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From: Courtney Howard
Date: 21 Oct 2007
Time: 11:28:41 -0500
Remote Name: 24.13.244.11
I have read over the Jones et al study (2005) along with the Franken et al study (2005), the Yaruss et al study (2006), and your conversation with Yaruss published in AJSLP (2007) and I am unsure why you make such claims as to discouraging evidence of interventions like DCM and Family-Focused Treatment programs. Although preliminary, I find the evidence reported in the Franken study to be hopeful and definitely worthy of future clinical trials. Should we, as researchers and clinicians, refuse other up-and-coming intervention programs that are showing compliance with and success simply because they have not yet undergone the criteria which you deem “gold standard”? Simply because something is different does not mean it is superior or inferior to what you believe; it’s just different. Shouldn’t the goal be to find what’s best for the individual and their family? Do you have any specific data to show that these therapies do not work or are harmful to children? To comment on your conversation with Yaruss (because you brought it up): I’m not going to go into what Yaruss said because you obviously already know it, but based on reading that, do you feel that successful treatment only occurs when complete fluency is achieved? I know that would be what parents hope would happen as a result of therapy, and that clinicians would want to facilitate as much as possible, but there are other versions of success. For example: Would you say Yaruss’s treatment failed for a hypothetical child who, at post-treatment, had 3% disfluency but engaged in no associated behaviors as was the case pre-treatment, exhibited higher self esteem, and whose parents were counseled and felt that the changes made were sufficient and were pleased with the intervention? I would say, as that child’s clinician, that treatment program was beneficial whether or not disfluency reduced to 1 or 0%. 100% fluency is not the “be all, end all” for all children who stutter whether given treatment or not. Additionally, could you comment on the availability of practicing Lidcombe therapy? From what I understand, there are not an abundance of trainers to implement this intervention. It doesn’t matter how successful an intervention is research-wise if no one can actually perform it in the real world. As for Yaruss’s style of intervention, I know several clinicians that implement this everyday with children and their families. Thank you in advance for your comments and clarification. I look forward to reading your 2007 paper.