Stuttering Interventions for Children, Adolescents, and Adults: A Systematic Review as a Part of Clinical Guidelines
Journal of Communication Disorders
Laiho, A., Elovaara, H., et al. (2022).
Journal of Communication Disorders, 99, 106242.
<div>This systematic review investigates the effect of fluency interventions for young children, adolescents, and adults who stutter.</div>
Finnish Association of Speech and Language Therapists (Finland)
2000 to 2018
<div>Peer-reviewed intervention study, meta-analysis, or systematic review</div>
38
<div>Only three studies were located that investigated fluency treatments in children aged 7 to 12 years. Limited evidence was noted for:</div>
<div>
<ul>
<li>a computer-based stuttering program,</li>
<li>combined cognitive behavioral and speech modification methods, and</li>
<li>reduced rate of speech.</li>
</ul>
<div>Due to a limited number of studies investigating this population, small sample sizes, and heterogeneity between studies, further research is needed to determine the efficacy of fluency treatment for children who stutter.</div>
</div>
<div>Speech restructuring treatments generally reduced stuttering in adolescents and adults who stutter, however, no specific fluency treatment method was supported in this population. No significant differences in outcomes were noted regarding telepractice versus in-person delivery for the Camperdown Program.</div>
<div> </div>
<div>Limitations to these findings included reduced methodological rigor, small sample sizes within most included studies, and potential for publication bias. Further research is warranted to determine the efficacy of specific fluency treatments for adolescents and adults who stutter.</div>
<div>For adolescents and adults who stutter, cognitive behavioral therapy in combination with speech restructuring treatment reduced the presence of social anxiety disorder, increased positive experiences of stuttering, and reduced dysfluency. Additional alternative methods (e.g., Linklater voice method, Alexander Technique) resulted in reduced stuttering without maintenance or generalization.</div>
<div> </div>
<div>Limitations to these findings included reduced methodological rigor, small sample sizes within most included studies, and potential for publication bias. Further research is warranted to determine the efficacy of specific fluency treatments for adolescents and adults who stutter.</div>
<div>
<div>In adolescents and adults who stutter:</div>
<ul>
<li>No significant difference in outcomes was noted for speech modification versus delayed auditory feedback in a singular study with small sample size.</li>
<li>No significant difference in fluency outcomes were noted between MPI and prolonged speech treatment.</li>
</ul>
<div>Limitations to these findings included reduced methodological rigor, small sample sizes within most included studies, and potential for publication bias. Further research is warranted to determine the efficacy of specific fluency treatments for adolescents and adults who stutter.</div>
</div>
<div>A singular case study reported cessation of stuttering with the self-imposed timeout method in adults and adolescents who stutter. Limitations to these findings included reduced methodological rigor, small sample sizes within most included studies, and potential for publication bias. Further research is warranted to determine the efficacy of specific fluency treatments for adolescents and adults who stutter.</div>
<div>Findings regarding fluency interventions in children under the age of six demonstrated the following:</div>
<div>
<ul>
<li><strong>The Lidcombe Program </strong>(LP) delivered via individual or group treatment was effective in reducing stuttering. There was no significant difference in outcomes for in-person and telepractice delivery for the LP. </li>
<li><strong>Other direct stuttering treatments </strong>(e.g., Speech Motor Training, Extended Length Utterance) resulted in increased fluency. </li>
<li><strong>Indirect stuttering treatment </strong>(e.g., Rotterdam Evaluation Study of Stuttering Therapy in preschool children, Randomized Trial-Demands and Capacities Model [RESTART-DCM], Palin Parent-Child Interaction [Palin PCI]) generally resulted in improved fluency and parental confidence.</li>
</ul>
<div>Limitations to this review included a small number of studies investigating treatment effects in this population and potential publication bias. Further research is indicated to determine the efficacy of fluency treatment in young children who stutter.</div>
</div>
