Speak Out October 2016

Association news

The Clinical Guideline for Stuttering Management is a timely

event in light of two pivotal developments in the field.

Clinical guideline for stuttering management

Last year Speech Pathology Australia commissioned the preparation of a Clinical Guideline for Stuttering Management. Mark Onslow, Director of the Australian Stuttering Research Centre at The University of Sydney, was recruited as the project officer he reports on the guideline’s recent release.

provided by the Australian National Health and Medical Research Council. During the second part of last year a draft was circulated for comment to the speech pathology community and to the Australian Speak Easy Association, and early this year the guideline was made available on the Speech Pathology Australia website. The guideline focuses on clinical targets of behavioural control of stuttering and the management of mental health problems, which appear to be fundamental to the presenting complaints of those who stutter and their parents. Clinical trials are included within the guideline as the fundamental unit of clinical research that is informative for clinicians. Among the more vexing issues for the working party was to make a defensible recommendation to the profession about how to measure and manage any mental health problems experienced by adult and child clients. That is a critical issue because attainment of benchmark clinical skills with assessment and management of mental health issues is beyond the jurisdiction of the speech pathology profession. Working party members Lana McCarthy Private Practice, Sydney Amanda Lyons Mater Health and Wellness, Brisbane Shane Erickson School of Allied Health, La Trobe University Monique Maguire Private Practice, Melbourne Brenda Carey Private Practice, Melbourne Adriana Penman School of Health and Rehabilitation Sciences, University of Queensland Anna Hearne College of Humanities and Social Sciences, Massey University, Auckland The guidelines are currently available to view on the SPA website. 1 Sackett, D. L., Rosenburg, W. M. C., Gray, J. A. M., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: What it is and what it isn’t. British Medical Journa l, 312, 71–72.

A call for expressions of interest was disseminated to the Australian speech pathology community, which led to the appointment of three working party leaders: Robyn Lowe from the Australian Stuttering Research Centre, and Verity MacMillan and Stacey Sheedy from the Stuttering Unit, South West Sydney Local Health Network, Sydney. Robyn led the working party for adult management, and Stacey and Verity led working parties for pre- school children and school-aged and adolescent clients. There were seven members of the working party, who are listed below. The Clinical Guideline for Stuttering Management is a timely event in light of two pivotal developments in the field. The first is increasing evidence during past decades of quality of life impairment caused by stuttering during the life-span, notably mental health problems. Recent findings are showing evidence of mental health problems emerging during the primary school years for children who stutter. The second development is increasing and compelling evidence for effective clinical control of stuttering shortly after onset during early childhood. Considered together, those developments present speech pathologists with an imposing duty of care for clients who stutter. In the first instance they are duty bound to do all that is possible to provide early effective intervention to stop the adverse developmental course of the disorder. For those clients who develop chronic stuttering, speech pathologists are responsible for providing assessment and management of the speech problems associated with the disorder. It is also their responsibility to screen for any associated mental health problems and to ensure such health problems are managed properly by the appropriate health professional. The working party incorporated principles of evidence-based practice in its considerations, using the well-known definition of it being, “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” (p71), incorporating considerations of clinical expertise and client needs. Clinical trials were classified using guidelines

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October 2016 www.speechpathologyaustralia.org.au

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