Does Speech and Language Therapy Work?
by Pam Enderby and Joyce Emerson 1995

In this book, Enderby and Emerson have tackled the difficult task of evaluating the efficacy of speech and language therapy. They address the treatment of stammering in Chapter 8 (pp 130-150).

In the introductory chapter, they outline the methodology used in behavioural research and discuss the problems in evaluating where so many variables are involved. This is particularly true in stammering, where people who stammer are not a homogenous group, and where therapists often employ more than one treatment technique which makes it difficult to disentangle what is effective in therapy.

In Chapter 8, the authors look at the available research on the efficacy of therapy for stammering and come to the comforting conclusion that most treatment methods seem to be effective, at least in the short term. Not surprisingly, therapy programmes which include strategies for improving both speech and attitudes seem to be the most effective. The problem of maintenance of fluency has preoccupied therapists in recent years, and any respectable research must look at the log-term effects of any treatment methods. A number of studies suggest that whilst fluency may be achieved at the conclusion of treatment, this level of fluency will not be maintained insignificant number of subjects.

Enderby and Emerson pose a number of interesting questions, which include the need to determine the optimum length of treatment, and the most appropriate things to measure to determine outcome. They say that changes in functional communication are frequently used as a criterion for the efficacy of treatment and go on to comment that it is more difficult to evaluate changes in conversations, social interaction and general communication than traditional methods such as measuring speech rates or counting blocks.

The second part of the chapter is concerned with early intervention to prevent the development of stammering, and its treatment in young children. Whilst estimates vary, as many as 80% of children probably achieve normally fluency speech spontaneously. More research is needed to identify those children who are at risk of developing a chronic stammer. At present we know very little about the efficacy of preventive speech and language therapy for young children.

This is probably not a book to buy unless one is interested in the efficacy of therapy for a wide range of communication problems. The authors took on a Herculean task and have succeeded in producing an interesting and well-informed study.

Reviewed in the Spring 1996 issue of 'Speaking Out' by Maggie Fawcus

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