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Early treatment for stuttering: what are the issues?. Is it necessary?Direct vs. indirect approachesHistorical, theoretical and practice basesSome representative approaches:IndirectDirect/indirect traditional (e.g. Gottwald, Rustin)Direct/operant (Lidcombe)Potential mechanisms for changeEffi
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1. Treatment of very early stuttering and parent-administered therapy: the state of the art Nan Bernstein Ratner
2. Early treatment for stuttering: what are the issues? Is it necessary?
Direct vs. indirect approaches
Historical, theoretical and practice bases
Some representative approaches:
Indirect
Direct/indirect traditional (e.g. Gottwald, Rustin)
Direct/operant (Lidcombe)
Potential mechanisms for change
Efficacy data and their limitations
Future needs
3. Therapy for early stuttering: is it necessary? The good news: 80% of early stuttering appears to spontaneously resolve (Yairi & colleagues)
Potential prognostic indicators: family history of chronicity, gender, age at onset, time since onset, language profile.
Poor prognostic indicators: severity, pattern, awareness
The new mantra for fluency and SLI: Watch and see
Suggested wait time from onset: up to 18 months if child does not show distress; monitor pattern and reactions
The bad news: prognostic variables are defined over the population, and do not predict specific cases well (no crystal ball).
4. Predictors of chronicity and remission*