Effectiveness of speech therapy in treating vocal blocking tics in children with Tourette syndrome: Two case reports.

Tourette syndrome is characterized by at least two motor tics and one vocal tic, which persist for over a year. Infrequently, tics can manifest as blocking tics in speech when they prevent a person from starting to speak or interrupt their speech flow. Vocal blocking tics (VBTs) resemble stuttering, and they can be difficult to differentiate from each other. A previous report described two patients with severe VBTs who did not benefit from stuttering-therapy-based speech therapy and were treated effectively with cannabis-based medicine. Here, we present the cases of two patients, seven- and nine-year-old boys, who benefited from speech therapy in which stuttering therapy techniques were used. Detailed descriptions of the interventions are included. Further research is needed to test the effectiveness of speech therapy in treating VBTs in a larger group of children with Tourette syndrome.

Stuttering interventions for children, adolescents, and adults: a systematic review as a part of clinical guidelines.

INTRODUCTION: Stuttering may have a holistic effect on the quality of life of a person who stutters by limiting participation in social situations, resulting in feelings of isolation and frustration, leading to difficulties in education and employment and increasing the likelihood of mental health problems. Even young children who stutter may have negative experiences of speaking. Therefore, it is important to treat stuttering behavior effectively in both children and adults. The purpose of this paper was to systematically review group and case studies about the effectiveness of behavioral stuttering interventions to provide evidence-based guidelines for clinicians. METHODS: Systematic data retrieval was conducted in four electronic databases (PsycINFO, CINAHL, PubMed, Cochrane). The assessment of search results was conducted according to predetermined inclusion and exclusion criteria by two independent judges. The methodological quality of each paper was assessed using strict criteria to include only high-quality research. RESULTS: The search revealed 2293 results, and 38 papers (systematic reviews N=3, group design studies N=21 and case studies N=14) with acceptable methodological quality were included. The data show that there is most evidence about the treatment of early childhood stuttering, very little evidence about school-aged children and some evidence about adults. The most convincing evidence is about the Lidcombe Program in the treatment of young children who stutter, but also other methods have promising evidence. Our data imply that in the treatment of adults who stutter, holistic treatments may influence speech fluency and overall experience of stuttering behavior. Speech restructuring treatments may have a positive effect on overt characteristics of stuttering, but not on covert stuttering behavior. CONCLUSIONS: The results of this review agree with earlier reviews about the treatment of young children. However, due to different inclusion criteria, this review also shows the benefits of holistic treatment approaches with adults and adolescents.

Long- and short-term results of children's and adolescents' therapy courses for stuttering.

BACKGROUND: It is widely known that most young children recover from stuttering. Evaluations of this spontaneous recovery vary from 40 to 80% of stuttering children. However, if the child is already older than 6 years of age, the spontaneous recovery will be less likely. The effectiveness of stuttering treatment, and especially fluency shaping methods, has been frequently studied. Good results in the treatment of stuttering for school-aged children have been accomplished by several treatment methods. However, stuttering modification treatments have not been studied so intensively. AIMS: This study addresses the effects of intensive therapy courses on the stuttering behaviour of children and adolescents. The courses included speech therapy, where stuttering modification treatment was used, and also parental guidance. METHODS & PROCEDURES: Taking part in the study were 21 children/adolescents who stutter, and 29 of their mothers/fathers took part in the study. The children were between the ages of 6.8 and 14.0 years. The effectiveness of therapy was evaluated in three ways. First, the speech of the children who stutter was videotaped at both the beginning and the end of the course and the samples were transcribed and analysed. Second, the parents and adolescents completed a feedback questionnaire at the end of the course. And third, the parents and adolescents completed a follow-up questionnaire 9 months after the course. The aim was to evaluate the changes in stuttering behaviour after the therapy course. OUTCOMES & RESULTS: The results indicate that stuttering severity became milder or did not change during the course. The percentage of syllables stuttered dropped with two-thirds of the participants. This result was replicated with avoidance behaviour and struggle behaviour. The quality of stuttering became milder, and by the end many children had shorter moments of stuttering and more repetitions and prolongation instead of blocks. Two participants did not complete the questionnaire. Of those who did, all but one adolescent, and all except one parent, reported that the positive changes in stuttering behaviour had continued during the follow-up period. CONCLUSIONS: The implication is that intensive therapy courses can be helpful to some participants who stutter.