Evidence for the treatment of co-occurring stuttering and speech sound disorder: A clinical case series

Abstract

Purpose: There is a paucity of evidence to guide treatment for children with co-occurring stuttering and speech sound disorder. Some guidelines suggest treating the two disorders simultaneously using indirect treatment approaches; however, the research supporting these recommendations is over 20 years old. In this clinical case series, we investigate whether these co-occurring disorders could be treated concurrently using direct treatment approaches supported by up-to-date, high-level evidence, and whether this could be done in an efficacious, safe and efficient manner.

Method: Five pre-school-aged participants received individual concurrent, direct intervention for both stuttering and speech sound disorder. All participants used the Lidcombe Program, as manualised. Direct treatment for speech sound disorder was individualised based on analysis of each child’s sound system.

Result: At 12 months post commencement of treatment, all except one participant had completed the Lidcombe Program, and were less than 1.0% syllables stuttered on samples gathered within and beyond the clinic. These four participants completed Stage 1 of the Lidcombe Program in between 14 and 22 clinic visits, consistent with current benchmark data for this programme. At the same assessment point, all five participants exhibited significant increases in percentage of consonants correct and were in alignment with age-expected estimates of this measure. Further, they were treated in an average number of clinic visits that compares favourably with other research on treatment for speech sound disorder.

Conclusion: These preliminary results indicate that young children with co-occurring stuttering and speech sound disorder may be treated concurrently using direct treatment approaches. This method of service delivery may have implications for cost and time efficiency and may also address the crucial need for early intervention in both disorders. These positive findings highlight the need for further research in the area and contribute to the limited evidence base.

Keywords:

• Lidcombe Program
• childhood stuttering
• speech sound disorder
• concurrent treatment

Declaration of interest

The authors report no conflicts of interest.

Funding

This research was supported by funds provided to research higher degree candidates by the School of Humanities and Social Science, University of Newcastle, Australia. These funds support various administrative aspects of their candidature. This research was also supported by an Australian Postgraduate Award; and in-part by a Speech Pathology Australia Research Higher Degree Student Research Grant.

Notes

1 For more detailed information regarding the treatment procedures for each participant in this research study, please use the following link to download a copy of the first author’s PhD thesis: http://hdl.handle.net/1959.13/1296498

2 This study was conducted using an earlier (2011) version of the LP training manual. The current version (Packman et al., 2016) no longer includes %SS as a compulsory weekly/clinical measure.

3 Note that in the revised version of this treatment manual, the SR scale has changed to a 9-point scale (where 0 = no stuttering and 9 = extremely severe stuttering) (Packman et al., 2016).

4 These errors were interpreted as being age appropriate, delayed, or atypical in line with available normative information (Grunwell, 1987, 1997).

5 Note that data is missing for participant 5, as they did not complete Stage 1 of the LP while enrolled in this research study