3. The Position of Speech Pathology Australia
The following statements articulate the position of Speech Pathology Australia regarding stuttering assessment and management and are informed by current best evidence.
3.1 It is the position of Speech Pathology Australia that speech pathologists have the knowledge and skills to assess and provide intervention services to individuals who stutter.
Speech pathologists have knowledge of communication development and disorders across the lifespan which includes disorders of fluency and stuttering. They understand that efficient and effective communication skills enable engagement in education, employment, social interaction and community participation. Speech pathologists are trained to facilitate communication skills. Speech pathologists therefore play a critical role in the differential diagnosis of stuttering, selection and delivery of appropriate intervention programs based on a client’s needs and in working collaboratively with other health professionals. These behaviours are consistent with the minimum competency levels described in the Competency Based Occupational Standards for entry into the profession of speech pathology in Australia.
3.2 Speech Pathology Australia advocates early intervention for all pre-school children who stutter.
Speech Pathology Australia strongly advocates accessible early intervention services for all pre-school children who stutter. Research evidence indicates that early intervention provides the best chance of clinical success, the best chance to prevent negative life impacts and consequences of chronic stuttering and appears to be the most economical use of resources to treat the disorder.
Speech Pathology Australia advocates use of evidence-based practice in the selection of assessment and intervention programs.
3.3 Assessment and treatment of stuttering across the lifespan should be based on the best available evidence and considered in the context of the client’s goals, functioning and well-being.
Speech Pathology Australia advocates the use of evidenced based assessment and treatment. Evidence based and effective treatment options are available for preschool children, school aged children, adolescents and adults. Speech pathologists at all times should select assessment and treatment programs based on individual needs and the best available evidence.
3.4 Speech Pathology Australia recognises that speech pathologists should work collaboratively with clients and other professionals as appropriate in the provision of stuttering assessment and intervention services.
Speech pathologists should consider stuttering from a holistic perspective and ensure they work collaboratively with the client and other health professionals. Stuttering may impact an individual’s social, educational and vocational attainment, quality of life and mental health. Speech pathologists should screen for speech related anxiety as appropriate and refer to other health professionals such as clinical psychologists as needed.
3.5 Speech Pathology Australia does not recommend machine-aided treatments.
Speech Pathology Australia advocates the use of evidenced based interventions. Current evidence for portable machine–aided treatments such as the Speech Easy device is poor and as such there are no machine-aided treatments which can be recommended at this time.
3.6 Speech Pathology Australia does not recommend pharmacological treatments.
Speech Pathology Australia advocates the use of intervention techniques that are evidenced based. There is no evidence of clinically meaningful treatment effects from pharmacological treatments for stuttering (Boethe et al, 2006; Boyd et al, 2011). However, it is recognised that a person who stutters may be prescribed medication for co-occurring conditions such as a mental health disorder.