Evidence for the treatment of co-occurring stuttering and speech sound disorder

This thesis presents two studies detailing evidence relating to the treatment of co-occurring stuttering and speech sound disorders in early childhood. The first study was a qualitative investigation of how the two co-occurring disorders are being currently managed by clinicians working in the field. Thirteen Australian speech-language-pathologists were recruited to take part in semi-structured interviews that explored management and service delivery. Thematic analysis using the principles of grounded theory revealed several core themes. The majority of the clinicians reported using a serial service delivery with this caseload, typically treating one disorder before the other. The minority of clinicians that treated this caseload concurrently reported that doing so appeared cost- and time-efficient. The core theme of this study highlighted that although clinicians are using evidence-based treatment programs to treat either disorder in isolation, they are confused around a method of service delivery and are in much need of up-to-date empirical evidence to support their clinical reasoning for this caseload. The second study, a Phase I clinical trial, involved 5 single case studies. Five children with co-occurring stuttering and speech sound disorder, aged between 3-6 years, received concurrent treatment for their disorders using direct treatment approaches supported by evidence-based practice (Lidcombe Program, minimal pairs, traditional articulation therapy). Four of the five children showed statistically significant improvements in the primary outcome measure for stuttering, percentage of syllables stuttered. All five children showed statistically significant improvements in the primary outcome measure for speech sound disorder, percentage of consonants correct. The findings suggest that for some children with co-occurring stuttering and speech sound disorder, concurrent therapy using direct treatment programs may be efficient and efficacious. The implications for this on service delivery, clinical practice and future research opportunities are discussed.