European Symposium
on Fluency Disorders
Presentations
Fontys University of Applied Sciences, Eindhoven, The Netherlands & ECSF consortium
Yvonne van Zaalen, president of the International Cluttering Association, is an associate professor at Fontys University, Eindhoven, the Netherlands. Her area of research is the production of speech and language processes in (dis)fluent speech. As a senior fluency specialist she has three decades of experience working with people with cluttering and stuttering.
Reference is made to stuttering - as one of the primary characteristics in the description of various syndromic intellectual disabilities. Specifically, Down syndrome and Fragile-X syndrome include "stuttering" as a characteristic of speech. In recent years this understanding has come under increasing scrutiny by researchers and clinicians. An extensive literature review and experimental research indicate that although the speech of people with Down Syndrome or Fragile-X can be identified as disfluent, the described characteristics in many cases refer to cluttering or another disfluency type more than they refer to stuttering. The complex relationship between cognition, language, fluency and intelligibility is investigated.
University College London, UK
Susanne Cook is a speech therapist from Germany, with special interest in fluency disorders. 2007 she obtained a Master from University College London where she also completed her PhD in 2011 on "Affective factors, bullying, language and motor abilities in relation to treatment outcome for children who stutter".
In this pilot study, the reaction of older children who stutter (CWS) to their own speech and their perception about how others reacted to them were examined. Day-to-day changes in perception of own-speech and emotional impact of others on their stuttering were assessed using a new questionnaire (Daily Questionnaire). Nineteen CWS (mean age13.10 yrs, SD=2.8 yrs) participated in an intensive stuttering treatment and completed the Daily Questionnaire on 19 successive days. The Daily Questionnaire was shown to be valid and reliable as a way of assessing day-to-day experiences of CWS and the influence these experiences had on these children's lives. Factors were analysed using cross-lagged panel correlation. The results of the study will be presented and the consequences for the therapy process will be discussed. Co-Authors: Chris McManus, Chris Donlan & Peter Howell.
Univeristy of Limerick, Ireland
Jonathon Linklater, an Irish SLT and ECSF-graduate, stutters himself. He established an intensive therapy program called the Dublin Adult Stuttering (DAS) course in 2005. Jonathon is undertaking a PhD at the University of Limerick, with co-supervision from Trinity College Dublin. He is Chair of the Irish Association of Speech and Language Therapists.
Dublin Adult Stuttering (DAS) was established to provide an appropriate and accessible service for adults who stutter in the Eastern region of Ireland. Therapy studies reported may demonstrate short term effects but fail to show long term effects, with treatment often aimed at reducing overt symptoms. DAS focused on internationally established theoretical principles of avoidance reduction and stuttering more fluently (Sheehan 1975, Van Riper 1973). The process of therapy was client centered, realistic, and based on achievable goals. It addressed both the overt and covert features of stuttering, with a strong emphasis on client acceptance, empowerment and peer support. Outcomes from a number of self-report measures is reported. For example the Wright Ayre Stuttering Severity Profile (WASSP) (Wright & Ayre, 2000) and the LCB (Craig, Franklin and Andrews, 1984) demonstrated significant improvement at follow-up, compared to a non-treatment control. The positive effects of therapy are maintained at 24 months.
University of Minnesota, USA
Dr. Sasisekaran is an Assistant Professor at the University of Minnesota. Her research focuses on psycholinguistic processes and their interaction with speech motor control in persons who stutter.
We investigated phonemic encoding and monitoring in a dual task paradigm. Twenty children (7 to 15 years) and ten adults, all typically fluent, performed a phoneme or rhyme monitoring task in a picture naming - written word interference paradigm. The complexity of the task was varied by manipulating the extent of phoneme or rhyme overlap between the name of the picture and the written word - replica (e.g., bed - bed), related (e.g., bed - bell), and unrelated (e.g., bed - cap) conditions. Participants also provided manual responses to tones presented at short or long stimulus onset asynchrony from picture onset. The younger and older groups were slower than adults in the monitoring tasks, although the younger group had more monitoring errors in the related condition. In the tone task, significant differences in both response time and percent errors were observed between the younger and the older groups. Pilot data from children who stutter will also be presented and the implications for fluent speech production will be discussed.
University of Applied Sciences Utrecht, The Netherlands & ECSF consortium
Mark Pertijs, MSc, is a lecturer in fluency disorders at Utrecht University of Applied Sciences and an ECSF staff member. As a project manager he is involved in the development of an "Evidence-based guideline developmental stuttering in children and adults" in cooperation with CBO Dutch Institute for Healthcare Improvement.
Different types of therapy are available for the treatment of stuttering, but little is known about the success rate of these therapies and about the quality of the effect. For the speech therapist and the person who stutters, it is often unclear which therapy is best in a given situation. Evidence-based guidelines are based on the best available scientific evidence, given the needs of the person who stutters. They can serve as tools to improve quality, transparency and organization of care. In the Netherlands, a guideline on developmental stuttering, based on the GRADE Working Group approach is under construction. Both professionals and persons who stutter are participating in the working group. This presentation will focus on the value of evidence-based guidelines in stuttering therapy and on the process of developing an evidence-based guideline on stuttering using the GRADE Working Group approach.
Australian Stuttering Research Centre, The University of Sydney, Australia
Ann Packman has worked for over 30 years with people who stutter as a practitioner, teacher and researcher. She has over 100 publications on stuttering in peer-reviewed journals. Her research includes treatment development and she has a special interest in theoretical perspectives on the nature and cause of stuttering.
Where possible, treatments for a condition or a disorder should target its cause. However, the cause of stuttering is poorly understood and hence, historically, many treatments for stuttering have been driven by causal theory. While recent brain imaging research is indicating that stuttering is underpinned by a deficit in neural processing for spoken language, this in itself explains little about the complexity of the disorder. In this presentation, a new multifactorial causal model of stuttering is presented and the extent to which different treatments fit the model is explored. This working model, known as the Packman and Attanasio (P&A) model, is supported by recent clinical and laboratory research. It comprises three factors; an underlying neural processing problem, triggers, and modulators. The question prompting the P&A model was not "What causes stuttering?" but rather "What causes individual moments of stuttering?"
Thomas More University College, Antwerp, Belgium
ECSF consortium
Kurt Eggers, Ph.D., is head of the SLT and audiology department at Thomas More U College, visiting lecturer at the U of Oulu and Turku U (Finland), and ECSF-coordinator. He has lectured nationally and internationally on fluency disorders and his research focuses on the role of temperament & attentional processes in stuttering, normal speech disfluencies, and disfluencies in Down syndrome.
Current paper gives an overview of the main research findings of this group in the area of temperament and attentional processes. Initial questionnaire-based studies showed differences on inhibitory control and attentional functioning between CWS and CWNS. Consecutive computer paradigm-based studies corroborated these findings by revealing differences on the efficiency of attentional networks, response control, and auditory attentional shifting. Findings will be linked to the available literature of other research groups.
School of Logopedics at the Uniklinik RWTH Aachen, Aachen, Germany & ECSF staff member
Peter Schneider holds degrees in Pedagogics and Logopedics and works since 1990 as a lecturer at the School of Logopedics, Uniklinik RWTH Aachen. He developed the Stuttering Modification approach KIDS together with dr. Patricia Sandrieser and has authored books, treatment/assessment materials on stuttering for specialists, stuttering children and their parents.
Artevelde University College Ghent, Belgium & ECSF staff member
Veerle Waelkens holds a Bachelor's degree in speech and language pathology, a Post graduate certificate in speech Fluency, and works since 2003 as a lecturer in speech fluency disorders at Artevelde U College Ghent and in a private practice oriented at treating stuttering, cluttering and speech anxiety.
Mini-KIDS is a stuttering modification treatment that is developed from Van Riper's and Dell's approach that takes into account the learning strategies of pre-school children.Children at the age of 2-4 years learn from models in their environment. Therefore the parents are crucial in this approach. Stuttering children are able to speak fluently most of the time. The loss of control during stuttering events can lead into the vicious circle of effort, tension and shame. The model of an easy and assertive stuttering in the child's environment shows better coping strategies and frequently leads to recovery. But even if the stuttering should remain the child is best prepared.Children from 4-6 years are able to observe and to control voluntarily their speech. The phases of Van Riper's and Dell's stuttering modification are adapted to the cognitive and emotional development of this age. Children and parents are desensitized against stuttering and its triggers. They learn the perceptive, motor and linguistic skills that are necessary to identify real stuttering symptoms and to modify them. The goal is either the recovery or an assertive and easy stuttering and the prevention of the vicious circle of effort, tension and shame.
The workshop provides in depth information on the following points
- What goals Mini-KIDS aims at?
- For which cases Mini-KIDS is indicated?
- How parents are involved into the treatment process?
- What are the main techniques for children to voluntarily control stuttered speech?
- How can these techniques be established in everyday life?
- What are limitations of Mini-KIDS?
Participants of the workshop will be able to describe the treatment according Mini-KIDS and will gain in-depth insight in the used techniques.The workshop is in a hands-on-format and will make use of several video-examples and practical exercises. Hand-outs will be provided.
Department of Communication Sciences and Disorders, Syracuse University, Syracuse, New York, USA
Victoria Tumanova, Ph.D., is an Assistant Professor in the department of Communication Sciences and Disorders at Syracuse University studying childhood fluency disorders. The goal of her research is to further our understanding of the roles of temperament, and linguistic and speech-motor control abilities in the development of stuttering in young children.
During the early stages of speech and language development important differences exist between children who do and do not stutter in terms of type and frequency of speech disfluencies. In this presentation new empirical data on speech disfluencies of preschool-age children will be discussed. Specifically, I will focus on significance of type and frequency of speech disfluencies to parental concern about stuttering, diagnosis of this disorder as well as to children's emotional reactivity during speech.
University of Central Florida, Orlando, Florida, USA & University Ghent, Belgium
Martine Vanryckeghem received her Ph.D. from Southern Illinois University. She is a Professor at the University of Central Florida, Orlando, and Guest Professor at the University of Gent, Belgium. From 1990 until 2000, Dr. Vanryckeghem served as managing editor of the Journal of Fluency Disorders. She is a member of ASHA's inaugural cadre of fluency specialists and ASHA Fellow.
The journey since the incipient stages of Two Factor theory has been an expedition that spans many decades and crosses many continents. This theoretical model led to applied research and set the stage for the design of a series of standardized tests exploring the different components that surround stuttering. Realizing that the assessment of a person who stutters needs to move beyond clinical observation so as to include the perspective of the individual, Brutten and colleagues researched a number of standardized self-report tests cross-culturally. This "view from within" augments clinical observation, leads to improved differential diagnosis and the reduction of false positives and negatives. In addition, this inside perspective supplements therapeutic planning, pointing to the targets of treatment. Specifically, this presentation will focus on one particular dimension of stuttering as a multi-modal disorder: the evaluation of speech-associated attitude. This cognitive component has shown to have a powerful impact on the individual who stutters. Recent research revealed that even preschoolers who stutter, as a group, think negatively about their speech. This phenomenon increases with age and needs the clinician's attention early on.
PhD student, Australian Stuttering Research Centre, University of Sydney, Australia
Sabine van Eerdenbrugh trained as a SLT and clinical educator in Belgium and The Netherlands. She has worked in various paediatric settings in Belgium and Australia, treating children for communication disorders including stuttering. She is currently a PhD student in Sydney, Australia, and is developing an Internet version of the Lidcombe Program.
The Lidcombe program is a treatment for preschool age children who stutter. Parents implement the treatment components with their child at home. A SLT trains the parent and supervises the treatment process during weekly clinic visits that are attended by the parent and child. This presentation will describe the development and trialling of a Lidcombe Program Parent Training package, which will soon be accessible on the Internet for both parents and SLTs. It is anticipated that SLTs will find this Training Package of great help to them in their clinical practice. The Parent Training package will be presented, with examples of training modules given. The main findings of a feasibility study, conducted with six parents of preschool age children who stutter, will be presented and discussed. The presentation will conclude with the clinical implications of this innovative clinical tool and possibilities for future research.
Wayne State University, USA
Shelly Jo Kraft, Ph.D., is an Assistant Professor at Wayne State University where she serves as the Director of the Behavioral Speech and Genetics Laboratory. Her current research focuses on the identification of genes associated with developmental stuttering, neuro-functional and anotomical correlates, and factors contributing to stuttering severity in children and adults.
Clear evidence exists for heritability of developmental stuttering, and much interest is focused on the identification of causal genes for the disorder. Linkage analysis is a powerful tool used to detect the location of associated genes in related individuals who all share in a particular trait. In an effort to understand the seemingly elusive genetic etiology of stuttering, a linkage strategy for locating multiple genes, each of large to moderate effect, was initiated in the sizable recruitment of families ascertained for high-density profiles and Caucasian, Western European ancestry. The identification of risk alleles in the largest non-consanguineous family study employing genome-wide linkage will be reported with whole-exome sequencing data for 97 multigenerational families (n=1154). This presentation will discuss different strategies of linkage, association, and exome sequencing as well as combined approaches that incorporate functional theories behind the various endophenotypes of stuttering.
Honorary researcher at the Bristol Speech & Language Therapy Research Unit and visiting fellow at the University of the West of England, Bristol, UK
Rosemarie Hayhow has worked with stuttering for 40 years in clinical, educational and research settings. She is interested in personal experiences of therapy and how these can help us identify the components and processes of therapy and better understand what facilitates or hinders change.
We have moved into an era where therapy is increasingly commissioned on the basis of outcomes that demonstrate the efficient achievement of meaningful goals in association with different treatment options. The notion of clinic based evidence has been received enthusiastically at conferences and yet in the face of diminishing services we still argue over which measures best reflect what professionals and service users can and wish to achieve. This presentation explores some of the history and problems around outcome measurement and looks to the future where agreed outcomes could improve our chances of providing funded care for people of all ages who stutter. In addition, the right measures could facilitate national and international comparisons on different care pathways and treatment approaches. We might even learn about matching ‘what works' with those for whom it works best.