Selecting Treatments and Monitoring Outcomes: The Circle of Evidence-Based Practice and Client-Centered Care in Treating a Preschool Child Who Stutters
Purpose: The purpose of the present clinical forum is to compare how 2 clinicians might select among therapy options for a preschool-aged child who presents with stuttering close to onset. Method: I discuss approaches to full evaluation of the child's profile, advisement of evidence-based pract...
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| description | Purpose: The purpose of the present clinical forum is to compare how 2 clinicians might select among therapy options for a preschool-aged child who presents with stuttering close to onset. Method: I discuss approaches to full evaluation of the child's profile, advisement of evidence-based practice options open to the family, the need for monitoring of the child's response, and selection of other approaches, if the child appears nonresponsive to the 1st-line approach. Results: Although some researchers and clinicians appear to favor endorsement of a single recommended treatment for early stuttering, I do not find this approach helpful or consistent with newer mandates for patient-centered care. I am also most comfortable recommending RESTART demands and capacities model as the 1st treatment approach, with parent consent, because its mechanism of action appears transparent and well-documented. Conclusions: There are numerous well-supported intervention options for treating preschool children who stutter. No single therapy can possibly work for all clients. I discuss available options that I feel have sufficient evidence-based support for use with young children who stutter. I emphasize the need to consider more, not fewer, acceptable therapy options for children who do not respond positively to a selected treatment approach within a reasonable time frame. |
| doi_str_mv | 10.1044/2017_LSHSS-17-0015 |
| format | Article |
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Method: I discuss approaches to full evaluation of the child's profile, advisement of evidence-based practice options open to the family, the need for monitoring of the child's response, and selection of other approaches, if the child appears nonresponsive to the 1st-line approach. Results: Although some researchers and clinicians appear to favor endorsement of a single recommended treatment for early stuttering, I do not find this approach helpful or consistent with newer mandates for patient-centered care. I am also most comfortable recommending RESTART demands and capacities model as the 1st treatment approach, with parent consent, because its mechanism of action appears transparent and well-documented. Conclusions: There are numerous well-supported intervention options for treating preschool children who stutter. No single therapy can possibly work for all clients. I discuss available options that I feel have sufficient evidence-based support for use with young children who stutter. I emphasize the need to consider more, not fewer, acceptable therapy options for children who do not respond positively to a selected treatment approach within a reasonable time frame.</description><identifier>ISSN: 0161-1461</identifier><identifier>EISSN: 1558-9129</identifier><identifier>DOI: 10.1044/2017_LSHSS-17-0015</identifier><identifier>PMID: 29322185</identifier><language>eng</language><publisher>United States: American Speech-Language-Hearing Association</publisher><subject>Analysis ; Care and treatment ; Child ; Child, Preschool ; Children & youth ; Clinical Decision-Making ; Clinical Diagnosis ; Clinical Forum: Treatment of Stuttering in Children ; Evidence Based Practice ; Evidence-based medicine ; Evidence-Based Medicine - methods ; Families & family life ; Female ; Humans ; Interrater Reliability ; Intervention ; Language Acquisition ; Language Skills ; Male ; Medical Care Evaluation ; Medical personnel ; Medical prognosis ; Outcome Assessment (Health Care) - methods ; Outcomes of Treatment ; Parent-Child Relations ; Parents & parenting ; Pathology ; Patient-Centered Care - methods ; Phonetics ; Preschool Children ; Preschool Education ; Progress Monitoring ; Risk factors ; Speaking ; Speech therapy ; Speech Therapy - methods ; Stuttering ; Stuttering - diagnosis ; Stuttering - therapy ; Therapy ; Treatment outcome</subject><ispartof>Language, speech & hearing services in schools, 2018-01, Vol.49 (1), p.13-22</ispartof><rights>COPYRIGHT 2018 American Speech-Language-Hearing Association</rights><rights>Copyright American Speech-Language-Hearing Association Jan 2018</rights><rights>Copyright © 2018 American Speech-Language-Hearing Association</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c550t-32da8232ab6eeb9da6e4e19d55bb4e98c0ae21661e62e92f378c03fc263584cb3</citedby><cites>FETCH-LOGICAL-c550t-32da8232ab6eeb9da6e4e19d55bb4e98c0ae21661e62e92f378c03fc263584cb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttp://eric.ed.gov/ERICWebPortal/detail?accno=EJ1166682$$DView record in ERIC$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29322185$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ratner, Nan Bernstein</creatorcontrib><title>Selecting Treatments and Monitoring Outcomes: The Circle of Evidence-Based Practice and Client-Centered Care in Treating a Preschool Child Who Stutters</title><title>Language, speech & hearing services in schools</title><addtitle>Lang Speech Hear Serv Sch</addtitle><description>Purpose: The purpose of the present clinical forum is to compare how 2 clinicians might select among therapy options for a preschool-aged child who presents with stuttering close to onset. Method: I discuss approaches to full evaluation of the child's profile, advisement of evidence-based practice options open to the family, the need for monitoring of the child's response, and selection of other approaches, if the child appears nonresponsive to the 1st-line approach. Results: Although some researchers and clinicians appear to favor endorsement of a single recommended treatment for early stuttering, I do not find this approach helpful or consistent with newer mandates for patient-centered care. I am also most comfortable recommending RESTART demands and capacities model as the 1st treatment approach, with parent consent, because its mechanism of action appears transparent and well-documented. Conclusions: There are numerous well-supported intervention options for treating preschool children who stutter. No single therapy can possibly work for all clients. I discuss available options that I feel have sufficient evidence-based support for use with young children who stutter. I emphasize the need to consider more, not fewer, acceptable therapy options for children who do not respond positively to a selected treatment approach within a reasonable time frame.</description><subject>Analysis</subject><subject>Care and treatment</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children & youth</subject><subject>Clinical Decision-Making</subject><subject>Clinical Diagnosis</subject><subject>Clinical Forum: Treatment of Stuttering in Children</subject><subject>Evidence Based Practice</subject><subject>Evidence-based medicine</subject><subject>Evidence-Based Medicine - methods</subject><subject>Families & family life</subject><subject>Female</subject><subject>Humans</subject><subject>Interrater Reliability</subject><subject>Intervention</subject><subject>Language Acquisition</subject><subject>Language Skills</subject><subject>Male</subject><subject>Medical Care Evaluation</subject><subject>Medical personnel</subject><subject>Medical prognosis</subject><subject>Outcome Assessment (Health Care) - methods</subject><subject>Outcomes of Treatment</subject><subject>Parent-Child Relations</subject><subject>Parents & parenting</subject><subject>Pathology</subject><subject>Patient-Centered Care - methods</subject><subject>Phonetics</subject><subject>Preschool Children</subject><subject>Preschool Education</subject><subject>Progress Monitoring</subject><subject>Risk factors</subject><subject>Speaking</subject><subject>Speech therapy</subject><subject>Speech Therapy - methods</subject><subject>Stuttering</subject><subject>Stuttering - diagnosis</subject><subject>Stuttering - therapy</subject><subject>Therapy</subject><subject>Treatment outcome</subject><issn>0161-1461</issn><issn>1558-9129</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNptkt9qFDEUxgdRbK2-gKAEBPFmapKZZGZ6IdRhtcpKhV3xMmQyZ3ZSMklNMgWfxNc169ZtV0wgCTm_7zv5c7LsOcGnBJflW4pJJZari9UqJ1WOMWEPsmPCWJ03hDYPs2NMOMlJyclR9iSEK5xaWRSPsyPaFJSSmh1nv1ZgQEVtN2jtQcYJbAxI2h59cVZH57eRyzkqN0E4Q-sRUKu9MoDcgBY3ugerIH8vA_Toq5fJScEfeWt0ssrbNIBPwVZ6QNrusmxNZeIhqNE5g9pRmx59Hx1axTkmQXiaPRqkCfDsdj7Jvn1YrNuLfHn58VN7vswVYzjmBe1lTQsqOw7QNb3kUAJpesa6roSmVlgCJZwT4BQaOhRV2ioGRXnB6lJ1xUn2bud7PXcT9Cod10sjrr2epP8pnNTiMGL1KDbuRnCCGa6rZPDm1sC7HzOEKCYdFBgjLbg5CNLUDeMpXZHQV_-gV272Nl1PUIwLWtW0IXfURhoQ2g4u5VVbU3HOaF3yqq5wok7_Q6Xew6SVszDotH8geH1PMII0cQzOzFE7Gw5BugOVdyF4GPaPQbDY1p24qzuRFtu6S6KX959xL_lbaAl4sQPAa7UPLz6T9Dk8_eBvPivdGA</recordid><startdate>20180101</startdate><enddate>20180101</enddate><creator>Ratner, Nan Bernstein</creator><general>American Speech-Language-Hearing Association</general><scope>7SW</scope><scope>BJH</scope><scope>BNH</scope><scope>BNI</scope><scope>BNJ</scope><scope>BNO</scope><scope>ERI</scope><scope>PET</scope><scope>REK</scope><scope>WWN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7RV</scope><scope>7T9</scope><scope>7X7</scope><scope>7XB</scope><scope>88B</scope><scope>88E</scope><scope>88G</scope><scope>8A4</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>CJNVE</scope><scope>CPGLG</scope><scope>CRLPW</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0P</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PQEDU</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180101</creationdate><title>Selecting Treatments and Monitoring Outcomes: The Circle of Evidence-Based Practice and Client-Centered Care in Treating a Preschool Child Who Stutters</title><author>Ratner, Nan Bernstein</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c550t-32da8232ab6eeb9da6e4e19d55bb4e98c0ae21661e62e92f378c03fc263584cb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Analysis</topic><topic>Care and treatment</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children & youth</topic><topic>Clinical Decision-Making</topic><topic>Clinical Diagnosis</topic><topic>Clinical Forum: Treatment of Stuttering in Children</topic><topic>Evidence Based Practice</topic><topic>Evidence-based medicine</topic><topic>Evidence-Based Medicine - methods</topic><topic>Families & family life</topic><topic>Female</topic><topic>Humans</topic><topic>Interrater Reliability</topic><topic>Intervention</topic><topic>Language Acquisition</topic><topic>Language Skills</topic><topic>Male</topic><topic>Medical Care Evaluation</topic><topic>Medical personnel</topic><topic>Medical prognosis</topic><topic>Outcome Assessment (Health Care) - methods</topic><topic>Outcomes of Treatment</topic><topic>Parent-Child Relations</topic><topic>Parents & parenting</topic><topic>Pathology</topic><topic>Patient-Centered Care - methods</topic><topic>Phonetics</topic><topic>Preschool Children</topic><topic>Preschool Education</topic><topic>Progress Monitoring</topic><topic>Risk factors</topic><topic>Speaking</topic><topic>Speech therapy</topic><topic>Speech Therapy - methods</topic><topic>Stuttering</topic><topic>Stuttering - diagnosis</topic><topic>Stuttering - therapy</topic><topic>Therapy</topic><topic>Treatment outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ratner, Nan Bernstein</creatorcontrib><collection>ERIC</collection><collection>ERIC (Ovid)</collection><collection>ERIC</collection><collection>ERIC</collection><collection>ERIC (Legacy Platform)</collection><collection>ERIC( SilverPlatter )</collection><collection>ERIC</collection><collection>ERIC PlusText (Legacy Platform)</collection><collection>Education Resources Information Center (ERIC)</collection><collection>ERIC</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Linguistics and Language Behavior Abstracts (LLBA)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Education Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Education Periodicals</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Education Collection</collection><collection>Linguistics Collection</collection><collection>Linguistics Database</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Education Database</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Education</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Language, speech & hearing services in schools</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ratner, Nan Bernstein</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><ericid>EJ1166682</ericid><atitle>Selecting Treatments and Monitoring Outcomes: The Circle of Evidence-Based Practice and Client-Centered Care in Treating a Preschool Child Who Stutters</atitle><jtitle>Language, speech & hearing services in schools</jtitle><addtitle>Lang Speech Hear Serv Sch</addtitle><date>2018-01-01</date><risdate>2018</risdate><volume>49</volume><issue>1</issue><spage>13</spage><epage>22</epage><pages>13-22</pages><issn>0161-1461</issn><eissn>1558-9129</eissn><abstract>Purpose: The purpose of the present clinical forum is to compare how 2 clinicians might select among therapy options for a preschool-aged child who presents with stuttering close to onset. Method: I discuss approaches to full evaluation of the child's profile, advisement of evidence-based practice options open to the family, the need for monitoring of the child's response, and selection of other approaches, if the child appears nonresponsive to the 1st-line approach. Results: Although some researchers and clinicians appear to favor endorsement of a single recommended treatment for early stuttering, I do not find this approach helpful or consistent with newer mandates for patient-centered care. I am also most comfortable recommending RESTART demands and capacities model as the 1st treatment approach, with parent consent, because its mechanism of action appears transparent and well-documented. Conclusions: There are numerous well-supported intervention options for treating preschool children who stutter. No single therapy can possibly work for all clients. I discuss available options that I feel have sufficient evidence-based support for use with young children who stutter. I emphasize the need to consider more, not fewer, acceptable therapy options for children who do not respond positively to a selected treatment approach within a reasonable time frame.</abstract><cop>United States</cop><pub>American Speech-Language-Hearing Association</pub><pmid>29322185</pmid><doi>10.1044/2017_LSHSS-17-0015</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Language, speech & hearing services in schools, 2018-01, Vol.49 (1), p.13-22 |
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| source | MEDLINE; Education Source; Alma/SFX Local Collection |
| subjects | Analysis Care and treatment Child Child, Preschool Children & youth Clinical Decision-Making Clinical Diagnosis Clinical Forum: Treatment of Stuttering in Children Evidence Based Practice Evidence-based medicine Evidence-Based Medicine - methods Families & family life Female Humans Interrater Reliability Intervention Language Acquisition Language Skills Male Medical Care Evaluation Medical personnel Medical prognosis Outcome Assessment (Health Care) - methods Outcomes of Treatment Parent-Child Relations Parents & parenting Pathology Patient-Centered Care - methods Phonetics Preschool Children Preschool Education Progress Monitoring Risk factors Speaking Speech therapy Speech Therapy - methods Stuttering Stuttering - diagnosis Stuttering - therapy Therapy Treatment outcome |
| title | Selecting Treatments and Monitoring Outcomes: The Circle of Evidence-Based Practice and Client-Centered Care in Treating a Preschool Child Who Stutters |
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