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Early Treatment Benefits Preschool Stutterers

Behavioral Therapy Helps, Study Shows
WebMD Health News

Sept. 22, 2005 - Stuttering is common among young children. Though most will develop normal speech by the time they reach school age, new research suggests that early treatment may make all the difference for some kids.

Early evaluation is important for all preschoolers who stutter, according to the researchers, because it is impossible to be certain which children will stop stuttering without help and which ones will continue to stutter.

"Parents who ignore early stuttering could be condemning their child to a lifetime of struggling to speak," says Mark Onslow, PhD, who directs the Australian Stuttering Research Center. "Your child might recover without treatment, but that is a big risk to take," he notes in the strongly worded statement.

Praise Good Speech

Onslow and colleagues developed a behavioral treatment - called the Lidcombe programme -- for preschool-age stutterers now widely used in Australia, Europe, Canada, and the United States. The treatment is administered by parents during their normal interactions with their children, rather than by a professional in a clinical setting.

Parents learn when to praise normal speech and call attention to stuttered speech in training sessions with speech pathologists. The general rule is that normal speech is acknowledged five times for each time the stuttered speech is mentioned, but this is flexible, Onslow says.

Parents also learn how to evaluate their child's stuttering in clinical terms to help the speech pathologist assess progress.

"Conceptually this is ridiculously simple, but it actually requires a great deal of training," Onslow tells WebMD.

In the Sept. 24 issue of the British Medical Journal, the Australian researchers report on a study involving 54 preschoolers who did and did not receive the treatment.

The treated children had significantly improved speech at nine months compared with the untreated children, with stuttering decreasing by 77% and 43%, respectively.

Onslow says the findings prove that early intervention can make a big difference.

'The Earlier the Better'

As many as one in five children experience some degree of stuttering as they begin to develop language, according to the advocacy group The Stuttering Foundation. Young children often start stuttering between the ages of 2 and 6, and three times as many preschool-aged boys stutter as girls.

Stuttering can be so minor that it is barely perceptible, or it can be so severe that children find it hard to communicate.

While the Australian approach is not the only treatment for early stuttering, it is the only one that has been studied extensively, says J. Scott Yaruss, PhD. Yaruss is co-director of the Stuttering Center of Western Pennsylvania.

He tells WebMD that there is a growing consensus that young children who stutter do benefit from treatment.

"There was a time when the field did not embrace this, but fortunately I think that time has passed," he says.

Yaruss says children with a family history of stuttering and children who are very bothered by it tend to be more at risk for continuing to stutter.

"But we can't say with certainty that a child will or will not grow out of it," he says. "That is why parents shouldn't wait. Children who stutter should be evaluated and treated, if necessary: the earlier the better."

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