Speak Out low res October 2016

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16 Speak Out October 2016
Association news
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
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.
Clinical guideline for
stuttering management
The Clinical
Guideline for
Stuttering
Management
is a timely
event in light
of two pivotal
developments in
the field.
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.
1Sackett, 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 Journal, 312, 71–72.