Affiliation: Australian Stuttering Research Centre, The University of Sydney, Australia
Title: Exploring the relationship between treatment and causal theory in stuttering
Ann Packman has worked for over 30 years with people who stutter as a practitioner, teacher and researcher. She has over 100 publications on stuttering in peer-reviewed journals. Her research includes treatment development and she has a special interest in theoretical perspectives on the nature and cause of stuttering.
Abstract: Where possible, treatments for a condition or a disorder should target its cause. However, the cause of stuttering is poorly understood and hence, historically, many treatments for stuttering have been driven by causal theory. While recent brain imaging research is indicating that stuttering is underpinned by a deficit in neural processing for spoken language, this in itself explains little about the complexity of the disorder. In this presentation, a new multifactorial causal model of stuttering is presented and the extent to which different treatments fit the model is explored. This working model, known as the Packman and Attanasio (P&A) model, is supported by recent clinical and laboratory research. It comprises three factors; an underlying neural processing problem, triggers, and modulators. The question prompting the P&A model was not "What causes stuttering?" but rather "What causes individual moments of stuttering?"
Affiliation: University of Applied Sciences Utrecht, The Netherlands & ECSF consortium
Title: Evidence-based clinical guidelines in stuttering therapy.
Mark Pertijs, MSc, is a lecturer in fluency disorders at Utrecht University of Applied Sciences and an ECSF staff member. As a project manager he is involved in the development of an "Evidence-based guideline developmental stuttering in children and adults" in cooperation with CBO Dutch Institute for Healthcare Improvement.
Abstract: Different types of therapy are available for the treatment of stuttering, but little is known about the success rate of these therapies and about the quality of the effect. For the speech therapist and the person who stutters, it is often unclear which therapy is best in a given situation. Evidence-based guidelines are based on the best available scientific evidence, given the needs of the person who stutters. They can serve as tools to improve quality, transparency and organization of care. In the Netherlands, a guideline on developmental stuttering, based on the GRADE Working Group approach is under construction. Both professionals and persons who stutter are participating in the working group. This presentation will focus on the value of evidence-based guidelines in stuttering therapy and on the process of developing an evidence-based guideline on stuttering using the GRADE Working Group approach.
Affiliation: University of Central Florida, Orlando, Florida, USA & University Ghent, Belgium
Title: Speech-associated attitude and its broader framework: The legacy of Gene Brutten
Martine Vanryckeghem received her Ph.D. from Southern Illinois University. She is a Professor at the University of Central Florida, Orlando, and Guest Professor at the University of Gent, Belgium. From 1990 until 2000, Dr. Vanryckeghem served as managing editor of the Journal of Fluency Disorders. She is a member of ASHA's inaugural cadre of fluency specialists and ASHA Fellow.
Abstract: The journey since the incipient stages of Two Factor theory has been an expedition that spans many decades and crosses many continents. This theoretical model led to applied research and set the stage for the design of a series of standardized tests exploring the different components that surround stuttering. Realizing that the assessment of a person who stutters needs to move beyond clinical observation so as to include the perspective of the individual, Brutten and colleagues researched a number of standardized self-report tests cross-culturally. This "view from within" augments clinical observation, leads to improved differential diagnosis and the reduction of false positives and negatives. In addition, this inside perspective supplements therapeutic planning, pointing to the targets of treatment. Specifically, this presentation will focus on one particular dimension of stuttering as a multi-modal disorder: the evaluation of speech-associated attitude. This cognitive component has shown to have a powerful impact on the individual who stutters. Recent research revealed that even preschoolers who stutter, as a group, think negatively about their speech. This phenomenon increases with age and needs the clinician's attention early on.
Affiliation: Thomas More University College, Antwerp, Belgium & ECSF consortium
Title: Inhibition and attention in childhood stuttering
Kurt Eggers, Ph.D., is head of the SLT and audiology department at Thomas More U College, visiting lecturer at the U of Oulu and Turku U (Finland), and ECSF-coordinator. He has lectured nationally and internationally on fluency disorders and his research focuses on the role of temperament & attentional processes in stuttering, normal speech disfluencies, and disfluencies in Down syndrome.
Abstract: Current paper gives an overview of the main research findings of this group in the area of temperament and attentional processes. Initial questionnaire-based studies showed differences on inhibitory control and attentional functioning between CWS and CWNS. Consecutive computer paradigm-based studies corroborated these findings by revealing differences on the efficiency of attentional networks, response control, and auditory attentional shifting. Findings will be linked to the available literature of other research groups.
Shelly Jo Kraft
Affiliation: Wayne State University, USA
Title: The genetic proclivity of stuttering
Shelly Jo Kraft, Ph.D., is an Assistant Professor at Wayne State University where she serves as the Director of the Behavioral Speech and Genetics Laboratory. Her current research focuses on the identification of genes associated with developmental stuttering, neuro-functional and anotomical correlates, and factors contributing to stuttering severity in children and adults.
Abstract: Clear evidence exists for heritability of developmental stuttering, and much interest is focused on the identification of causal genes for the disorder. Linkage analysis is a powerful tool used to detect the location of associated genes in related individuals who all share in a particular trait. In an effort to understand the seemingly elusive genetic etiology of stuttering, a linkage strategy for locating multiple genes, each of large to moderate effect, was initiated in the sizable recruitment of families ascertained for high-density profiles and Caucasian, Western European ancestry. The identification of risk alleles in the largest non-consanguineous family study employing genome-wide linkage will be reported with whole-exome sequencing data for 97 multigenerational families (n=1154). This presentation will discuss different strategies of linkage, association, and exome sequencing as well as combined approaches that incorporate functional theories behind the various endophenotypes of stuttering.
Affiliation: Honorary researcher at the Bristol Speech & Language Therapy Research Unit and visiting fellow at the University of the West of England, Bristol, UK
Title: We're all in it for the outcomes but which ones?
Rosemarie Hayhow has worked with stuttering for 40 years in clinical, educational and research settings. She is interested in personal experiences of therapy and how these can help us identify the components and processes of therapy and better understand what facilitates or hinders change.
Abstract: We have moved into an era where therapy is increasingly commissioned on the basis of outcomes that demonstrate the efficient achievement of meaningful goals in association with different treatment options. The notion of clinic based evidence has been received enthusiastically at conferences and yet in the face of diminishing services we still argue over which measures best reflect what professionals and service users can and wish to achieve. This presentation explores some of the history and problems around outcome measurement and looks to the future where agreed outcomes could improve our chances of providing funded care for people of all ages who stutter. In addition, the right measures could facilitate national and international comparisons on different care pathways and treatment approaches. We might even learn about matching ‘what works' with those for whom it works best.
Yvonne van Zaalen
Affiliation: Fontys University of Applied Sciences, Eindhoven, The Netherlands & ECSF consortium
Title: Cluttering and persons with mental challenges
Yvonne van Zaalen, president of the International Cluttering Association, is an associate professor at Fontys University, Eindhoven, the Netherlands. Her area of research is the production of speech and language processes in (dis)fluent speech. As a senior fluency specialist she has three decades of experience working with people with cluttering and stuttering.
Abstract: Reference is made to stuttering - as one of the primary characteristics in the description of various syndromic intellectual disabilities. Specifically, Down syndrome and Fragile-X syndrome include "stuttering" as a characteristic of speech. In recent years this understanding has come under increasing scrutiny by researchers and clinicians. An extensive literature review and experimental research indicate that although the speech of people with Down Syndrome or Fragile-X can be identified as disfluent, the described characteristics in many cases refer to cluttering or another disfluency type more than they refer to stuttering. The complex relationship between cognition, language, fluency and intelligibility is investigated.