Clear recommendations can be given only for few stutter therapies, say experts

About 1% of children and adolescents, 0.2% of women, and 0.8% of men suffer from stuttering. However, based on the available studies, clear recommendations can be given only for a few of the currently available stutter therapies. Further research is necessary to determine the long-term effectiveness and efficacy of therapeutic procedures and their settings. This is the conclusion reached by Katrin Neumann and co-authors in their article in the current issue of the Deutsches Ärzteblatt International (Dtsch Arztebl Int 2017, 114: 383-90).

For those affected by it, stuttering is a problem that should not be underestimated. About 1% of children and adolescents, 0.2% of women, and 0.8% of men suffer from stuttering. However, based on the available studies, clear recommendations can be given only for a few of the currently available stutter therapies. Further research is necessary to determine the long-term effectiveness and efficacy of therapeutic procedures and their settings. This is the conclusion reached by Katrin Neumann and co-authors in their article in the current issue of the Deutsches Ärzteblatt International (Dtsch Arztebl Int 2017, 114: 383-90). In it, the authors summarize the new clinical practice guideline for the pathogenesis, diagnosis, and treatment of speech fluency disorders.

The most common speech disorder, defined by the authors as "originary, neurogenic, non-syndromic stuttering," is a central nervous disorder of speech and language planning that arises in childhood due to genetic predisposition. This leads to a stutter-type speech fluency disorder and the associated vegetative, motor, and emotional reactions. Stuttering usually begins at the age of 2 to 6 years. Most affected persons go into remission by puberty. The risk factors for persistence of stuttering include, among others, being male and having a history of stuttering in the family. Irrespective of the age of the affected person, stutter therapy should be offered no later than 12 months after the onset of stuttering if the speech fluency disorder persists.

On the basis of a systematic literature review, Katrin Neumann and co-authors assessed the efficacy of the current stutter therapies. They recommend using procedures for speech restructuring, such as "fluency shaping" and "Camperdown," which develop a new way to speak that does not allow the typical disfluencies of stuttering. In children, there is strong evidence for the Lidcombe Program, which is based on the principle of positive reinforcement learning and is carried out with the parents' constant cooperation. In contrast, stutter therapies based on medication, hypnosis, or unspecific methods, or those based solely or mainly on breathing regulation or rhythmic speech cueing, should not be used.

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