Speech Outcomes of a Prolonged-Speech Treatment for Stuttering

1996 ◽  
Vol 39 (4) ◽  
pp. 734-749 ◽  
Author(s):  
Mark Onslow ◽  
Leanne Costa ◽  
Cheryl Andrews ◽  
Elisabeth Harrison ◽  
Ann Packman
Keyword(s):  
Outcome Measures ◽  
Treatment Program ◽  
Free Speech ◽  
Outcome Research ◽  
Speech Rate ◽  
Residential Setting ◽  
Detailed Data ◽  
Rate Range ◽  
Posttreatment Period ◽  
Speech Naturalness

It has been shown that people who stutter can speak with greatly reduced stuttering after treatments that use variations of Goldiamond's (1965) prolonged-speech (PS). However, outcome research to date has not taken account of several important issues. In particular, speech outcome measures in that research have been insufficient to show that lasting relief from stuttering has been achieved by clients outside the clinic for meaningful periods. The present study used extensive speech outcome measures across a variety of situations in evaluating the outcome of an intensive PS treatment (Ingham, 1987). The speech of 12 clients in this treatment was assessed on three occasions prior to treatment and frequently—on eight occasions—after discharge from the residential setting. For 7 clients, a further assessment occurred at 3 years posttreatment. Concurrent dependent measures were percent syllables stuttered, syllables per minute, and speech naturalness. The dependent measures were collected in many speaking situations within and beyond the clinic. Dependent measures were based on speech samples of substantive duration, and covert assessments were included in the study. Detailed data were presented for individual subjects. Results showed that 12 subjects who remained with the entire 2-3-year program achieved zero or near-zero stuttering. The majority of subjects did not show a regression trend in %SS or speech naturalness scores during the posttreatment period, either within or beyond the clinic. Some subjects showed higher posttreatment %SS scores during covert assessment than during overt assessment. Results also showed that stuttering was eliminated without using unusually slow and unnatural speech patterns. This treatment program does not specify a target speech rate range, and many clients maintained stutter-free speech using speech rates that were higher than the range typically specified in intensive PS programs. A significant correlation was found between speech rate and perceived posttreatment speech naturalness.

Treatment and Generalization Effects in an Experimental Treatment for a Stutterer Using Contingency Management and Speech Rate Control

1977 ◽  
Vol 42 (3) ◽  
pp. 394-407 ◽  
Author(s):  
Roger J. Ingham ◽  
Ann Packman
Keyword(s):  
Treatment Program ◽  
Free Speech ◽  
Rate Control ◽  
Speech Rate ◽  
Contingency Management ◽  
Experimental Treatment ◽  
Rate Range ◽  
Negative Findings ◽  
Control Procedures

An experimental treatment program for an adult stutterer, using contingency management and rate control procedures, is described. During laboratory sessions, a combination of both procedures resulted in maintained stutter-free speech within a target speech rate range. Bidaily recordings of the subject’s speech across all non-laboratory speaking situations, preceding and throughout the laboratory treatment, revealed no correspondence between laboratory and nonlaboratory speech behavior. Some positive and negative findings from this study are considered with respect to contingency management of stuttering.

Speech Naturalness and Prolonged-Speech Treatments for Stuttering

1992 ◽  
Vol 35 (2) ◽  
pp. 274-282 ◽  
Author(s):  
Mark Onslow ◽  
Brett Hayes ◽  
Leanne Hutchins ◽  
Denis Newman
Keyword(s):  
Treatment Program ◽  
Free Speech ◽  
Significant Positive Correlation ◽  
Speech Quality ◽  
Positive Correlation ◽  
Empirical Information ◽  
Scale Scores ◽  
Quality Assessments ◽  
Speech Naturalness

It is well known that unusual speech quality may result from stuttering treatments that are based on prolonged speech. However, empirical information concerning the speech quality associated with those treatments is lacking. The present study was designed to contribute such empirical information. Results indicated that speech quality assessments of posttreatment clients, using Martin, Haroldson, and Triden's (1984) speech naturalness scale, gave similar results regardless of whether they were based on monologues or conversations. The speech quality of those clients remained stable at the conclusion of their treatment program. Further, there was a significant, positive correlation between pretreatment speech measures and measures of speech naturalness made after the establishment of stutter-free speech. The subjects whose pretreatment stuttering was the most severe had posttreatment speech naturalness scores that were more than two scale values worse than the subjects whose pretreatment stuttering was the least severe. Speech naturalness scale scores are presented for nonstutterers and posttreatment stutterers and these data are compared with existing findings.

scholarly journals Long-term improvements following a residential combined physical and psychological programme for chronic low back pain

2021 ◽  
Vol 10 (2) ◽  
pp. e001068
Author(s):  
Shaun Wellburn ◽  
Cormac G Ryan ◽  
Andrew Coxon ◽  
Alastair J Dickson ◽  
D John Dickson ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Outcome Measures ◽  
Chronic Low Back Pain ◽  
Rating Scale ◽  
Secondary Outcome ◽  
Low Back ◽  
Residential Setting ◽  
Wide Range

ObjectivesEvaluate the outcomes and explore experiences of patients undergoing a residential combined physical and psychological programme (CPPP) for chronic low back pain.DesignA longitudinal observational cohort design, with a parallel qualitative design using semistructured interviews.SettingResidential, multimodal rehabilitation.Participants136 adults (62 male/74 female) referred to the CPPP, 100 (44 male/56 female) of whom completed the programme, during the term of the study. Ten (2 male/8 female) participated in the qualitative evaluation.InterventionA 3-week residential CPPP.Outcome measuresPrimary outcome measures were the STarT Back screening tool score; pain intensity—11-point Numerical Rating Scale; function—Oswestry Disability Index (ODI); health status/quality of life—EQ-5D-5L EuroQol five-Dimension-five level; anxiety—Generalised Anxiety Disorder-7; depression—Patient Health Questionnaire-9. Secondary outcome measures were the Global Subjective Outcome Scale; National Health Service Friends and Family Test;.ResultsAt discharge, 6 and 12 months follow ups, there were improvements from baseline that were greater than minimum clinically important differences in each of the outcomes (with the sole exception of ODI at discharge). At 12 months, the majority of people considered themselves a lot better (57%) and were extremely likely (86%) to recommend the programme to a friend. The qualitative data showed praise for the residential nature of the intervention and the opportunities for interaction with peers and peer support. There were testimonies of improvements in understanding of pain and how to manage it better. Some participants said they had reduced, or stopped, medication they had been taking to manage their pain.ConclusionsParticipants improved, and maintained long term, beyond minimum clinically important differences on a wide range of outcomes. Participants reported an enhanced ability to self-manage their back pain and support for the residential setting.

Methodologic Issues regarding Outcome Measures for Clinical Drug Trials of Psychiatric Complications in Dementia

1995 ◽  
Vol 8 (1_suppl) ◽  
pp. 8-17
Author(s):  
Linda Teri ◽  
Rebecca G. Logsdon
Keyword(s):  
Outcome Measures ◽  
Outcome Research ◽  
Drug Trials ◽  
Psychometric Characteristics ◽  
Content Assessment ◽  
Dementia Patients ◽  
Prior Use ◽  
Clinical Drug Trials ◽  
Psychiatric Complications ◽  
Clinical Drug

Selecting outcome measures that are both psychometrically sound and sensitive to change is a very important aspect of clinical outcome research. A variety of measures have been introduced in recent years to assess behavioral complications in dementia, but few have been adequately tested in clinical trials. This article provides a discussion of factors to consider in selecting measures, including psychometrics, item content, assessment source, and sensitivity to change. A review of behavioral and psychiatric measures for dementia patients is provided, including measures of general behavioral disturbance, and measures specifically developed for agitation and depression. Each measure's psychometric characteristics, prior use with demented patients, and strengths and weaknesses with regard to treatment outcome research is summarized. The importance of linking measures to the investigators’ hypotheses is discussed, along with recommendations for evaluating and selecting outcome measures depending on the needs of the specific investigation. ( J Geriatr Psychiatry Neurol 1995; 8(suppl 1):S8–S17).

Patient- and Clinician-Rated Outcome Measures for Clinical Decision Making in Rehabilitation

2011 ◽  
Vol 20 (1) ◽  
pp. 37-45 ◽  
Author(s):  
Lori A. Michener
Keyword(s):  
Decision Making ◽  
Outcome Measures ◽  
Program Development ◽  
Treatment Program ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Daily Activities ◽  
Outcomes Of Care ◽  
Injury Patient ◽  
The Impact

Outcome measures can be classified as clinician rated and patient rated. Clinician-rated measures predominantly assess impairments, whereas patient-rated measures, also known as patient-based measures, are designed to evaluate the impact of the injury on a patient’s daily activities, work, and recreation. Currently, there is a greater reliance on clinician-rated impairment measures for clinical decision making, specifically with treatment planning and assessing outcomes of care. To comprehensively evaluate the effect of an injury, patient-rated outcome measures must be used because they allow for the assessment of a patient’s ability to perform daily activities and participate in work and recreation that is affected by an injury. Clinician-rated impairment measures should be used to guide the development of a treatment program, and patient-rated measures should be used for both treatment-program development and assessing treatment outcomes in daily clinical practice. The purposes of this article are to describe patient- and clinician-rated outcome measures and to provide guidance and illustrate the benefits of the use of these measures in clinical decision making and documenting outcomes of care.

The Modification of Speech Naturalness During Rhythmic Stimulation Treatment of Stuttering

2001 ◽  
Vol 44 (4) ◽  
pp. 841-852 ◽  
Author(s):  
Roger J. Ingham ◽  
Wendy Sato ◽  
Patrick Finn ◽  
Heather Belknap
Keyword(s):  
Second Language ◽  
Adolescent Girls ◽  
Free Speech ◽  
Rhythmic Stimulation ◽  
Adult Esl ◽  
Adult Participant ◽  
Problematic Aspect ◽  
Speech Naturalness ◽  
Fluent Speakers

This study investigated the modification of speech naturalness during stuttering treatment. It systematically replicated an earlier study (Ingham & Onslow, 1985) that demonstrated that unnatural-sounding stutter-free speech could be shaped into more natural-sounding stutter-free speech by using regular feedback of speech-naturalness ratings during speaking tasks. In the present study, the same procedure was used with three persons who stutter—2 adolescent girls and 1 adult man—during rhythmic stimulation conditions. The two adolescent participants spoke only English, but Spanish was the first and English the second language (ESL) of the adult participant. For the 2 adolescents, it was demonstrated that their unnatural-sounding rhythmic speech could be shaped to levels found among normally fluent speakers without losing the fluency-inducing benefits of rhythmic speech. The findings indicate that speech-naturalness feedback may be a powerful procedure for overcoming a problematic aspect of rhythmic speech treatments of stuttering. However, it was not possible to deliver reliable speech-naturalness feedback to the adult ESL speaker, who also displayed a strong dialect. The study highlights the need to find strategies to improve interjudge agreement when using speech-naturalness ratings with speakers who display a strong dialect.

scholarly journals Using Syllabic Speech Technique to Decline Stuttering Severity in Persian-speaking School-age Children With Stuttering

2021 ◽  
Author(s):  
Peyman Zamani ◽  
Neda Tahmasebi ◽  
Mohammad Soroush Mehdifard ◽  
Saeed Hesam
Keyword(s):  
Outcome Measures ◽  
Free Speech ◽  
School Age Children ◽  
School Age ◽  
Single Group ◽  
Time Points ◽  
Significant Difference ◽  
Preliminary Study ◽  
T1 And T2 ◽  
Verbal Encouragement

Introduction: Studies have shown that Syllable Speech Technique (SST) can be a useful  and practical way to achieve stutter-free speech for Children With Stuttering (CWS). In this preliminary study, the use of SST in Persian-speaking school-age CWS was investigated. Materials and Methods: Ten 8- to 11-year-old students with stuttering were entered in the single-group pretest-posttest study as participants. Their speech fluency has been enhanced using SST accompanied by verbal encouragement for stutter-free speech. The percentage of stuttered syllables, stuttering severity, and communication attitude as outcome measures were evaluated in three time points: before the intervention (T0), after the intervention (T1), and one month after the intervention (T2). Results: The children showed significantly better scores on all outcome measures at T1 (P≤0.004) and T2 (P≤0.005) compared with T0. There was no significant difference between T1 and T2 (P≥0.026). Conclusion: The reported benefits of SST in stuttering reduction and speech-related anxiety- relieving of Persian-speaking school-age CWS confirms the feasibility and usefulness of this technique.

Does Psychotherapy Help Some Students? An Overview of Psychotherapy Outcome Research

2006 ◽  
Vol 9 (5) ◽  
pp. 2156759X0500900
Author(s):  
Kelly C. Eder ◽  
Susan C. Whiston
Keyword(s):  
Standard Deviation ◽  
Children And Adolescents ◽  
Therapeutic Relationship ◽  
Outcome Measures ◽  
Outcome Research ◽  
Psychotherapy Outcome ◽  
Clinical Issues ◽  
Psychotherapy Outcome Research ◽  
Meta Analyses

This article provides a brief overview of the outcome research on psychotherapy with children and adolescents. Outcome research indicates that psychotherapy can be effective with both children and adolescents, with meta-analyses indicating that youth who participated in this type of intervention tended to score on the outcome measures half of a standard deviation or more above those who did not receive any intervention. Little is known about the process of psychotherapy with children, but there are some indications that the therapeutic relationship is important. Moreover, there is some research that supports the assumption that certain types of treatment are most helpful with specific clinical issues.

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