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Purpose: This study investigated the complexity of stuttering behavior. It described and classified the complexity of stuttering behavior in relation to age, behavioral treatment outcomes, stuttering severity, anxiety-related mental health, impact of stuttering, and gender. Method: For this study, a taxonomy was developed--LBDL-C7--which was based on the Lidcombe Behavioral Data Language of stuttering. It was used by five experienced judges to analyze the complexity of stuttering behavior for 84 adults and adolescents before and after speech restructuring treatment. Data were 3,100 stuttering moments, which were analyzed with nominal logistic regression. Results: The complexity of stuttering behavior appears not to change as a result of treatment, but it does appear to change with advancing age. Complexity of stuttering behavior was found to be independently associated with clinician stuttering severity scores but not with percentage of syllables stuttered or self-reported stuttering severity. Complexity of stuttering behavior was not associated with gender, anxiety, or impact of stuttering. Conclusion: Clinical and research applications of these findings are discussed., Stuttering The cause of stuttering is not yet fully understood, despite decades of research and theorizing (see Packman & Attanasio, 2017). However, much recent research indicates that it is a [...]

Purpose: Case-study methodology studying change is often used in the field of speech-language pathology, but it can be criticized for not being statistically robust. Yet with the heterogeneous nature of many communication disorders, case studies allow clinicians and researchers to closely observe and report on change. Such information is valuable and can further inform large-scale experimental designs. In this research note, a statistical analysis for case-study data is outlined that employs a modification to the Reliable Change Index (Jacobson & Truax, 1991). The relationship between reliable change and clinical significance is discussed. Example data are used to guide the reader through the use and application of this analysis. Method: A method of analysis is detailed that is suitable for assessing change in measures with binary categorical outcomes. The analysis is illustrated using data from one individual, measured before and after treatment for stuttering. Conclusions: The application of this approach to assess change in categorical, binary data has potential application in speech-language pathology. It enables clinicians and researchers to analyze results from case studies for their statistical and clinical significance. This new method addresses a gap in the research design literature, that is, the lack of analysis methods for noncontinuous data (such as counts, rates, proportions of events) that may be used in case-study designs., Case-study methodology is 'an empirical enquiry that investigates a contemporary phenomenon in-depth and within its real-life context' (Yin, 2009, p. 18). With historical foundations in behavioral science, single-case-study research dates [...]

Purpose: This study aimed to explore the use of myofunctional devices (MDs) by speech-language pathologists (SLPs) to gain a better understanding of how SLPs are utilizing these in the treatment of their patients. Method: Eleven SLPs from four countries participated in semistructured interviews. The interview transcripts were analyzed using qualitative content analysis. Participants' responses were coded and categorized to identify key themes related to the use of MDs in therapy. Results: Five key themes, composed of 11 main categories and 54 subcategories, were identified. Themes highlighted variability in the use of MDs, including the type of device, application of the device, and dosage. Successful outcomes with the use of MDs were influenced by clinical experience and training, a multidisciplinary approach, along with client/family adherence to therapy. Participants frequently described the use of MDs as one component of an overall therapy program and reported on the need for further research to guide the use of MDs in speech-language pathology treatment. Conclusions: The use of MDs in speech-language pathology practice is often related to the expertise and experience of the SLP. Although SLPs report positive clinical outcomes, there remains a need for further research to support the use of MDs in therapy. [ABSTRACT FROM AUTHOR]

Objectives: Stuttering has been associated with a range of anxiety disorders, including social phobia. In the general community, anxiety disorders are frequently associated with increased rates of mood and substance use disorders. Therefore, in the present study, the authors sought to determine the rate of mood and substance use disorders among adults who stutter. Method: The study employed a matched case--control design. Participants included 92 adults seeking treatment for stuttering and 920 age--and gender-matched controls. Mental health assessments were conducted via a computerized psychiatric diagnostic interview. Conditional logistic regression models were used to estimate odds ratios for the prevalence of mood and substance use disorders in both groups. Results: When compared with matched controls, adults seeking treatment for stuttering had twofold increased odds of meeting criteria for a 12-month diagnosis of any mood disorder but were not found to report significantly higher lifetime prevalence rates for any substance use disorder. Conclusions: Although adults who stutter in the present study were characterized by significantly higher rates of mood disorders than matched controls, they do not appear to self-medicate with substances such as alcohol. Results are discussed in terms of treatment implications and possible reasons why adults who stutter may avoid alcohol. KEY WORDS: stuttering, mood disorders, substance use, alcohol use, anxiety, Anxiety, mood, and substance use disorders are among the most common and disabling psychiatric disorders in the general community (Kessler et al., 1994; Ormel et al., 1994; Wells et al., [...]

Purpose: In this study, the authors investigated the efficacy of video self-modeling (VSM) following speech restructuring treatment to improve the maintenance of treatment effects. Method: The design was an open-plan, parallel-group, randomized controlled trial. Participants were 89 adults and adolescents who undertook intensive speech restructuring treatment. Post treatment, participants were randomly assigned to 2 trial arms: standard maintenance and standard maintenance plus VSM. Participants in the latter arm viewed stutter-free videos of themselves each day for 1 month. Results: The addition of VSM did not improve speech outcomes, as measured by percent syllables stuttered, at either 1 or 6 months postrandomization. However, at the latter assessment, self-rating of worst stuttering severity by the VSM group was 10% better than that of the control group, and satisfaction with speech fluency was 20% better. Quality of life was also better for the VSM group, which was mildly to moderately impaired compared with moderate impairment in the control group. Conclusions: VSM intervention after treatment was associated with improvements in self-reported outcomes. The clinical implications of this finding are discussed., Behavioral control of stuttering is a core component of the clinical management of many who stutter (Onslow, 1996). To that end, there is compelling evidence in favor of treatments based [...]

Purpose: A growing number of speech-language pathologists (SLPs) are using orofacial myofunctional therapy (OMT) and/or myofunctional devices (MDs) in the treatment of their clients. However, governing bodies suggest SLPs carefully consider the availability and quality of evidence in the utilization of these therapies in speech-language pathology treatment. The purpose of this study was to review the existing evidence for OMT and MDs used by SLPs. Method: A systematic quantitative review was conducted using key search terms in three electronic platforms housing multiple databases, along with a hand search, to identify additional literature. All studies published in English in full text were included if they reported pre- and posttreatment data of OMT and/or MDs provided by an SLP. Data were extracted and analyzed by the first author and confirmed by the co-authors. Results: Twenty-eight studies met the criteria for inclusion in the review. Two thirds were published in the last decade and involved the use of OMT/MDs targeting multiple areas of speech pathology intervention within the same study, that is, swallowing, breathing, oral hygiene, and speech production. Majority of studies were rated as low level of evidence. All studies used OMT, with very few using MDs. While the assessment, treatment protocols, and outcome measures were highly variable, all of the studies reported an improvement in the function of the orofacial systems posttreatment. Few studies reported long-term follow-up data. Almost half of the studies recommended the use of OMT/MDs in a multidisciplinary/interdisciplinary team or in conjunction with other therapy. Conclusions: There has been an increase in literature over the last decade in SLPs’ use of OMT; however, there are only a small number of studies to date that explore the use of MDs. There is a growing body of evidence to support the use of OMT and MDs within a multidisciplinary team for people with communication and swallow difficulties. However, development of future research should consider investigating assessment and outcome measures, optimal dosage, and service delivery. [ABSTRACT FROM AUTHOR]