Selecting Treatments and Monitoring Outcomes: The Circle of Evidence-Based Practice and Client-Centered Care in Treating a Preschool Child Who Stutters

选择治疗方案和监测结果:循证实践与以患者为中心的护理相结合的循环疗法在治疗学龄前口吃儿童中的应用

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Abstract

PURPOSE: The purpose of the present clinical forum is to compare how 2 clinicians might select among therapy options for a preschool-aged child who presents with stuttering close to onset. METHOD: I discuss approaches to full evaluation of the child's profile, advisement of evidence-based practice options open to the family, the need for monitoring of the child's response, and selection of other approaches, if the child appears nonresponsive to the 1st-line approach. RESULTS: Although some researchers and clinicians appear to favor endorsement of a single recommended treatment for early stuttering, I do not find this approach helpful or consistent with newer mandates for patient-centered care. I am also most comfortable recommending RESTART demands and capacities model as the 1st treatment approach, with parent consent, because its mechanism of action appears transparent and well-documented. CONCLUSIONS: There are numerous well-supported intervention options for treating preschool children who stutter. No single therapy can possibly work for all clients. I discuss available options that I feel have sufficient evidence-based support for use with young children who stutter. I emphasize the need to consider more, not fewer, acceptable therapy options for children who do not respond positively to a selected treatment approach within a reasonable time frame.

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