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Fresh science and pioneering practice
130
JCPSLP
Volume 17, Number 3 2015
Journal of Clinical Practice in Speech-Language Pathology
Brenda Carey
(top), Sue
O’Brian (centre),
Mark Onslow
THIS ARTICLE
HAS BEEN
PEER-
REVIEWED
KEYWORDS
CAMPERDOWN
PROGRAM
STUTTERING
TECHNOLOGY
Technology in practice
The Camperdown Program
Brenda Carey, Sue O’Brian, and Mark Onslow
Packman, 2003). This treatment has been chosen because
it has been used both for in-clinic and telepractice clinical
trials, and has outcomes from randomised controlled trials
that have been published in peer-reviewed journals (Carey
et al., 2010).
The Camperdown Program is a speech restructuring
treatment that was designed for adults (O’Brian et al., 2003)
and has since been adapted for use with adolescents
(Carey, O’Brian, Lowe, & Onslow, 2014; Carey, O’Brian,
Onslow, Packman, & Menzies, 2012; Hearne, Packman,
Onslow, & O’Brian, 2008). Speech restructuring refers to
the use of a novel speech technique to reduce stuttering
(Onslow & Menzies, 2010). Data have been presented for
19 adults who stutter who have participated in two in-clinic
treatment trials (O’Brian et al., 2003; O’Brian, Cream,
Onslow, & Packman, 2001). In addition, data have been
presented for 32 adults who stutter who have participated
in three telepractice trials of this treatment (Carey et al.,
2010; Erickson et al., 2012; O’Brian, Packman, & Onslow,
2008). Outcomes show that for adults, the program when
delivered in-clinic and by telepractice is efficacious, has
high client satisfaction, and is more efficient than traditional
intensive treatment formats of other programs (for example,
see Boberg & Kully, 1994; Onslow, Costa, Andrews,
Harrison, & Packman, 1996; Block, Onslow, Packman,
Gray, & Dacakis, 2005). Reductions in stuttering have been
maintained for 6–12 months post treatment. The mean
number of clinician contact hours to the maintenance stage
of the treatment has ranged from 8–20. For adolescents,
there have been fewer treatment trials. Data have been
presented for 20 adolescents who participated in three
telepractice and in-clinic trials (Carey et al., 2012, 2014;
Hearne et al., 2008). Outcomes for adolescents show more
variability in stuttering reduction. In the largest of these trials
(Carey et al., 2014), adolescents significantly reduced their
stuttering frequency and severity; however, only half of the
participants reduced their avoidance of speaking situations.
For the three adolescent trials, the mean number of clinician
contact hours to the maintenance stage of the treatment
has ranged from 11–16. For both adults and adolescents in
the Camperdown Program trials, in-clinic and telepractice,
reductions in self-reported severity ratings are consistent
with those shown from %SS data. Satisfaction outcomes,
when obtained, have also been favourable.
Assessment
Whether the consultation is in-clinic or by telepractice, for
most clients engagement with technology often begins well
During the past two decades, new technologies
have led to the development of telepractice in
medicine generally, and speech pathology
specifically. However, more recently, the
influence of technology is extending beyond
telepractice, affecting all that we do in the
clinic. This paper uses the Camperdown
Program, a treatment for adolescents and
adults who stutter, to demonstrate this idea. It
describes how technology may be integrated
into the four stages of the Camperdown
Program in ways that may make treatment
more accessible, realistic, and engaging for
clients. Risks to integrating technology into
our clinical practice are identified.
T
echnology has been described as “the branch of
knowledge that deals with the creation and use
of technical means and their interrelation with life,
society, and the environment”
(Dictionary.com,n.d.). It
influences the way we live, and consequently the way we
work. In relation to speech pathology practice, it has long
been used in the form of unsophisticated tools like tape
recorders and rating machines. In recent years, technology
has involved such devices as the Internet, computers
and their many applications, iPads, recording devices,
and smartphones. Arguably, in the last two decades, the
influence of technology has been greatest in increasing
access to stuttering treatments through telepractice.
Telepractice is “the application of telecommunications
technology to deliver clinical services at a distance … for
the purposes of assessment, intervention, consultation
and/or supervision” (Speech Pathology Australia, 2014,
p. 4). Over that time, many children, adolescents and
adults in several countries have participated in clinical trials
evaluating the efficacy of stuttering treatment delivered
by telepractice. There are published telepractice clinical
trials ranging from single case studies to randomised
controlled trial designs (for a review of these see Lowe,
O’Brian, & Onslow, 2014). While technology continues
to drive telepractice treatment and research, today its
influence arguably extends far beyond telepractice. Given
this expanding influence, it seems timely to consider how
technology is being used more generally in our clinical
practice today. The treatment used in this exploration is
the Camperdown Program (O’Brian, Onslow, Cream, &