A Multidimensional Approach for School-Aged Children who Stutter.

Therapy for school-aged children who stutter (CWS) and their parents should be holistic, individualized, and multidimensional, considering the child within their real-life context and using a solution rather than problem-focused approach; highlighting and drawing on the strengths, resources, values; and coping skills that each family brings. Therapy at the Michael Palin Centre draws on a number of psychological approaches, including solution-focused brief therapy, cognitive behavior therapy, acceptance and commitment therapy, and compassion-focused therapy. Aspects of these approaches are discussed in this article to describe the therapeutic intervention for two school-aged CWS (aged 8 and 15 years). The Palin Model (2019) is used to conceptualize the factors that influence stuttering, as well as the different components of therapy that may be relevant for each individual family. The overarching aim of therapy, for children to become competent and effective communicators, whether they stutter or not, is described through a range of practical therapeutic activities, including exploring communication skills, openness and desensitization, exploring thoughts and feelings around stuttering, building confidence, expanding comfort zones, and developing self-efficacy. Qualitative and quantitative outcomes are presented for each clinical case.

Nurturing a Resilient Mindset in School-Aged Children Who Stutter.

Purpose: To consider the rationale, methods, and potential benefits of nurturing the growth of resilience in school-aged children who stutter. Stuttering in childhood can have negative psychological consequences for some, including the development of a negative attitude toward their speech from a young age (Vanryckeghem, Brutten, & Hernandez, 2005) and possible co-occurring psychopathology in adolescence and adulthood, in particular, anxiety disorders (Blood, Blood, Maloney, Meyer, & Qualls, 2007; Iverach & Rapee, 2014; McAllister, Kelman, & Millard, 2015). Children who stutter also frequently report teasing and bullying by their peers (Blood & Blood, 2007; Boyle, 2011; Langevin, Packman, & Onslow, 2009), which can have a significant impact on children's confidence and psychological well-being. However, the capacity of children who stutter to cope or "bounce back" from adversity is not routinely explored or incorporated in therapy for stuttering. Method: This clinical focus article will explore the construct of resilience and consider why it may be important for children who stutter and their parents. A framework for understanding resilience in relation to stuttering is used, drawing from the Reaching In Reaching Out Resiliency Program (for children aged under 8 years and their parents) and the Penn Resiliency Program (for children aged 8 years and over). Conclusions: The role of parents is key in modeling resilient responses to children and creating a resilience-rich environment. As children who stutter may be more vulnerable to adversity, some may benefit from targeted support to build their resilience, in order to enhance their ability to overcome challenges and thrive.

An exploration of the mechanisms of change following an integrated group intervention for stuttering, as perceived by school-aged children who stutter (CWS).

PURPOSE: To explore the process of change and role of resilience following an integrated group intervention for children who stutter (CWS). METHOD: Using an exploratory multiple case study design, this research sought to identify the most significant changes perceived by seven participants following therapy, the mechanisms of change, and the role of resilience in the process of change. Quantitative measurements of resilience were combined with qualitative analysis of semi-structured interviews. RESULTS: Thematic analysis of qualitative data showed that cognitive and emotional change was a key driver for therapeutic change, enabled by the shared experience of the group and a positive therapeutic environment. These changes were generalised into clients' real-world experiences, facilitated by their support network. Quantitative data demonstrated a statistically reliable positive change in overall Resiliency scores for four participants and reduced impact of stuttering scores on OASES-S for all participants, maintained at 12 month follow-up. CONCLUSIONS: This study demonstrates the importance of adopting an integrated approach in therapy for CWS, which incorporates Cognitive Behavioural Therapy (CBT) as a key component, to facilitate change and build resilience. These results are unique to this cohort of CWS and further investigation into the use of CBT and the process of change may be warranted. EDUCATIONAL OBJECTIVES: The reader will be able to (1) describe the integrated intervention used in this study (2) define the most significant change following therapy for the participants involved (3) summarise the key factors that facilitated change during the therapy process (as perceived by the participants).