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Purpose Although considerable efforts have been made to investigate the effectiveness of pharmacological treatments for stuttering, little is known about how the stuttering community perceives these treatments. This study aimed to assess and quantify beliefs regarding pharmacotherapy for adults who stutter and to establish whether behavioural intentions to undertake treatment were related to these beliefs. Method An adapted version of the Beliefs about Medicine Questionnaire was completed by adults who stutter. Participants also reported perceptions of their stuttering including its overall impact, ratings of previous speech therapy, and behavioural intentions to initiate pharmacotherapy and speech therapy in future. Results Necessity and concern beliefs were distributed widely across the sample and in a pattern indicating a relatively balanced perception of the benefits and costs of medication prescribed specifically for stuttering. Of the study’s measures, the necessity-concerns differential most strongly predicted the behavioural intention to initiate pharmacotherapy. The overall impact of stuttering predicted intentions to seek both pharmacotherapy and speech therapy. Participants reported the likelihood of pursuing pharmacotherapy and speech therapy in equal measure. Conclusions The theoretical model of medication representations appears to be a useful framework for understanding the beliefs of adults who stutter towards the medical treatment of their disorder. The findings of this study may be of interest to clinicians and researchers working in the field of stuttering treatment and to people who stutter considering pharmacotherapy. [ABSTRACT FROM AUTHOR]

See Crinion (doi:10.1093/brain/awy075) for a scientific commentary on this article.Stuttering is a neurodevelopmental condition affecting 5% of children, and persisting in 1% of adults. Promoting lasting fluency improvement in adults who stutter is a particular challenge. Novel interventions to improve outcomes are of value, therefore. Previous work in patients with acquired motor and language disorders reported enhanced benefits of behavioural therapies when paired with transcranial direct current stimulation. Here, we report the results of the first trial investigating whether transcranial direct current stimulation can improve speech fluency in adults who stutter. We predicted that applying anodal stimulation to the left inferior frontal cortex during speech production with temporary fluency inducers would result in longer-lasting fluency improvements. Thirty male adults who stutter completed a randomized, double-blind, controlled trial of anodal transcranial direct current stimulation over left inferior frontal cortex. Fifteen participants received 20 min of 1-mA stimulation on five consecutive days while speech fluency was temporarily induced using choral and metronome-timed speech. The other 15 participants received the same speech fluency intervention with sham stimulation. Speech fluency during reading and conversation was assessed at baseline, before and after the stimulation on each day of the 5-day intervention, and at 1 and 6 weeks after the end of the intervention. Anodal stimulation combined with speech fluency training significantly reduced the percentage of disfluent speech measured 1 week after the intervention compared with fluency intervention alone. At 6 weeks after the intervention, this improvement was maintained during reading but not during conversation. Outcome scores at both post-intervention time points on a clinical assessment tool (the Stuttering Severity Instrument, version 4) also showed significant improvement in the group receiving transcranial direct current stimulation compared with the sham group, in whom fluency was unchanged from baseline. We conclude that transcranial direct current stimulation combined with behavioural fluency intervention can improve fluency in adults who stutter. Transcranial direct current stimulation thereby offers a potentially useful adjunct to future speech therapy interventions for this population, for whom fluency therapy outcomes are currently limited. [ABSTRACT FROM AUTHOR]

James Braid (1795-1860), the natural philosopher, gentleman scientist, the inquisitive and sagacious, structured thinker, the safe, innovative, and efficacious surgeon--renowned for his personal character, range of surgical skills, and overall clinical excellence (especially in the treatment of dangerous and difficult forms of disease, and the correction of deformities such as club-foot, spinal curvature, knock knees, bandy legs, squint, etc.)--the early adopter (and advocate) of ether anaesthesia and, significantly, the originator of scientific hypnotism and the intentional use of structured suggestion has, to a large extent, been written out of history. This article examines Braid's schooling, his apprenticeship as both surgeon and apothecary, his university training, and his interactions with colleagues; and how these, combined with his scientific and intellectual interests, and his professional challenges, came together in Mr. James Braid, surgeon (aged 46)--the 'right man' at the 'right time'--who encountered Charles Lafontaine, in Manchester, in November 1841. [ABSTRACT FROM AUTHOR]

Background The growing range of available treatment options for people who stutter presents a challenge for clinicians, service managers and commissioners, who need to have access to the best available treatment evidence to guide them in providing the most appropriate interventions. While a number of reviews of interventions for specific populations or a specific type of intervention have been carried out, a broad-based systematic review across all forms of intervention for adults and children was needed to provide evidence to underpin future guidelines, inform the implementation of effective treatments and identify future research priorities. Aims To identify and synthesize the published research evidence on the clinical effectiveness of the broad range of non-pharmacological interventions for the management of developmental stuttering. Methods & Procedures A systematic review of the literature reporting interventions for developmental stuttering was carried out between August 2013 and April 2014. Searches were not limited by language or location, but were restricted by date to studies published from 1990 onwards. Methods for the identification of relevant studies included electronic database searching, reference list checking, citation searching and hand searching of key journals. Appraisal of study quality was performed using a tool based on established criteria for considering risk of bias. Due to heterogeneity in intervention content and outcomes, a narrative synthesis was completed. Main Contribution The review included all available types of intervention and found that most may be of benefit to at least some people who stutter. There was evidence, however, of considerable individual variation in response to these interventions. The review indicated that effects could be maintained following all types of interventions (although this was weakest with regard to feedback and technology interventions). Conclusions This review highlights a need for greater consensus with regard to the key outcomes used to evaluate stuttering interventions, and also a need for enhanced understanding of the process whereby interventions effect change. Further analysis of the variation in effectiveness for different individuals or groups is needed in order to identify who may benefit most from which intervention. [ABSTRACT FROM AUTHOR]

Background Overt stuttering is inhibited by approximately 80% when people who stutter read aloud as they hear an altered form of their speech feedback to them. However, levels of stuttering inhibition vary from 60% to 100% depending on speaking situation and signal presentation. For example, binaural presentations of delayed auditory feedback (DAF) and frequency-altered feedback (FAF) have been shown to reduce stuttering by approximately 57% during scripted telephone conversations. Aims To examine stuttering frequency under monaural auditory feedback with one combination of DAF with FAF (COMBO-2) and two combinations of DAF with FAF (COMBO-4) during scripted telephone conversations. Methods & Procedures Nine adult participants who stutter called 15 local businesses during scripted telephone conversations; each condition consisted of five randomized telephone calls. Conditions consisted of (1) baseline (i.e. non-altered feedback), (2) COMBO-2 (i.e. 50-ms delay with a half octave spectral shift up), and (3) COMBO-4 (i.e. 200-ms delay and a half octave spectral shift down in addition to the COMBO-2). Participants wore a supra-aural headset with a dynamic condenser microphone while holding a receiver to their contralateral ear when making telephone calls. Outcomes & Results Stuttering was significantly reduced during both altered auditory feedback (AAF) conditions by approximately 65%. Furthermore, a greater reduction in stuttering was revealed during the COMBO with four effects (74%) as compared with the COMBO with two effects (63%). Conclusions & Implications Results from the current study support prior research reporting decreased stuttering under AAF during scripted telephone conversations. Findings that stuttering was significantly reduced to a greater extent under the COMBO with four effects condition suggest that second signals reduce stuttering along a continuum. Additionally, findings support prior research results of decreased stuttering frequency under AAF during hierarchically difficult speaking situations. Clinical application of these findings may be that people who stutter can use specific software or smartphone applications that produce second speech signals to inhibit stuttering frequency effectively during telephone conversations. [ABSTRACT FROM AUTHOR]

Abstract: This article looks back over the years and identifies some of the most influential thinkers, writers, and researchers who have had a profound effect on the way the therapy at the Michael Palin Centre for Stammering Children in London has evolved. It tracks the changes that have occurred in theoretical perspective, treatments offered, and the delivery of therapy. In particular this author is interested in the changing nature of the therapeutic relationship between professionals and people who stutter (PWS), and describes the way it has developed from the “expert professional” towards a more collaborative relationship that recognises the “expert patient”. It was inspired by a book written in 1902 by Mr Beasley, a person who stammered. After several unsuccessful attempts to find a ‘cure’ he found his own solution to his stuttering and then used what he had learned to help many others. Much of what he wrote was well ahead of his time and reminds us, the professionals, of the importance of listening to and taking account of the views of PWS in therapy and designing treatment that meets the needs of the individual. This article also looks briefly at evidence based practice (EBP) and the issues involved in measuring outcomes that reflect the complex and individual nature of the problem. Finally the importance of the research in developing the knowledge and skill base of clinicians as well as PWS is acknowledged and discussed and the way ahead signposted. Educational objectives: The reader will learn about (1) the early history and development of stuttering therapy, (2) the influence of a variety of psychotherapeutic approaches, (3) the relevance of designing therapy to meet the needs of the PWS, and (4) discuss the role of ‘common’ factors in EBP. [Copyright &y& Elsevier]