From: Anne Bothe
Date: 10/19/00
Time: 11:35:02 AM
Remote Name: 128.192.22.206
Hi, Tenille – I'm glad to be getting some questions from students!
I have to be very careful about answering your question about pediatricians – I don't want to get into trying to speak for an entire profession, especially one that I am not part of. (Is anybody aware of a recent survey about pediatricians beliefs and recommendations about stuttering?) I can tell you about my own experience, and the experience of colleagues that I have talked with about this, and our general feeling is yes, many pediatricians will often tell parents that stuttering or disfluent speech is not something that needs treatment or that will go away on its own. Given that somewhere between 25% and 80% of very young children who stutter are estimated to recover without receiving professional treatment, depending on who you read and how you interpret different kinds of data, such advice would be good enough, often enough, that people giving it would end up being intermittently reinforced for giving it – so it's going to continue! And there are many SLPs who would agree, too, that 2 and 3 year olds don't need treatment for their stuttering because it will most likely go away – I just read the literature differently and interpret the data differently.
You also commented about being surprised that the children responded so well to a direct procedure that "basically highlighted their awareness of stuttering moments" – this comment just made me smile, because I was not surprised at all. If anything, I have a bit of a concern about our research that we are just showing yet again that correcting or highlighting or whatever you want to call it (the correct behavioral term is "punishing," but people put so many unfortunate and incorrect connotations onto that poor little word that I hesitate to use it) will reduce stuttering. This stuff has been demonstrated over and over in adults since the late 1950s and in children since about 1970 – so in a way that part of my research really isn't showing anything new at all.
Was the parents' stopping the children when they stuttered and praising their fluent speech the only direct treatment used in this study? Yes. And would it be considered a stuttering modification technique – No. Stuttering modification refers more to changing attitudes about stuttering and/or changing the sound or style of a given stutter – We tend to credit this sort of approach to Dr. Van Riper, and it includes learning to pull out of a stutter, or learning to do relaxed easy repetitions, things like that. I would put parental reinforcers/corrections in the general category of fluency shaping, even though some of the characteristics of the general category don't apply here.
Thanks for your questions!