Adult Stuttering

Google “stuttering treatment for adults” and up will pop thousands of links to websites alleging “the best” or “latest” or “groundbreaking” treatments for stuttering. Among other things, you’ll find pages recommending acupuncture, cognitive behaviour therapy, regulated breathing techniques, delayed auditory feedback devices, EMG feedback, video self-modelling, time outs, and prolonged or smooth speech techniques.

So how do you know which treatments are backed up by peer-reviewed, published research evidence? What types of treatments should adults who stutter seek out when looking for evidence-based treatments to achieve their fluency goals?

Fortunately for all of us (including busy speech pathologists!), in 2006, a group of researchers led by Anne Bothe in the United States published a systematic review of peer-reviewed stuttering treatment studies, including all the techniques listed above. After reviewing 39 relatively high quality stuttering articles, covering 16 treatment categories, Bothe and her colleagues concluded as follows:

“For adults who stutter, many of the articles that met this review’s trial quality criterion support the use of prolonged-speech-type procedures within a comprehensive treatment framework that includes initial intensive work, practice in front of groups, specific transfer or generalization tasks, self-evaluation of speech and/or self-management of program steps, a focus on speech naturalness and feedback of naturalness measurements, and an active contingent management program that continues to address not only stuttering but also speech naturalness and self-evaluation skills.” (Our emphasis)

The Australian Stuttering Research Centre, affiliated with Sydney University, has developed an evidence-based treatment that includes all of the elements highlighted above. It’s called the Camperdown Program.

(How the creation of the Camperdown Program might have looked if we could see ideas*)

When studying for his Masters of Speech Language Pathology at Sydney University, David was lucky enough to be trained in the Camperdown Program by its creators. In March 2014, David attended a post-graduate workshop in Brisbane run by Drs Brenda Carey and Sue O’Brian, co-authors of the Treatment Manual (with Mark Onslow, Ann Packman and Angela Cream) and each a lead author of peer-reviewed clinical trials on the effectiveness of the program.

The Camperdown Program is a speech restructuring program that includes prolonged-speech-type procedures. Treatment requires the client to learn a new speech pattern that is incompatible with stuttering. The main aim of the program is to reduce stuttering in everyday speech situations (i.e. not just in the clinic). It also helps clients develop the skills to self-manage their stuttering over time and to reduce the risk of relapse. The Program is composed of four stages:

1. Client training to use the speech pattern and to self-rate the severity of their stuttering and the naturalness of their speech.
2. Training in the clinic to attain stutter-free, natural sounding speech.
3. Training to use the new technique in the real world.
4. Problem-solving skills training to manage stuttering and to minimise the risk of relapse.

To date, the Camperdown Program has been tested clinically on over 100 participants in 8 published clinical trials.  It’s been tested on adults and teenagers, in intensive and non-intensive formats, and via the phone and web-cam (Skype).  More information about the program can be found here, and copies of some of the key clinical trials are available through our clinic.

Related articles:

• Does anxiety cause stuttering?
• Online stuttering therapy
• Banter Research Review 1: Stuttering Relapse – Video Self-Modelling versus Cognitive Behaviour Therapy
• Stuttering treatments: what works for whom? An evidence update
• Controlling stuttering: what it feels like in the real world
• Doing two things at once: empowering adults who stutter to make informed choices about their fluency

Key Reference: Bothe, K., Davidow, J.H., Bramlett, R.E., & Ingham, R.J. (2006). Stuttering Treatment Research 1970-2005: I. Systematic Review Incorporating Trial Quality Assessment of Behavioural, Cognitive and Related Approaches. American Journal of Speech-Language Pathology, 15(4) 321.

* Actually this is one of the amazing plates from Thought-Forms, by Annie Besant & C.W. Leadbeater: http://tinyurl.com/l9kcxnn

Image: http://tinyurl.com/mfybms7