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Purpose: The purpose of this research note was to validate a simplified version of the Dutch nonword repetition task (NWR; Rispens & Baker, 2012). The NWR was shortened and scoring was transformed to correct/incorrect nonwords, resulting in the shortened NWR (NWR-S). Method: NWR-S and NWR performance were compared in the previously published data set of Rispens and Baker (2012; N = 88), who compared NWR performance in 5 participant groups: specific language impairment (SLI), reading impairment (RI), both SLI and RI, one control group matched on chronological age, and one control group matched on language age. Results: Analyses of variance showed that children with SLI + RI performed significantly worse than other participant groups in NWR-S, just as in NWR. Logistic regression analyses showed that both tasks can predict an SLI + RI outcome. NWR-S holds a sensitivity of 82.6% and a specificity of 95.4% in identifying children with SLI + RI. The sensitivity of the original NWR is 87.0% with a specificity of 87.7%. Conclusions: As the original NWR, the NWR-S comprising a subset of 22 nonwords scored with a simplified scoring system can identify children with combined SLI and RI while saving a significant amount of the needed assessment time.

Introduction: Little is known about the clinical decision-making process that speech-language pathologists (SLPs) make when they decide which treatment approach they will use with preschool age children who stutter (PCWS). Frequently used approaches are the Lidcombe Program, RESTART-DCM, Mini-KIDS, the Palin Parent-Child Interaction program, and the Social Cognitive Behavior Therapy. In this study, we explored which attributes play a role in the complex process that precedes this clinical decision. We also explored if SLPs from the Netherlands, who are expected to follow the recommendations formulated in the Dutch professional stuttering guidelines, use different treatment approaches than SLPs from Belgium, who do not have specific guidelines to follow. Finally, we explored whether the number of years of experience of SLPs had an impact on the choice for treatment. Methods: This study used an observational design in which 36 SLPs, additionally qualified in the treatment of stuttering, completed a questionnaire. The SLPs spoke Dutch, resided in the Netherlands or Belgium, and used more than one treatment approach for PCWS in their standard practice. Results: The following attributes affected the choice for treatment approach of most SLPs: (1) the child's reactions to the stuttering, (2) the child's language (and speech) skills, (3) the child's age, (4) the family's lifestyle, (5) the parent's ease to understand a treatment approach as judged by the SLPs, and (6) the amount and quality of published research-based evidence. The decision-making of experienced SLPs is significantly more affected by the child's stuttering severity and time since onset compared to less experienced SLPs (both U = 90, p = 0.05). Dutch SLPs did not take other attributes into account than Belgian SLPs. Discussion/Conclusion: This study was a first attempt to explore which attributes affect the decision for a specific treatment. Further prospective research is needed. [ABSTRACT FROM AUTHOR]

A clinical, evidence-based model to inform clients and their parents about the nature of stuttering is indispensable for the field. In this paper, we propose the Erasmus Clinical Model of Stuttering 2.0 for children who stutter and their parents, and adult clients. It provides an up-to-date, clinical model summary of current insights into the genetic, neurological, motoric, linguistic, sensory, temperamental, psychological and social factors (be it causal, eliciting, or maintaining) related to stuttering. First a review is presented of current insights in these factors, and of six scientific theories or models that have inspired the development of our current clinical model. Following this, we will propose the model, which has proven to be useful in clinical practice. The proposed Erasmus Clinical Model of Stuttering visualizes the onset and course of stuttering, and includes scales for stuttering severity and impact, to be completed by the (parent of) the person who stutters. The pathway of the model towards stuttering onset is based on predisposing and mediating factors. In most children with an onset of stuttering, stuttering is transient, but if stuttering continues, its severity and impact vary widely. The model includes the circle of Engel (1977), which visualizes unique interactions of relevant biological, psychological, and social factors that determine the speaker's experience of stuttering severity and its impact. Discussing these factors and their interaction with an individual client can feed into therapeutic targets. The model is supplemented by a lifeline casus. • A new clinical, evidence-based model to inform children who stutter and their parents, and adult clients about stuttering. • The onset and development of stuttering is visualized in a Figure. • Biological, psychological, and social factors are related to the speaker's experience of stuttering severity and impact. • A hypothetical lifeline casus illustrates the model. [ABSTRACT FROM AUTHOR]

Almost half of the children born very preterm (VP) experience language difficulties at school-age, specifically with more complex language tasks. Narrative retelling is such a task. Therefore, we explored the value of narrative retelling assessment in school-aged children born VP, compared to item-based language assessment. In 63 children born VP and 30 age-matched full-term (FT) controls Renfrew's Bus Story Test and Clinical Evaluation of Language Fundamentals were assessed. The retelling of the Bus Story was transcribed and language complexity and content measures were analyzed with Computerised Language Analysis software. Narrative outcomes of the VP group were worse than that of the FT group. Group differences were significant for the language complexity measures, but not for the language content measures. However, the mean narrative composite score of the VP group was significantly better than their mean item-based language score, while in the FT group the narrative score was worse than the item-based score. Significant positive correlations between narrative and item-based language scores were found only in the VP group. In conclusion, in VP children narrative retelling appears to be less sensitive to detecting academic language problems than item-based language assessment. This might be related to the mediating role of attention in item-based tasks, that appears not to affect more spontaneous language tasks such as retelling. Therefore, in school-aged children born VP we recommend using narrative assessment, in addition to item-based assessments, because it is more related to spontaneous language and less sensitive to attention problems. [ABSTRACT FROM AUTHOR]

Highlights • Children's self-report on recovery from stuttering should not replace traditional criteria (expert rating and parental report). • Children's self-report needs to be added when considering the status of stuttering. • Future studies on recovery should add self-reports to improve the validity of the stuttering recovery rate estimates. • Clinicians are recommended to take into account children's self-report on stuttering status. Abstract Purpose The first purpose was to define the recovery rate in children who stutter in a clinical sample, adding self-report to validate recovery status. The second purpose was to explore whether children who were judged to be recovered showed subjective experiences that might be interpreted as coping behaviors used to control speech fluency. Methods In this longitudinal study, preschool-age children whose parents consulted a speech-language pathologist about stuttering were followed for 9 years. At follow-up, children's self-reports on stuttering were reported, as well as traditional criteria on recovery (parental and expert judgment). The Overall Assessment of the Speaker's Experience of Stuttering (OASES) was used to collect children's experiences with speaking. Results Eleven of the 15 children (73%) were judged by parents and clinicians to have recovered from stuttering. However, when considering children's self-reports, 9 children (60%) might be considered to have recovered. In addition, 3 children who were judged to be recovered reported experiences with speaking that were uncommon, even compared to children who continued to stutter. Conclusion In this exploratory study of a clinical population , the recovery rate in children that received treatment for stuttering appeared to be comparable to a non-clinical population. Considering self-reports can improve validity of assessing the "recovery rate". Moreover, recovery in children may not be effortless; instead, it may be the result of conscious or unconscious coping behavior. Future studies are recommended to consider self-reports to improve validity of recovery, and to document experiences with speaking to explore effortless, spontaneous fluency versus controlled fluency. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this study was to evaluate the incremental cost–effectiveness and cost–utility of the Lidcombe Program (LP) compared with treatment based on the Demands and Capacities Model (RESTART-DCM) for preschool children who stutter. Method A cost–effectiveness and cost–utility analysis were carried out alongside a Randomized Clinical Trial (the RESTART-study). In total, 199 children in 20 speech clinics participated. Outcome measures included the number needed to treat, based on the percentage of children who did not stutter at 18 months, and Health-related Quality of Life (EQ-VAS and HUI3) at 3, 6, 12 and 18 months. Health-related Quality of Life scores were used to calculate quality adjusted life years (V-QALYs for the EQ-VAS and U-QALYs for the HUI3). Direct and indirect costs were measured by cost questionnaires. Missing data were multiply imputed. Percentages of children who did not stutter in both groups were compared by a chi-square test. Between-group differences in mean QALYs and costs, as well as cost effectiveness and cost–utility ratios, were evaluated by applying bootstrapping techniques. Results After 18 months, health outcomes were slightly better in the LP group, although only the difference in V-QALYs was statistical significant (0.018; 95% CI: 0.008 to 0.027) with a small effect size (Cohen's d = 0.17). Mean costs for the LP group were significantly higher compared to the RESTART-DCM group (€3199 versus €3032), again with a small effect size (Cohen's d = 0.14). The incremental cost–effectiveness ratio was €3360 for one additional child who did not stutter with the LP, and the estimated cost–utility ratios were €10,413 (extra cost per extra V-QALY) and €18,617 (extra cost per extra U-QALY). The results indicated a high probability that the LP is cost-effective compared to RESTART-DCM treatment given a threshold for willingness-to-pay of €20,000 per QALY. Conclusions Differences in effects and costs between the LP and RESTART-DCM treatment were small. Cost–effectiveness and cost–utility ratios were in favor of the LP. The LP is considered a good alternative to RESTART-DCM treatment in Dutch primary care. [ABSTRACT FROM AUTHOR]

The Fifth Croatia Stuttering Symposium of 2022 continued the Fourth Croatia Stuttering Symposium 2019 theme of the connection between research and clinical practice. At the 2022 Symposium, there were 145 delegates from 21 countries. This paper documents the contents of the third of three Symposium modules. The module topic was mental health and early stuttering, and that pre-schoolers who stutter are at risk of developing mental health issues. A clinical situation was considered where a parent of a 3-year-old child asked a clinician what the early signs of mental health issues might be for a child who stutters. A distinguished scholar presented a 5-minute video interpretation of research about this topic. Three master clinicians then each presented a 2-minute video demonstration of how that research might be applied in a clinical situation. Following that, the convenors moderated a discussion between the distinguished scholar, master clinicians, and delegates regarding the research and how it applies to clinical practice. • We considered mental health and early stuttering. • We considered the early signs of mental health issues. • A distinguished scholar, master clinicians, and delegates discussed the matter. [ABSTRACT FROM AUTHOR]