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28

ACQ

Volume 12, Number 1 2010

ACQ

uiring knowledge in speech, language and hearing

Outcomes for the reported clients have been gained

retrospectively through a file audit and are therefore limited in

generalisability. However, there is little outcome information

in the literature on weekly PS treatment to guide clinicians.

Hence, this paper provides some preliminary information

indicating that for some adults who stutter, a one-hour weekly

PS treatment program may be a viable option to consider.

References

Block, S., Onslow, M., Packman, A., Gray, B., & Dacakis, G.

(2005). Treatment of chronic stuttering: outcomes from a

student training clinic.

International Journal of Language and

Communication Disorders

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,(4), 455–466.

Carey, B., O’Brian, S., Onslow, M., Block, S., & Jones,

M. (2009). A randomised controlled non-inferiority trial

of a telehealth treatment for chronic stuttering: the

Camperdown Program.

International Journal of Language

and Communication Disorders

(electronic publication ahead

of print, retrieved 22 April 2009).

Harrison, E., Onslow, M., Andrews, C., Packman, A., &

Webber, M. (1998). Control of stuttering with prolonged

speech: preliminary outcome of a one-day instatement

program. In A. K. Cordes and R. J. Ingham (Eds.),

Treatment

efficacy for stuttering: A search for empirical bases

(pp.

191–212). San Diego, CA: Singular Publishing Group.

James, J.E. (1981). Behavioral self-control of stuttering

using time-out from speaking.

Journal of Applied Behavior

Analysis

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, 25–37.

James, J.E., Ricciardelli, L.A., Hunter, C.E., & Rogers, P.

(1989). Relative efficacy of intensive and spaced behavioural

treatment of stuttering.

Behaviour Modification

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, 376–395.

O’Brian, S., Onslow, M., Cream, A., & Packman, A.

(2003). The Camperdown Program: Outcomes of a new

prolonged speech treatment model.

Journal of Speech,

Language and Hearing Research

,

46

, 933–946.

O’Brian, S., Packman, A., & Onslow, M. (2008). Telehealth

delivery of the Camperdown Program for adults who stutter:

A phase 1 trial.

Journal of Speech, Language, and Hearing

Research

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, 184–195.

Onslow, M. (1996).

Behavioural Management of Stuttering

.

San Diego, CA: Singular Publishing Group, Inc.

Onslow, M., & Packman, A. (1997). Designing and

implementing a strategy to control stuttered speech in

adults. In R. F. Curlee and G.M. Siegel (Eds.),

Naturalness

and treatment of stuttering new directions

. (pp. 356–376).

Needham Heights, MA: Allyn and Bacon.

Packman, A., Onslow, M., & Van Doorn, J. (1994).

Prolonged speech and the modification of stuttering:

Perceptual, acoustic, and electroglottographic data.

Journal

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, 724–737.

or improved upon their negotiated criteria. C3 showed a

marginal increase in SRs and %SS from those gained at the

end of the weekly treatment phase. It is noteworthy that C5

did not require all elements of PS to control his stutter.

Discussion

Teaching PS in a one-hour weekly format was an effective

service delivery model for these clients. Despite treatment

visits being spaced a week apart, clients were able to learn

the PS pattern, vary their naturalness levels and apply PS in

everyday situations to reduce their stuttering severity, as

evidenced by beyond clinic SRs. As previously stated, one

client, C3, showed an increase in severity at the end of

maintenance. This increase, however, still fell within the

range of his maintenance criteria and was at levels that C3

reported being satisfied with.

In describing the outcomes of a One-Day Instatement

Program for PS Harrison et al. (1998) reported that 24

treatment hours were required for clients to reach the

maintenance phase. For the Camperdown Program

outcomes, O’Brian et al. (2003) reported an average of 20.1

hours (range 13–29 hours) to reach the maintenance phase.

Block et al. (2005) reported that 45 hours were required to

complete the instatement and transfer phases of a 5-day

intensive PS treatment. The treatment duration for the five

clients presented in this paper was an average of 23 hours

(range 8–43) and is comparable to these other publications.

For certain clients providing PS treatment on a weekly

basis can be advantageous. Weekly treatment can be

tailored to individual client needs particularly in regards to

their goals, learning styles, and circumstances. This is of

great consequence for clients who require an interpreter or

have limited English competency. Additionally, some clients

(e.g., C5) may not require all elements of PS to control their

stutter so treatment can be flexible. Further, when clients

are treated in a non-intensive weekly format, generalisation

of PS is not likely to be adversely affected. Clients can ease

into the use of PS during everyday life situations (Onslow

& Packman, 1997). Finally, many speech pathology clinics

would be able to implement this service delivery model. For

example, weekly treatment is potentially more accessible

to isolated or rural clinicians who may not have appropriate

resources to provide a group intensive treatment format and

smaller clinics who may not receive sufficient numbers of

adult referrals in order to form a group.

There are disadvantages of weekly treatment. For some

clients, treatment may take longer than reported in the

more recent intensive format literature. It is difficult to

determine whether clients treated individually are potentially

“missing” valuable learning experiences that may take

place in a group/intensive format. For example, being able

to interact and practice with other people who stutter or

being exposed to using PS for an extended period of time.

Hearne et al. (2008) hypothesised that for adolescents, the

group component of the intensive day of the Camperdown

Program may be beneficial due to peer support. This may

be relevant to adults. Lastly, more intensive practice of PS

may be indicated if the client is not progressing in a weekly

format.

The method described in this paper is one way of teaching

PS. There are alternative methods described in the literature

that clinicians might consider, in particular that described in

the Camperdown Program (O’Brian et al., 2003; Carey et

al., 2008). Clinicians need to consider the literature as well

as clients’ needs and responsiveness to various teaching

methods when deciding how to implement treatment.

Wendy Lloyd

has worked at the Stuttering Unit, Bankstown Health

Service, for 6 years. Wendy treats adults and children of all ages

who stutter and provides phone consultations to speech pathologists

across Australia. Wendy contributes to the Continuing Professional

Education in Stuttering (CPES) program run in conjunction with the

Australian Stuttering Research Centre and Macquarie University

through clinical observation days and workshops.

Correspondence to:

Wendy Lloyd

Locked mailbag 1600

Bankstown, NSW, 2200

phone: + 61 2 9780 2766

email:

wendy.lloyd@sswahs.nsw.gov.au