Identification and Prevention of Stuttering
by Hans Månsson, speech therapist, Bornholm, Denmark
Project description of a longitudinal study of childhood stuttering
A few decades ago assumptions on early
childhood stuttering - including intervention strategies - were rarely
based on direct information on early childhood stutterers, but mostly on
knowledge about and treatment of adult stuttering.
Non-avoidance and fluency shaping are examples of treatment of adult stuttering, which are modified to children.
In recent years scientists have studied pre-school children, who stutter, but, typical for these studies, the examined children are found by parents and/or professionals working with pre-school children, who - perhaps by coincidence - go to see a university clinic. Whether the data collected for these studies are representative for a total population, is for that reason doubtful.
In Denmark the international research, and especially that of intervention strategies have - with some delay - been the primary source of inspiration in the professional contribution to the prevention of childhood stuttering.
More detailed studies of childhood stuttering - concerning origin, characteristics, progression, prognosis, and effect of intervention - have not taken place in Denmark - yet.
The purpose of the present research work is to study early childhood stuttering by direct interaction with children who stutter and their near environment in a total population. That is to include all children born in a certain period of time in a well-defined area - namely the county of Bornholm, Denmark.
The study will contribute to the understanding of childhood stuttering as it occurs in a population, including:
In connection with the Bornholm 3-year screening model, which approximately 98% of the parents accept, all children born in 1995 and 1996 in the county of Bornholm (approx. 1000 children) are examined.
In relation to this screening the children are assessed concerning fluency disorders, and, in case of disfluencies in the speech of the child or in the family, the parents are offered a detailed examination, partly through a direct examination of the child, and partly by a detailed interview with the parents. These children/families will be followed over a period of four years.
Simultaneously a group of 48 3-year old children without fluency disorders are assessed as to the same linguistic and non-verbal skills.
The data material will been evaluated, and results, conclusions and implications will be published in the years 2000 and 2004.
Professional identification and intervention in connection with early childhood stuttering, as it presently takes place in the project period will simultaneously be described as carefully as possible so that the study can give indications as to the efficiency of the intervention effort.
Phase 1: (has been carried out)
Implementation of a preliminary study.
Period: December 1995 and January 1996.
The study included all children born
in 1990 and 1991, a total of 1042 children, in the county of Bornholm.
The intention of the study was to examine early childhood stuttering in
a well-defined population in connection with the local 3-year screening
(Reference: Dansk Audiologopædi, 1997,1 pp. 2-10, with methods and results of the preliminary study, related research and suggestions for a detailed longitudinal study in early childhood stuttering).
Phase 2: (has been carried out)
Initiatives to secure a professional and scientific quality.
Period: February - December 1997.
Establishing a support group. Members of the group are:
As a result of this initiative the following stuttering researchers are attached to the project as external consultants:
Phase 3: (has been carried out).
Period: December 1997 - February 1998.
3.1: Extension of the 3-year screening model with a module to identify prospective stuttering behaviour or other risk factors among 3-year old children.
3.2: Preparation of a detailed plan for a follow up parental interview and evaluation of the child among the families, who have accepted a closer examination.
3.3: Description of the following longitudinal research of the children with fluency disorders and their families.
3.4: Preparation of a detailed plan for the implementation of the control group examination.
3.5: Preparation of information material
and organization of course activities with a view to attract attention
to early childhood stuttering among professionals who are working with
pre-school children - e.g. health nurses, family doctors and day care personnel.
Forwarding information material to the news media in the county of Bornholm.
Implementation of the longitudinal study.
4.1: It is attempted that children offered a 3-year screening in 1998 and 1999 are offered an assessment as that mentioned in phase 3.1. If the child is stuttering, has been stuttering and/or has a family history concerning stuttering the parents will be interviewed more carefully in regard to the linguistic and communicative development, etc. of the child.
4.2: In case of ascertained stuttering behaviour, a detailed examination as that mentioned in phase 3.2 is offered.
4.3: During the following 4 years these children/families are observed through one home visit annually.
4.4: In the years 1998 and 1999, 48 3-year old children are selected to make up a control group of fluently speaking children. These children are assessed and the parents interviewed as soon as possible after the 3-year screening.
4.5: In December 1997 written information material has been distributed to selected groups of professionals and the news media on Bornholm as mentioned in phase 3.5.
Information courses have been carried through in March 1998.
The collected material is evaluated. Results, conclusions and implications will be published in 2000 and 2003-2004.
The total cost of the stuttering project is DKK 555.000.
The funding is based on grants from:
The Egmont Foundation
The "Den Danske Banks" Foundation
The Association for Stutterers in Denmark
The "Lingvistisk-Logopædisk Studielegat"
The Rosalie Petersens Foundation
Danish Research Council for the Humanities
Health Insurance Fund
The Ministry of Education in Denmark
The Ministry of Social Affairs
Project Manager: Hans Månsson,
Speech and Hearing Consultant.
Phone: +45 56488680 / Fax: +45 56493086 / Email: email@example.com