Keynote speakersLudo Max
Affiliation: University of Washington, Seattle, WA, USA & Haskins Laboratories, New Haven, CT, USATitle: Neural control and sensorimotor mechanisms in stuttering: perspectives and experiments
Ludo Max, Ph.D., is an Associate Professor in Speech and Hearing Sciences at the University of Washington where he serves as Director of the Laboratory for Speech Physiology and Motor Control. He is also a Research Affiliate at Haskins Laboratories. His research focuses on neural and sensorimotor mechanisms in stuttering.
Abstract: Developing a thorough understanding of the fundamental mechanisms underlying stuttering will require a theoretical framework that accounts for the disorder's primary and associated speech characteristics, and that is consistent with empirically-verified models of sensorimotor control and neural functioning. Using a neurobiologically plausible model of the neural control of movements, our research program over the last several years has involved an integrated series of theoretically-motivated, hypothesis-driven experiments. This presentation will focus on the theoretical background and empirical data from this combined neuroimaging-psychophysical program of research. Specifically, the presentation will include our most recent data regarding stuttering children and adults' auditory and somatosensory processing; sensorimotor learning of speech and nonspeech movements; feedforward versus feedback motor control strategies; and predictive aspects of movement planning and execution, including motor-to-sensory priming. The various methodologies will be presented, and the findings will be integrated in the context of contemporary insights into the neuroscience of sensorimotor control.
Affiliation: Institute for Stuttering Treatment and Research, University of Alberta
Title: Long-term outcomes and the Comprehensive Stuttering ProgramMarilyn Langevin is the Director of Research at the Institute for Stuttering Treatment and Research (ISTAR), Faculty of Rehabilitation Medicine, University of Alberta. She has 24 years experience in integrating research into clinical practice. Her research interests include the evaluation of stuttering treatment, clinician-training, and school-based stuttering education programs.
Abstract: It is well known that substantial reductions in stuttering and improvements in attitudes toward communication can be achieved in the short-term; however, given the high potential for relapse there is need to investigate the degree to which such improvements are maintained in the long term. The Comprehensive Stuttering Program (CSP; Boberg & Kully, 1984; Langevin et al., 2010) is a treatment program for adults and adolescents that integrates prolonged speech and cognitive-behavioural techniques. For over 25 years its short- and long-term outcomes have been evaluated. In this presentation the need for long-term treatment outcomes will be discussed and an overview of the components of the CSP, the methods used to investigate outcomes, and the results of our outcome studies will be presented. This session will close with a discussion of a proposed model for treatment outcomes research that may be used to guide design of future outcomes investigations.
Affiliation: Chief Executive, British Stammering Association
Title: Fluency treatment from the client's perspective
Norbert Lieckfeldt is a person who stammers, starting his ‘professional stammering career' nearly 20 years ago as a volunteer on the helpdesk of the British Stammering Association. After spending ten years trying to fit in almost every position within the charity, he has finally found his niche as Chief Executive.
Abstract: Fluency therapy is a mutual process between therapist and client. It requires an awareness on the part of the therapist of what a client expects the outcome of therapy to be, and a negotiation around what is feasible and what can be delivered within the limits of the therapist's skills mix. Based on my personal experiences and results from a (non-scientific) questionnaire of adults who stammer, I will outline the most common themes in the expectations of people who stammer from fluency therapy. In addition, I will present research findings about the expectations of parents of children who stammer for their child's therapy outcomes, with a particular focus on recent findings from University College London. Based on these themes, I will end by exploring what impact clients' expectations may have on the skills mix required from a qualified fluency therapist.
Affiliation: Boston University, Boston, MA, USA
Title: The big leap: Understanding stuttering within the context of developmental cognitive neuroscience.
Deryk Beal, Ph.D., CCC-SLP is a postdoctoral research fellow at the Center for Computational Neuroscience and Neural Technologies - Speech Laboratory, Boston University. His research aims to understand the dynamic cortical and subcortical networks implicated in the neural control of voluntary movement for the purpose of developing novel treatments for stuttering.
Abstract: The rapid emergence of developmental cognitive neuroscience as a field of study is a timely occurrence for clinician-scientists interested in pursuing research that will establish a complete understanding of the neural bases of stuttering. Stuttering typically has its onset between the ages of 2 and 5 years old and persistence or recovery is determined within a 6 month to 3 year window from the age of onset. Despite stuttering being a childhood disorder that potentially persists across the lifespan, the majority of attempts to understand its neural underpinnings have been restricted to investigations of adults who stutter due to the methodological limitations of early neuroimaging studies. Recent advances have made it possible to track the development of human brain structure and function from early childhood through to the twilight years. This presentation will review data from investigations of brain structure and function in children and adults who stutter. Specifically, results detailing structural abnormalities in grey and white matter, as well as anomalous auditory-motor integration during speech production in children and adults who stutter will be presented. Results will be discussed within the context of neural development and directions for future research will be suggested.
Affiliation: Senior Lecturer, School of Human Communication Sciences, La Trobe University, Melbourne, Australia; Honorary Senior Research Fellow, Australian Stuttering Research Centre, University of Sydney, Australia; Honorary Research Fellow, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; Adjunct Senior Lecturer (Clinical), School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Australia
Title: The treatment of chronic stuttering: benefits and challenges
Dr. Susan Block is a specialist in stuttering assessment and treatment across the lifespan. She co-ordinates the stuttering program at the university and is responsible for academic and clinical experiences the students receive in stuttering. Her interest is integrating teaching, research and clinical practice. Susan is a Fellow of Speech Pathology Australia.
Abstract: Chronic stuttering can be a debilitating condition with significant effects on quality of life as well as limitations on other aspects of functioning. Treatment can be complex and ongoing. This has implications for management for the person who stutters, their family, and speech pathologists. Service delivery challenges and restrictions, which are often imposed by management, mean that evidence based best practice often is unable to be delivered. Furthermore, the ongoing cost of treatment can limit access to ongoing and sufficient service. Emerging evidence suggests that chronic stuttering may result in anxiety and personality attributes in adults that also warrant therapeutic attention in addition to the speech. Evidence also reveals that speech pathologists are more likely to be confident and choose to work with people with disorders with which they have had experience during their education. Thus it is imperative, if we are to ensure appropriate access to treatment for people who stutter, that those with experience and expertise provide mentoring and clinical experience opportunities for emerging members of our profession. This presentation will discuss a model for doing so.
Affiliation: Stammering Support Centre, Leeds Community Healthcare
Title: Bridges: reflections on the therapeutic alliance
Dr Trudy Stewart: Consultant Speech and Language Therapist, is highly experienced in disorders of fluency (stammering) with more than 30 years of clinical experience. She was the first speech and language therapist in the UK to be awarded a Ph.D in the field of stammering.Within the field of fluency she has written numerous research articles, papers and chapters on a range of subjects including psychological issues, client experience, group therapy and acquired stammering. She is the author self help books on stammering and several other books written for speech and language therapists and other professionals; many of these have been translated into other languages. She has been involved in clinical training of speech therapists at undergraduate and post graduate level in the UK, USA, Europe and Sri Lanka.
Abstract: A metaphor of bridges will be used to explore the client - clinician relationship in stammering therapy: client and clinician as travellers and architects working together to construct a way from the troubled present to an imagined future. The presentation will begin by considering the importance and centrality of the relationship in therapy and then move to examine the points of departure for both individuals. The key foundations, structure, and parameters of the alliance will be explored in addition to the issues involved in the building and maintenance of the relationship during a change process. Finally there will be a discussion of outcomes in relation to evidence within clinical practice and what we need to learn and develop to improve our bridge building.
Affiliation: University of Malta
Title: Stuttering Therapy: Using the 'Ridiculum!' Curse
Dr. Joseph G. Agius, Ed.D., is a registered Speech Language Pathologist with special interest in fluency disorders and humor research. He holds a Master of Science degree in Clinical Speech and Language Studies from Trinity College, University of Dublin and a Doctor of Education degree from the University of Sheffield. Dr. Agius lectures at the University of Malta on ‘Fluency Disorders', ‘Language and Psychiatry' and ‘Creativity, Humor and Communication'. He is also a staff member of the ECSF- European Clinical Specialization Course in Fluency Disorders.
Abstract:The most creative aspect of language is humour and it is one of the most important topics in the study of communication. Pedagogical trends in recent decades have also shifted toward the promotion of a more relaxed learning environment emphasizing ‘making learning fun'. Research has shown that children who stutter view speaking more negatively and experience more negative speech-related emotions than do non-stuttering peers. However, while practical strategies for helping children who stutter change their feelings and beliefs about stuttering are widely available, speech language pathologists feel uncomfortable targeting such goals. Strategies are needed to use in treatment that could help clinicians help children make changes. These tools could assist the child in finding a balance between modifying speech and developing and maintaining healthier attitudes and feelings. Creativity and humor are used as tools to help children ‘problem solve' and broaden perception to develop and maintain positive attitudes towards themselves and communication. Desensitization is a behavioural intervention. By using ‘humor' in stuttering therapy, the repeated pairing of a humor response with exposure to a feared stimulus gradually diminishes the feelings of anxiety evoked by the stimulus. Current research on humour and stuttering is presented .The results of a study exploring shifts in the attitude and feelings of schoolage children who stutter following a thinking skills programme are presented. The findings of this study led to a suggested model of intervention, the ‘Smart Intervention Strategy' (SIS), with school-aged children who stutter. Included in this framework is the humor component. The use of humour as a therapeutic tool is explored and the theory and rationale for its application in therapy is discussed.