Definition and application.... page 4 5. Evidence-based practice in stuttering: Some questions to consider.... page 4 6. Integrating functional measures with treatment: A tactic for enhancing personally significant change in the treatment of adults and adolescents who stutter... page 5 7. Integrating functional measures with treatment: a tactic for enhancing personally significant change in the treatment of adults and adolescents who stutter.... page 5 8. Evidence-based treatment and stuttering--historical perspective.... page 6 9. Connecting stuttering management and measurement: V. Deduction and induction in the development of stuttering treatment outcome measures and stuttering treatments.... page Connecting stuttering measurement and management: III. Accountable therapy.... page Construct validity of modified time-interval analysis in measuring stuttering and trained speaking patterns.... page Stuttering treatment for adults: an update on contemporary approaches.... page Becoming an effective clinician for people who stutter: you can do it!.... page The long term effectiveness of intensive stuttering therapy: a mixed methods study.... page The long term effectiveness of intensive stuttering therapy: A mixed methods study... page 9 Page 1

8 Search History 1. ; stammer.ti,ab; 30 results. 2. ; STUTTERING/; 3245 results. 3. ; SPEECH THERAPY/; 5173 results. 4. ; ADULT/; results. 5. ; 2 AND 3; 641 results. 6. ; 4 AND 5; 272 results. 7. ; (Vocal AND Fold AND Management).ti,ab; 302 results. 8. ; 6 AND 7; 0 results. 9. ; "vocal fold management".ti,ab; 0 results. 10. ; *SPEECH THERAPY/mt [Methods]; 951 results. 11. ; 6 AND 10; 85 results. 12. ; EVIDENCE-BASED MEDICINE/; results. 13. ; 5 AND 12; 15 results. 14. ; STUTTERING/; 3245 results. 15. CINAHL; FLUENCY DISORDERS/; 1491 results. 16. CINAHL; PROFESSIONAL PRACTICE, EVIDENCE-BASED/; results. 17. CINAHL; 15 AND 16; 33 results. 18. CINAHL; 17 [Limit to: (Age Groups Adult~ years or Middle Aged: years)]; 3 results. 19. EMBASE; STUTTERING/; 3612 results. 20. EMBASE; EVIDENCE BASED MEDICINE/ OR EVIDENCE BASED PRACTICE/; results. 21. EMBASE; 19 AND 20; 40 results. 22. EMBASE; 21 [Limit to: (Human Age Groups Adult 18 to 64 years)]; 6 results. Page 2

9 1. Integrating Functional Measures With Treatment: A Tactic for Enhancing Personally Significant Change in the Treatment of Adults and Adolescents Who Stutter. Citation: American Journal of Speech-Language Pathology, 01 August 2012, vol./is. 21/3( ), Ingham, Roger J.; Ingham, Janis C.; Bothe, Anne K. Full Text: Purpose: It is proposed that stuttering treatment, particularly for adults and adolescents who stutter, may benefit from more inventive and extensive use of functional measurement- measures that are also treatment agents. Such measures can be tailored to produce more personally significant and evidence-based treatment benefits. They may be especially useful when employed in conjunction with partial self-management and performance-contingent procedures. Method: Previous approaches to the definition of stuttering treatment goals and the measurement of stuttering treatment outcomes are critically reviewed. Suggestions for improvements are presented within the framework of an evidence-based and relatively standardized stuttering treatment. Results and Conclusion: Results from a review of existing literature and from 2 case studies show that 2 specific personally significant problems, saying one's name and addressing large audiences, were improved by implementing these strategies in treatment. Functional measures directly connected to treatment, and partially self-managed performancecontingent schedules, merit further research as methodologies that are suitable for conducting personally significant and evidence-based treatments with adults and adolescents who stutter. journal article CINAHL Available from EBSCOhost in American Journal of Speech-Language Pathology 2. Evidence-based treatment of stuttering: III. Evidence-based practice in a clinical setting. Citation: Journal of Fluency Disorders, 2003, vol./is. 28/3(219-35; quiz 235-6), X; X (2003) Langevin M; Kully D UNLABELLED: At the heart of evidence-based practice in stuttering treatment are four issues: (1) the collection of data to inform treatment; (2) the long standing concern with maintenance of treatment gains; (3) the need to demonstrate accountability to clients, payers and our profession as service providers; and (4) the desire to advance theoretical knowledge. This article addresses the first three of these issues from a practical point of view, illustrating how data collection for stuttering treatment outcome research in a clinical setting is intimately blended with that required for clinical purposes and providing an example of a process of evaluating data for clinical and research purposes.educational OBJECTIVES: The reader will learn about and be able to (1) differentiate between treatment outcome and treatment efficacy research, (2) describe models for integrating data collection for treatment outcome and clinical purposes, and (3) utilize guidelines for treatment efficacy that are applicable to outcome research to evaluate data for use in treatment outcome studies and to design outcome studies. Journal Article 3. Evidence-based treatment of stuttering: II. Clinical significance of behavioral stuttering treatments. Citation: Journal of Fluency Disorders, 2003, vol./is. 28/3(209-17; quiz 217-8), X; X (2003) Finn P Page 3

10 UNLABELLED: An evidence-based framework can be described as an empirically-driven, measurement-based, client-sensitive approach for selecting treatments. It is believed that using such a framework is more likely to result in a clinically significant outcome. For this paper, a clinically significant outcome was defined as a meaningful treatment change. It was suggested that there are at least three groups for whom a treatment's outcome is meaningful. These groups include clinicians/clinical researchers, the clients, and relevant others who have some interest in the outcome (e.g., parents of a child who stutters). The meaning and measurement of clinical significance was discussed for each of these three groups, based on research from the behavioral stuttering treatment literature.educational OBJECTIVES: The reader will learn about and be able to (1) broadly define a clinically significant outcome and identify some of the groups who are interested in such an outcome and (2) describe how clinical significance has been evaluated in stuttering treatment within an evidence-based framework. Journal Article 4. Evidence-based treatment of stuttering: I. Definition and application. Citation: Journal of Fluency Disorders, 2003, vol./is. 28/3( ; quiz 206-7), X; X (2003) Ingham JC UNLABELLED: The philosophy guiding evidence-based treatment and its application to decision-making in stuttering treatment is described. Limitations to the use of evidence-based treatment principles to guide stuttering treatment, namely the lack of a substantial treatment research literature that can serve as the basis for meta-analyses and systematic reviews of effective treatment studies, are bemoaned. Guidelines are provided to aid clinicians in their own conduct of critical evaluations of treatment research.educational OBJECTIVES: The reader will learn about and be able to (1) describe the four steps that characterize evidence-based practice, (2) evaluate previous efforts to develop practice guidelines for stuttering, (3) assess the importance of an evidence-based approach to stuttering treatment, and (4) discuss the need for more research that will contribute to the evidence base. Journal Article 5. Evidence-based practice in stuttering: Some questions to consider. Citation: Journal of Fluency Disorders, 2005, vol./is. 30/3(163-88), X; X (2005) Bernstein Ratner N UNLABELLED: A recent forum in JFD (28/3, 2003) evaluated the status of evidence-based practice in fluency disorders, and offered recommendations for improvement. This article re-evaluates the level of support available for some popular approaches to stuttering therapy and questions the relative value placed on some types of programs endorsed by the forum. Evidence-based practice is discussed within the context of emerging concerns over its application to non-medical interventions and suggestions are made for grounding fluency interventions by reference to empirically supported principles of change. A popular, evidence-based intervention for stuttering in young children (the Lidcombe program) is evaluated within the suggested parameters.educational OBJECTIVES: After reading this article, the reader will be able to: (1) evaluate the status of evidence-based practice in fluency disorders; (2) list concerns about the impact of narrow interpretation of EBP on research and practice in the Page 4

11 field of fluency disorders and other non-medical domains; (3) articulate the role of theory and basic research in selecting among and evaluating therapy approach options. Journal Article 6. Integrating functional measures with treatment: A tactic for enhancing personally significant change in the treatment of adults and adolescents who stutter Citation: American Journal of Speech-Language Pathology, 2012, vol./is. 21/3( ), ( ) Full Text: Ingham R.J.; Ingham J.C.; Bothe A.K. Purpose: It is proposed that stuttering treatment, particularly for adults and adolescents who stutter, may benefit from more inventive and extensive use of functional measurement- measures that are also treatment agents. Such measures can be tailored to produce more personally significant and evidence-based treatment benefits. They may be especially useful when employed in conjunction with partial self-management and performance-contingent procedures. Method: Previous approaches to the definition of stuttering treatment goals and the measurement of stuttering treatment outcomes are critically reviewed. Suggestions for improvements are presented within the framework of an evidence-based and relatively standardized stuttering treatment. Results and Conclusion: Results from a review of existing literature and from 2 case studies show that 2 specific personally significant problems, saying one's name and addressing large audiences, were improved by implementing these strategies in treatment. Functional measures directly connected to treatment, and partially self-managed performancecontingent schedules, merit further research as methodologies that are suitable for conducting personally significant and evidence-based treatments with adults and adolescents who stutter. American Speech-Language-Hearing Association. Journal: Review EMBASE Available from EBSCOhost in American Journal of Speech-Language Pathology 7. Integrating functional measures with treatment: a tactic for enhancing personally significant change in the treatment of adults and adolescents who stutter. Citation: American Journal of Speech-Language Pathology, August 2012, vol./is. 21/3(264-77), ; (2012 Aug) Ingham RJ; Ingham JC; Bothe AK PURPOSE: It is proposed that stuttering treatment, particularly for adults and adolescents who stutter, may benefit from more inventive and extensive use of functional measurement-measures that are also treatment agents. Such measures can be tailored to produce more personally significant and evidence-based treatment benefits. They may be especially useful when employed in conjunction with partial self-management and performance-contingent procedures.method: Previous approaches to the definition of stuttering treatment goals and the measurement of stuttering treatment outcomes are critically reviewed. Suggestions for improvements are presented within the framework of an evidence-based and relatively standardized stuttering treatment.results AND CONCLUSION: Results from a review of existing literature and from 2 case studies show that 2 specific personally significant problems, saying one's name and addressing large audiences, were improved by implementing these strategies in treatment. Functional measures directly connected to treatment, and partially self-managed performance-contingent schedules, merit further research as methodologies that are suitable for conducting personally significant and evidence-based treatments with adults and adolescents who stutter. Page 5

12 Full Text: Journal Article; Research Support, N.I.H., Extramural; Review Available from EBSCOhost in American Journal of Speech-Language Pathology 8. Evidence-based treatment and stuttering--historical perspective. Citation: Journal of Speech Language & Hearing Research, February 2009, vol./is. 52/1(254-63), ; (2009 Feb) Full Text: Prins D; Ingham RJ PURPOSE: To illustrate the way in which both fluency shaping (FS) and stuttering management (SM) treatments for developmental stuttering in adults are evidence based.method: A brief review of the history and development of FS and SM is provided. It illustrates that both can be justified as evidence-based treatments, each treatment seeking evidence of a different kind: FS seeks evidence concerning treatment outcome, and SM seeks evidence concerning the nature of the stutter event.conclusion: Although outcome evidence provides the principal support for FS, support for SM comes principally from a cognitive learning model of defensive behavior as applied to the nature of the stutter event. Neither approach can claim anything like uniform success with adults who stutter. However, self-management and modeling are strategies common to both approaches and have shown consistently positive effects on outcome. It is argued that both strategies merit additional treatment efficacy study. Cognitive behavior theory may provide a useful framework for this research. Historical Article; Journal Article; Research Support, N.I.H., Extramural; Review Available from EBSCOhost in Journal of Speech, Language and Hearing Research 9. Connecting stuttering management and measurement: V. Deduction and induction in the development of stuttering treatment outcome measures and stuttering treatments. Citation: International Journal of Language & Communication Disorders, July 2006, vol./is. 41/4(407-21), ; (2006 Jul-Aug) Onslow M BACKGROUND: The development of evidence-based practice, which is increasingly popular in stuttering treatment, is closely linked to the development of outcome measures.aims: Two approaches to the development of stuttering treatment outcome measures are outlined. The first is the deductive, top-down approach, where the development of specific outcome measures is guided by a priori general conceptualizations of the nature of the disorder. A competing approach to the development of stuttering treatment outcome measures is outlined. This is the inductive, or bottom up approach. This approach uses Baer's (1988, 1990) notion of specific complaints of clients as the starting point to develop inductive statements for use as general guidance for developing treatment outcome measures.main CONTRIBUTION: It is argued that the deductive approach to development of outcome measures has limitations. It is overly prescriptive, generating numerous and increasingly complex outcome measures that are potentially confusing for clinicians. Further, it is arbitrary and fragile, being linked to conceptualizations and theories about stuttering, which, by necessity, are limited themselves. Further, the development of numerous outcome measures is not compatible with the conduct of randomized controlled trials, which allow a maximum of two primary outcome measures. In contrast, the inductive approach to the development of outcome measures has in its favour that it is empirically driven rather than arbitrary, and that it facilitates a yoking of the development of clinical outcomes and the clinical methods to attain those outcomes. The approach is unlikely to lead to the development of fruitless treatment methods. Further, the approach is parsimonious to the Page 6

13 Full Text: extent that it is likely to produce few guiding generalities for treatment outcome assessment -- perhaps as few as two in the case of adults and one in the case of preschoolers. This is well suited to the use of the randomized controlled trial as a source of evidence for treatment efficacy.conclusions: One inductive statement that can be used to guide the development of outcome measures is that the ill effects of stuttered speech could be troubling for those who seek clinical help. The other is that those who seek clinical help are likely to experience speech-related anxiety. Together, these sources of information provide sound guidance for the development of outcome measures relating to stuttered speech and speech-related anxiety, and guidance for the development of treatments to offset those ill effects of the condition. Until another outcome measure can be derived from inductive processes, those treatment developments should serve all the needs of those who stutter and the clinicians who provide those needs. Journal Article Available from EBSCOhost in International Journal of Language and Communication Disorders 10. Connecting stuttering measurement and management: III. Accountable therapy. Citation: Full Text: International Journal of Language & Communication Disorders, July 2006, vol./is. 41/4(379-94), ; (2006 Jul-Aug) Cook F; Fry J BACKGROUND: This paper is intended to contribute to the current debate in relation to persistent stuttering and evidence-based clinical practice.aims: The paper will describe the authors' intervention framework for persistent stuttering, which is guided by evidence from the fields of stuttering and clinical psychology. It supports the opinion that the components of therapy should be grounded in empirically based theories that offer an explanation for the nature of stuttering, its persistence and its individual complexity. It will argue that the goals of therapy should reflect the client's personal values and experience of stuttering, as well as the knowledge and skills of the therapist.main CONTRIBUTION: The paper maintains that therapy for this disorder needs to account for the highly individual nature of the overt and covert dimensions of persistent stuttering and identify the formal and informal methods that measure progress and outcome. Current research and future directions will be touched on briefly. Journal Article Available from EBSCOhost in International Journal of Language and Communication Disorders 11. Construct validity of modified time-interval analysis in measuring stuttering and trained speaking patterns. Citation: Journal of Fluency Disorders, March 2012, vol./is. 37/1(42-53), X; X (2012 Mar) Alpermann A; Huber W; Natke U; Willmes K PURPOSE: The aim of the present study was to examine the construct validity of modified time-interval analysis. This measure allows judgments on stuttered and fluent speech as well as trained speaking patterns and might be valuable for outcome studies.method: Construct validity was investigated in an intervention study with two treatment groups (24 clients received stuttering modification treatment, 30 clients received fluency modification treatment) and a control group (38 stuttering adults). All participants were interviewed during surprise phone calls before and after treatment; the speech samples were analyzed by means of modified time-interval analysis and stuttering frequency counts.results: The outcomes confirmed prior hypotheses for the most part. Page 7

14 First, the amount of trained speaking patterns after therapy was significantly higher in both treatment groups than in the control group. Secondly, longitudinal changes in the treatment groups met prior expectations based on differing treatment goals and exceeded the changes in the control group. Modified time-interval analysis was sufficiently sensitive to detect changes of speech fluency, but underestimated spontaneous fluent speech when trained speaking patterns were applied.conclusion: The present study supports construct validity of modified time-interval analysis in measuring stuttering and trained speaking patterns, but also reveals a lack of accuracy.educational OBJECTIVES: At the end of this activity the reader will be able to (a) explain different forms of validity in relation to the use of modified time-interval analysis, (b) evaluate whether construct validity of modified time-interval analysis has been supported by the outcomes of an intervention study and (c) describe the usefulness and limitations of modified time-interval analysis for future research. Copyright 2011 Elsevier Inc. All rights reserved. Comparative Study; Journal Article; Research Support, Non-U.S. Gov't 12. Stuttering treatment for adults: an update on contemporary approaches. Citation: Seminars in Speech & Language, November 2010, vol./is. 31/4(272-82), ; (2010 Nov) Blomgren M This article provides a brief overview of historical and current approaches to stuttering treatment for adults. Treatment is discussed in terms of stuttering management approaches, fluency-shaping approaches, and combined approaches. The evidence base for these various approaches is outlined. Fluency-shaping approaches have the most robust outcome evidence. Stuttering management approaches are based more on theoretical models of stuttering, and the evidence base tends to be inferred from work using the approaches of cognitive behavior therapy and desensitization with other disorders such as anxiety. Finally, comprehensive approaches to treating stuttering are discussed, and several clinical methods are outlined. Comprehensive approaches target both improved speech fluency and stuttering management. Although it is presented that a comprehensive approach to stuttering treatment will provide the best results, no single approach to stuttering treatment can claim universal success with all adults who stutter. Thieme Medical Publishers. Journal Article; Review 13. Becoming an effective clinician for people who stutter: you can do it!. Citation: Seminars in Speech & Language, November 2010, vol./is. 31/4(283-5), ; (2010 Nov) Yaruss JS; Ratner NB Journal Article 14. The long term effectiveness of intensive stuttering therapy: a mixed methods study. Citation: Journal of Fluency Disorders, September 2012, vol./is. 37/3(164-78), X; X (2012 Sep) Irani F; Gabel R; Daniels D; Hughes S Page 8

15 PURPOSE: The purpose of this study was to gain a deeper understanding of client perceptions of an intensive stuttering therapy program that utilizes a multi-faceted approach to therapy. The study also proposed to gain a deeper understanding about the process involved in long-term maintenance of meaningful changes made in therapy.methods: The study used a mixed methods design. The core method was a phenomenological approach using semi-structured interviews. Objective clinical data was gathered concurrently. This included archival records and current measures on a variety of assessments to evaluate stuttering severity and attitudes toward communication.results: The major themes generated from participants' transcripts included (1) the positive effects of the Duration and Nature of the Program; (2) Speech Techniques Learned; (3) Attitude Change and Counseling; and (4) activities related to Desensitization and Transfer. The participants also reported positive effects of their personal motivation and clinician attitudes. Clinical data indicated that the participants made measurable clinical gains on all measures of stuttering severity and attitude change following the intensive clinic and these changes were maintained long after the program was completed.conclusions: It appears that this intensive stuttering therapy program is effective for making positive changes in behavioral measures of speech disfluencies, and attitudes. Clients reported multiple factors directly related to the program and personal factors that contributed to treatment effectiveness. Hence, future studies should explore and report on a variety of factors related to communication attitudes and overall quality of life in addition to behavioral measures of speech. Educational objectives: After reading this article, the learner will be able to: (a) identify the basic tenets of evidence-based practice; (b) summarize what we currently know about the effectiveness of behavioral treatments of stuttering; (c) identify factors that client report as important to treatment effectiveness. Copyright 2012 Elsevier Inc. All rights reserved. Clinical Trial; Journal Article 15. The long term effectiveness of intensive stuttering therapy: A mixed methods study Citation: Journal of Fluency Disorders, September 2012, vol./is. 37/3( ), X; X (September 2012) Irani F.; Gabel R.; Daniels D.; Hughes S. Purpose: The purpose of this study was to gain a deeper understanding of client perceptions of an intensive stuttering therapy program that utilizes a multi-faceted approach to therapy. The study also proposed to gain a deeper understanding about the process involved in long-term maintenance of meaningful changes made in therapy. Methods: The study used a mixed methods design. The core method was a phenomenological approach using semi-structured interviews. Objective clinical data was gathered concurrently. This included archival records and current measures on a variety of assessments to evaluate stuttering severity and attitudes toward communication. Results: The major themes generated from participants' transcripts included (1) the positive effects of the Duration and Nature of the Program; (2) Speech Techniques Learned; (3) Attitude Change and Counseling; and (4) activities related to Desensitization and Transfer. The participants also reported positive effects of their personal motivation and clinician attitudes. Clinical data indicated that the participants made measurable clinical gains on all measures of stuttering severity and attitude change following the intensive clinic and these changes were maintained long after the program was completed. Conclusions: It appears that this intensive stuttering therapy program is effective for making positive changes in behavioral measures of speech disfluencies, and attitudes. Clients reported multiple factors directly related to the program and personal factors that contributed to treatment effectiveness. Hence, future studies should explore and report on a variety of factors related to communication attitudes and overall quality of life in addition to behavioral measures of speech.educational objectives: After reading this article, the learner will be able to: (a) identify the basic tenets of evidence-based practice; (b) summarize what we currently know about the effectiveness of behavioral treatments of Page 9

16 stuttering; (c) identify factors that client report as important to treatment effectiveness Elsevier Inc.. Journal: Article EMBASE Page 10