Effectiveness of avoidance-reduction therapy for adults who stutter

The study aimed to investigate the efficacy of avoidance-reduction therapy for adults who stutter. Few studies exist with outcome measure data to support this approach. Dublin Adult Stuttering (DAS) was established to provide an appropriate and accessible therapy course for adults who stutter in the Eastern region of Ireland. DAS used principles of avoidance reduction and stuttering more fluently (J. G. Sheehan, 1975, Van Riper, 1973). Therapy addressed overt and covert features of stuttering; DAS had strong emphasis on client acceptance, empowerment and peer support. Outcomes from a number of self-report measures were analysed and reported; the WASSP (Wright & Ayre, 2000) and the LCB (Craig, Franklin & Andrews, 1984) demonstrated significant improvement at follow-up, compared to non-treatment controls. The positive effects of therapy (reduced severity of stuttering) were maintained at 24 months for WASSP and OASES (Yaruss & Quesal, 2010) and from pre to post-therapy for S24 (Craig, Franklin & Andrews, 1984) and LCB. In terms of behavioural measures, while % Syllables Stuttered did not change for the therapy group, SSI-3 (Riley, 1994) indicated less struggle up to 12 months post-therapy. Demographic variables and percentage change (in WASSP and LCB) were analysed for predictive change but no statistically significant differences were found 12 months post-therapy. While increased level of severity pre-therapy predicted lesser percentage reduction in %SS post-therapy, no 12-month outcomes could be inferred from how severely therapy participants scored at baseline. The study suggests that avoidance-reduction therapy was effective in making and maintaining attitudinal changes up to 24 months and behavioural changes up to 12 months; attrition did not artificially inflate long-term therapy effects. Future studies should aim to investigate these findings with a larger sample, especially with regard to behavioural data presented, and to match data to qualitative responses from participants.