Conversational speech of school-age children after syllable-timed speech treatment for stuttering.

Purpose: The purpose of this laboratory study was to investigate whether rhythmic speech was primarily responsible for stuttering reductions in four school-aged children after the instatement stage of the Westmead Program of syllable-timed speech (STS) intervention. The study was designed to inform further development of the program. Reduction in variability of vowel duration is a marker of STS, and it was predicted that this would be present in the children's conversational speech after Stage 1 of the program if they were using STS. To strengthen such a finding, it was also predicted that there would be no reduction in articulation rate, sentence complexity, and utterance length after treatment, as there is evidence that reductions in these can reduce stuttering. Perceptual judgments of speech quality after treatment were also made by independent listeners.Method: Participants were four children, ages 8-11 years, who completed Stage 1 of an STS program and whose stuttering had reduced significantly. Pre-treatment (PRE) and post-treatment (POST) within-clinic audio-visual recordings of conversational speech were analysed for percentage of syllables stuttered, variability of vowel duration, articulation rate, and length and complexity of utterance. Four blinded listeners made perceptual judgments of speech quality in the POST recordings.Result: Recordings of all children showed that variability of vowel duration clearly reduced from the PRE to POST speech samples. Importantly, articulation rate and language use were not compromised. Some possible indicators of rhythmicity were identified in one child in the perceptual study.Conclusion: The findings suggest that STS was primarily responsible for the clinically significant reductions in stuttering after Stage 1 of the program. There is an urgent need for more evidence-based interventions for stuttering in this age group and further development of STS interventions is warranted.

Phase II trial of a syllable-timed speech treatment for school-age children who stutter.

PURPOSE: A recent clinical trial (Andrews et al., 2012) showed Syllable Timed Speech (STS) to be a potentially useful treatment agent for the reduction of stuttering for school-age children. The present trial investigated a modified version of this program that incorporated parent verbal contingencies. METHODS: Participants were 22 stuttering children aged 6-11 years. Treatment involved training the children and their parents to use STS in conversation. Parents were also taught to use verbal contingencies in response to their child's stuttered and stutter-free speech and to praise their child's use of STS. Outcome assessments were conducted pre-treatment, at the completion of Stage 1 of the program and 6 months and 12 months after Stage 1 completion. RESULTS: Outcomes are reported for the 19 children who completed Stage 1 of the program. The group mean percent stuttering reduction was 77% from pre-treatment to 12 months post-treatment, and 82% with the two least responsive participants removed. There was considerable variation in response to the treatment. Eleven of the children showed reduced avoidance of speaking situations and 18 were more satisfied with their fluency post-treatment. However, there was some suggestion that stuttering control was not sufficient to fully eliminate situation avoidance for the children. CONCLUSIONS: The results of this trial are sufficiently encouraging to warrant further clinical trials of the method.

Syllable-timed speech treatment for school-age children who stutter: a phase I trial.

PURPOSE: This clinical trial determined the outcomes of a simple syllable-timed speech (STS) treatment for school-age children who stutter. METHOD: Participants were 10 children, ages 6-11 years, who stutter. Treatment involved training the children and their parents to use STS at near normal speech rates. The technique was practiced in the clinic and at home with the parents during everyday conversations. RESULTS: Nine months after commencing treatment, stuttering had decreased by >50% for half of the children, with 2 children attaining 81% and 87% reduction. Intention-to-treat analysis showed a clinically and statistically significant reduction in stuttering for the group even when a withdrawn participant was included. These results were mostly confirmed by self-reported stuttering severity ratings and were supported by improved situation avoidance and quality-of-life scores. There was considerable individual variation in response to the treatment. CONCLUSION: STS shows promise as a treatment for some school-age children who stutter. As a fluency technique, it is simple to learn and simple to teach, and the children in this study appeared to enjoy the treatment. The efficacy of the treatment could likely be improved with modifications.

A phase II trial of the Westmead Program: syllable-timed speech treatment for pre-school children who stutter.

This report presents a Phase II clinical trial of a syllable-timed speech treatment for early stuttering known as The Westmead Program. Of 17 children recruited, eight children aged between 3-4.5 years (mean 3 years 8 months) completed the treatment. The primary outcome measure was percentage syllables stuttered (%SS) measured from independent, blinded speech assessments of beyond-clinic audio recordings. Secondary outcomes were measures of treatment time, speech quality, and parent severity ratings. Dropouts occurred, but at a similar rate to other clinical trials of this nature. For the eight children who completed the treatment, mean pre-treatment stuttering was 6.0%SS and at 12-months post-Stage 2 entry stuttering had decreased to 0.2%SS, representing a mean stuttering reduction of 96%. A large effect size was obtained with a mean of 8.0 clinical hours required for these children to reach Stage 2. Independent listeners judged the everyday speech of all children to be not unnatural in any way. Stuttering reductions were attained with clinical efficiency and simplicity compared to other early stuttering interventions. Further clinical trials development of the treatment is warranted.

Using syllable-timed speech to treat preschool children who stutter: a multiple baseline experiment.

UNLABELLED: This report presents the results of an experimental investigation of the effects of a syllable-timed speech treatment on three stuttering preschool children. Syllable-timed speech involves speaking with minimal differentiation in linguistic stress across syllables. Three children were studied in a multiple baseline across participants design, with percent syllables stuttered (%SS) as the dependent variable. In the week following the initial clinic visit, each child decreased their beyond-clinic stuttering by 40%, 49% and 32%, respectively. These reductions are only evident in the time series after the introduction of the syllable-timed speech treatment procedure. Participants required a mean of six clinic visits, of approximately 30-60 min in duration, to reach and sustain a beyond-clinic %SS below 1.0. The results suggest that clinical trials of the treatment are warranted. EDUCATIONAL OBJECTIVES: The reader will be able to summarize, discuss and evaluate: (1) The nature, impact and treatment options available for early stuttering. (2) The syllable-timed speech treatment protocol administered. (3) The advantages of syllable-timed speech treatment for early stuttering. (4) The questions that further research needs to answer about the syllable-timed speech treatment.