Articles

'What made Roberta Rant and Rave?' at the International fluency Association 3rd World Congress on Fluency Disorders - Issue 14, Winter 2000
by Roberta Lees, Senior Lecturer, University of Strathclyde
The third world congress on fluency disorders was held from 7th to 11th August this year in Nyborg, Denmark. Nyborg apparently means 'Newcastle' but [nuborg] sounds much more interesting!
  The conference took place in the Strand Hotel which, as the name suggests, was beside the beach. This spacious hotel was well used to conferences so everything ran like clockwork and the food was first class. Talking about food, and I will mention the conference shortly, there was an interesting custom of the waiters/waitresses serving the main course then coming back and serving it a second time. We all got used to that very quickly! On the final evening the chefs excelled themselves and we celebrated the 10th anniversary of the International Fluency Association in style with excellent food and wine, followed by dancing. At this congress dinner Ehud Yairi was announced as the winner of the IFA prize for his enormous contribution to research on stammering. Lena Rustin also got special mention for her work with children who stammer. Lena has now retired and is a great loss to the profession - but I know we all wish her well in her retirement.
  Still thinking about the social side, excursions were offered on the Wednesday afternoon. These are based on the principle that 'all work and no play'. So, we were 'let out' to join a trip to Copenhagen or one to Egeskov castle, a 16th century castle situated beside a lake. The weather was beautiful that afternoon and many of us spent a few hours strolling around the extensive grounds of the castle, swaying on the tree walk (bridges suspended between trees) or getting lost in mazes. A few of the British contingent (no names supplied) even managed to find their way outside the grounds and got locked out. An unceremonious and undignified climbing over fences then took place. It all goes to prove that serious researchers and clinicians don¹t always get it right.
  Now to the conference itself; there were around 350 delegates from approximately 35 countries, so this was a truly international conference. The delegates were researchers, clinicians and people who stammer. Luckily for us the official language of the conference was English. The only irritating point was that some of the native English speakers (but not those from this country) did not allow for the fact that English was a second or third language for many of the participants. Some presentations were just too fast to be comprehensible to many. Like all large conferences, there were a few keynote speakers but mostly choices had to be made from the parallel sessions. Of course the papers you really wanted to hear were usually being delivered at the same time. The papers covered a great range of topics related to stammering including genetics, neuroimaging studies, speech abilities and stereotypes of those who stammer, treatment approaches and efficacy measures. There were also a few papers on cluttering, the Cinderella of fluency disorders. It is stimulating and exciting to learn what is happening in terms of research into the disorders, various treatment approaches and aspects of service delivery (even by means of tele-conferencing). We are all trying to 'explain' these disorders and find effective treatment approaches, which of course begs the question of how 'effective' should be defined.
  I could go on at length about the papers presented but I will restrict my comments to two areas which I find interesting and challenging. One of these areas is that of genetics. There were a number of papers on this topic, mainly from America. In one paper (Stager et al) 104 members of two very large families with a high incidence of stammering were studied. This study covered three generations and distinctive patterns for speech and fluency variables were found for each family. In addition, an international co-operative research project (Cox et al) involving four centres in three countries (USA, Sweden and Israel), was reported. In this study blood samples are taken from members of families with a high incidence of stammering and DNA is extracted from these blood samples. Attempts are being made to localise genes involved in the transmission of stammering. It can only be a matter of time before a genetic explanation for at least some of the cases of stammering becomes available. Obviously this will lead to more research into what is inherited.
  Another challenging area right now is to find ways of measuring efficacy of treatment. There are so many treatment approaches available but we need much more information on how we measure the benefits of each. There is no doubt that ways of measuring efficacy must include more than a measure of the speech symptom and interestingly Britain was well represented on this topic. It would seem that our emphasis on evidence based practice is having an influence on our choice of research topics. Hayhow et al described the development of a questionnaire to measure parental satisfaction with stammering therapy while Stewart assessed the perceptions of adult clients who had undergone speech and language therapy. We so rarely take the points of view of our clients or their carers into account when measuring how successful, or otherwise, we¹ve been. Millard et al discussed the value of children¹s drawings as an outcome measure while Lees and Hoey described the adaptation of an attitude questionnaire designed for adults which was used with pre-adolescent children.
  There was a large number of interesting papers, many from our colleagues in this country, eg Rustin, Nicholas, James, Anderson, Reid, Au-Yeung, Wright, Hayhow, Stewart, Ayre, Delaney and not forgetting Leahy.
  I think we can be justly proud of the quantity and quality of research coming from Britain and Eire but we must not be complacent. Let¹s hope that more can be encouraged to treat and investigate fluency disorders.