Tika Ormond

Extended follow-up of a randomized controlled trial of the Lidcombe Program of Early Stuttering Intervention

BACKGROUND In the Lidcombe Program of Early Stuttering Intervention, parents present verbal contingencies for stutter-free and stuttered speech in everyday situations. A previous randomized controlled trial of the programme with preschool-age children from 2005, conducted in two public speech clinics in New Zealand, showed that the odds of attaining clinically minimal levels of stuttering 9 months after randomization were more than seven times greater for the treatment group than for the control group. AIMS To follow up the children in the trial to determine extended long-term outcomes of the programme. METHODS & PROCEDURES An experienced speech-language therapist who was not involved in the original trial talked with the children on the telephone, audio recording the conversations using a telephone recording jack. Parental reports were gathered in addition to the childrens speech samples in order to obtain a balance of objective data and reports from a wide range of situations. OUTCOMES & RESULTS At the time of this follow-up, the children were aged 7-12 years, with a mean of 5 years post-randomization in the 2005 trial. Twenty of the 29 children in the treatment arm and eight of the 25 children in the control (no treatment) arm were able to be contacted. Of the children in the treatment group, one (5%) failed to complete treatment and 19 had completed treatment successfully and had zero or near-zero frequency of stuttering. Three of the children (16%) who had completed treatment successfully had relapsed after 2 or more years of speech that was below 1% syllables stuttered. Meaningful comparison with the control group was not possible because an insufficient number of control children were located and some of them received treatment after completing the trial. CONCLUSIONS & IMPLICATIONS The majority of preschool children are able to complete the Lidcombe Program successfully and remain below 1% syllables stuttered for a number of years. However, a minority of children do relapse and will require their parents to reinstate the treatment procedures.

Evaluating iPhone Recordings for Acoustic Voice Assessment

Aims: This study examined the viability of using iPhone recordings for acoustic measurements of voice quality. Methods: Acoustic measures were compared between voice signals simultaneously recorded from 11 normal speakers (6 females and 5 males) through an iPhone (model A1303, Apple, USA) and a comparison recording system. Comparisons were also conducted between the pre- and post-operative voices recorded from 10 voice patients (4 females and 6 males) through the iPhone. Participants aged between 27 and 79 years. Results: Measures from iPhone and comparison signals were found to be highly correlated. Findings of the effects of vowel type on the selected measures were consistent between the two recording systems and congruent with previous findings. Analysis of the patient data revealed that a selection of acoustic measures, such as vowel space area and voice perturbation measures, consistently demonstrated a positive change following phonosurgery. Conclusion: The present findings indicated that the iPhone device tested was useful for tracking voice changes for clinical management. Preliminary findings regarding factors such as gender and type of pathology suggest that intra-subject, instead of norm-referenced, comparisons of acoustic measures would be more useful in monitoring the progression of a voice disorder or tracking the treatment effect.

The role of language familiarity in bilingual stuttering assessment

Abstract The aim of this study was to evaluate the ability of English-speaking speech-language pathologists (SLPs) to evaluate stuttering behaviour in two Spanish–English bilingual adults who stutter (AWS1 and AWS2). The English-speaking SLPs were asked to judge the frequency, severity, type, duration, and physical concomitants of stuttering in both languages of the two AWS. The combined results from the English-speaking SLPs were then compared to the judgements of three Spanish–English bilingual SLPs. Results indicated that English-speaking SLPs (1) judged stuttering frequency to be greater in Spanish than English for AWS1, and equal in Spanish and English for AWS2, (2) were more accurate at evaluating individual moments of stuttering for the English samples compared to the Spanish samples, (3) identified fewer and less severe stuttering behaviours than the bilingual SLPs in both languages, and (4) were accurate judges of overall stuttering severity in both languages. The results correspond to past research examining the accuracy of stuttering evaluations in unfamiliar languages. Possible explanations for the findings, clinical implications, and future research directions are discussed.

Communication restriction in adults who stutter

Abstract This study explored communication restriction in adults with stuttering (AWS) by means of typical language measures obtained using the Systematic Analysis of Language Transcripts – New Zealand (SALT-NZ) software, as well as systemic functional linguistics (SFL) analyses. The areas of language productivity and complexity, modality (i.e. linguistic politeness) and the language of appraisal were compared between AWS and typically fluent speakers (adults with no stuttering (AWNS)). Ten-minute conversational samples were obtained from 20 AWS and 20 age- and sex-matched AWNS. Transcripts were analysed for quantity and complexity of verbal output, and frequency of use of modality and appraisal resource subtypes. Means comparison and correlation analyses were conducted using grouped data. AWS produced less language and less complex language than AWNS, measured by SALT-NZ and SFL indices. AWS also differed from AWNS in their use of modality resources to express politeness – they produced fewer modal operators and more comment adjuncts than AWNS. A smaller proportion of their language expressed the explicit appreciation of things. The linguistic patterns identified in the conversational language of AWS suggested a reduced openness to interpersonal engagement within communication exchanges, which may restrict opportunities for and the experience of such exchanges. The value of SFL to this area of research is discussed.

Collaborative practice and interprofessional education and workplace learning

One of the biggest challenges faced by workplace educators is the design and implementation of training that primarily requires an attitudinal change or a change in perspective. Currently in the health sector internationally there has been highlevel policy impetus given to interprofessional collaboration, yet health professions primarily educate their new practitioners in silos. The most influential consideration of the role and importance of interprofessional education (IPE) appears in reports published by the World Health Organization (WHO). In its latest report, the WHO considered a range of studies published in the literature (including a systematic review) and carried out extensive consultation culminating in the Framework for Action on Interprofessional Education and Collaborative Practice launched in 2010 (WHO, 2010).

Communication restriction in adults who stutter: Part II

ABSTRACT This article presents a follow-up study to Lee, van Dulm, Robb, and Ormond (2015). The aim was to explore communication restriction in adults with stuttering (AWS) using typical language measures and systemic functional linguistics (SFL) analyses. The article compared the pre- and post-treatment performance of AWS in language productivity and complexity, transitivity, modality, appraisal, and theme. Ten-minute conversational samples were obtained from 20 AWS before and after participation in intensive stuttering treatment. Transcripts were analysed for quantity and complexity of verbal output, and frequency of transitivity, modality, appraisal and theme resources. Between pre- and post-treatment, the following differences were observed: (1) a significant increase in frequency of modal operators, and trends approaching significance for (2) increased language complexity (3) increased language expressing appraisal. These changes suggest increased flexibility of language use in AWS following treatment, particularly towards interpersonal engagement. The value of SFL to this area of research is discussed.

Communication restriction in adults who stutter: Part III.

ABSTRACT This is the third article in a series examining communication restriction in adults with stuttering (AWS). The aim was to explore interpersonal communication behaviour in AWS at long-term treatment follow-up, using systemic functional linguistics (SFL) as an analytical framework. The performance of 10 AWS within 10-minute conversation samples was compared across pretreatment (T1), post-treatment (T2), and 12-month follow-up (T3), in terms of language productivity and complexity, modality, and appraisal. At T1 and T3, comparisons were also made to a control group (AWNS). Post-treatment increases in (1) language complexity, (2) frequency of modal operators, and (3) expression of appraisal were maintained in the AWS group at T3. No significant differences in these areas were found between AWS and AWNS at T3. The findings suggest that intensive comprehensive stuttering treatment can affect lasting functional change in interpersonal language use for AWS.