Semin Speech Lang 2011; 32(4): 319-329
DOI: 10.1055/s-0031-1292757
© Thieme Medical Publishers

Ethics in Stuttering Treatment in the Schools: Issues and Intersections

Jennifer B. Watson1 , Courtney T. Byrd2 , Barbara J. Moore3
  • 1Miller Speech and Hearing Clinic, Texas Christian University, Fort Worth, Texas
  • 2The University of Texas at Austin, Austin, Texas
  • 3Anaheim Union High School District, Anaheim, California
Further Information

Publication History

Publication Date:
05 December 2011 (online)

ABSTRACT

When the challenges of providing speech-language pathology services in school settings intersect with the complexities of meeting the unique needs of students who stutter, clinicians may encounter a variety of ethical issues. This article explores some of the ethical challenges of treating stuttering in school settings by discussing three clinical scenarios. Seedhouse's Ethics Grid is provided as a scaffold to support the critical analysis of school-based stuttering treatment issues. Factors examined include creating and respecting autonomy, serving student needs, doing good and minimizing risks, and telling the truth and keeping promises. In addition, clinical outcomes are considered in terms of their impact on students and family members, clinicians, students with communication disorders other than stuttering, and school personnel. Finally, some of the practical concerns when treating stuttering in school settings are discussed, including the law, codes of practice, wishes of others, as well as the effectiveness and efficiency of actions.

REFERENCES

  • 1 American Speech-Language-Hearing Association .Highlights and trends: ASHA counts for year end 2010. Available at: http://www.asha.org/research/memberdata/ Accessed April 25, 2011
  • 2 American Speech-Language-Hearing Association .Schools survey report: SLP caseload characteristics trends 1995–2010. 2010. Available at: http://www.asha.org/uploadedfiles/schools10caseloadtrends.pdf#search=%22school%22 Accessed April 25, 2011
  • 3 Chabon S S, Denton D R, Lansing C R, Scudder R R, Shinn R. Ethics Education. Rockville, MD: American Speech-Language-Hearing Association; 2007
  • 4 Body R, McAllister L. Ethics in Speech and Language Therapy. Chichester, West Sussex, UK: Wiley-Blackwell; 2009
  • 5 Irwin D, Pannbacker M, Powell T W, Vekovius G T. Ethics for Speech-Language Pathologists and Audiologists: An Illustrative Casebook. Clifton Park, NY: Thomson Delmar Learning; 2007
  • 6 Chabon S, Morris J. A consensus model for making ethical decisions in a less-than-ideal-world.  The ASHA Leader. 2004;  9 18-19
  • 7 Beauchamp T, Childress J. Principles of Biomedical Ethics. 6th ed. Oxford, England: Oxford University Press; 2009
  • 8 Seedhouse D. Ethics: The Heart of Health Care. Chichester, West Sussex, UK: Wiley-Blackwell; 2009
  • 9 Sim J. Ethical Decision Making in Therapy Practice. Oxford, England: Butterworth Heinemann; 1997
  • 10 American Speech-Language-Hearing Association .Code of Ethics [Ethics]. Available at: http://www.asha.org/docs/html/ET2010-00309.html Accessed October 24, 2011
  • 11 U.S. Congress .Individuals with disabilities education improvement act of 2004: Conference report (to accompany H.R. 1350) (report No. 108–779). Washington, DC: U.S. Government Printing Office; 2004
  • 12 Scott L. Decoding IDEA eligibility, DVD No. 6100. Stuttering Foundation, Memphis, TN; 2010. 
  • 13 Texas Speech-Language-Hearing Association .Eligibility guidelines for speech impairment. Available at: http://www.txsha.org/_pdf/Eligibility%20Guidelines%20for%20Speech%20Impairment%202009.pdf Accessed April 25, 2011
  • 14 Texas Speech-Language-Hearing Association .Implementation guidelines for speech impairment with a fluency disorder. Available at: http://www5.esc13.net/speechlang/docs/Eligibility/fluency/TSHA_Fluency2010.pdf Accessed April 25, 2011
  • 15 Bernstein Ratner N. Evidence-based practice in stuttering: some questions to consider.  J Fluency Disord. 2005;  30 163-188
  • 16 Nippold M A. Stuttering in school-age children: a call for treatment research.  Lang Speech Hear Serv Sch. 2011;  42 99-101
  • 17 American Speech-Language-Hearing Association .Guidelines for the training, use, and supervision of speech-language pathology assistants [Guidelines]. Available at: http://www.asha.org/docs/html/GL2004-00054.html Accessed October 24, 2011
  • 18 American Speech-Language-Hearing Association .Knowledge and skills for supervisors of speech-language pathology assistants [Knowledge and Skills]. Available at: http://www.asha.org/docs/html/KS2002-00031.html Accessed October 24, 2011
  • 19 Schooling T, Venediktov R, Leech H. Evidence-based systematic review: effects of service delivery on the speech and language skills of children from birth to five years of age. American Speech-Language-Hearing Association national center for evidence-based practice in communication disorders; 2010. Available at: http://www.asha.org/uploadedFiles/EBSR-Service-Delivery.pdf#search=%22schoolingsystematic%22 Accessed October 24, 2011
  • 20 Cirrin F M, Schooling T L, Nelson N W et al.. Evidence-based systematic review: effects of different service delivery models on communication outcomes for elementary school-age children.  Lang Speech Hear Serv Sch. 2010;  41 233-264
  • 21 Zebrowski P M. Treatment factors that influence therapy outcomes of children who stutter. In: Conture E G, Curlee R F, eds. Stuttering and Related Disorders of Fluency. 3rd ed. New York, NY: Thieme Medical Publishers; 2007: 23-38
  • 22 Manning W H. Evidence of clinically significant change: the therapeutic alliance and the possibilities of outcomes-informed care.  Semin Speech Lang. 2010;  31 207-216
  • 23 Travis L E, Johnson W, Shover J. The relation of bilingualism to stuttering: a survey in the East Chicago, Indiana Schools.  J Speech Disord. 1937;  2 185-189
  • 24 Howell P, Davis S, Williams R. The effects of bilingualism on stuttering during late childhood.  Arch Dis Child. 2009;  94 42-46
  • 25 Bedore L M, Fiestas C E, Peña E D, Nagy V J. Cross-language comparisons of maze use in Spanish and English in functionally monolingual and bilingual children.  Biling Lang Cogn. 2006;  9 233-247
  • 26 Bernstein Ratner N. Fluency and stuttering in bilingual children. In: Goldstein B A, ed. Bilingual Language Development & Disorders in Spanish-English Speakers. Baltimore, MD: Paul H. Brookes; 2004: 287-308
  • 27 Lim VPC, Lincoln M, Chan Y H, Onslow M. Stuttering in English-Mandarin bilingual speakers: the influence of language dominance on stuttering severity.  J Speech Lang Hear Res. 2008;  51 1522-1537
  • 28 Van Borsel J, Leahy M M, Pereira M B. Judging stuttering in an unfamiliar language: the importance of closeness to the native language.  Clin Linguist Phon. 2008;  22 59-67
  • 29 Van Borsel J, Maes E, Foulon S. Stuttering and bilingualism: a review.  J Fluency Disord. 2001;  26 179-205
  • 30 Watson J B, Kayser H. Assessment of bilingual/bicultural children and adults who stutter.  Semin Speech Lang. 1994;  15 149-164
  • 31 American Speech-Language-Hearing Association .Cultural competence [Issues in Ethics]. Available at: http://www.asha.org/docs/html/ET2005-00174.html April 25, 2011
  • 32 Moore B J, Montgomery J K. Making a Difference for America's Children: Speech-Language Pathologists in Public Schools. Austin, TX: Pro-Ed, Inc.; 2008
  • 33 Lass N J, Pannbacker M, Schmitt J F, Kiser A M, Mussa A M, Lockhart P. School administrators' perceptions of people who stutter.  Lang Speech Hear Serv Sch. 1994;  25 90-93
  • 34 Lass N J, Ruscello D M, Schmitt J F et al.. Teachers' perceptions of stutterers.  Lang Speech Hear Serv Sch. 1992;  23 78-81
  • 35 Ruscello D M, Lass N J, Schmitt J F, Pannbacker M D. Special educators' perceptions of stutterers.  J Fluency Disord. 1994;  19 125-132
  • 36 Healey E C. What the literature tells us about listeners' reactions to stuttering: implications for the clinical management of stuttering.  Semin Speech Lang. 2010;  31 227-235
  • 37 Brisk D J, Healey E C, Hux K A. Clinician's training and confidence associated with treating school-age children who stutter: a national survey.  Lang Speech Hear Serv Sch. 1997;  28 164-176
  • 38 Kelly E M, Martin J S, Baker K E et al.. Academic and clinical preparation and practices of school speech-language pathologists with people who stutter.  Lang Speech Hear Serv Sch. 1997;  28 195-212
  • 39 Cooper E, Cooper C. Clinician attitudes toward stuttering: two decades of change.  J Fluency Disord. 1996;  21 119-136
  • 40 Gottwald S, Amster B, LaSalle L. A checklist for assessing graduate student competencies in the area of fluency.  Perspect Fluency Fluency Disord. 2010;  20 6-9
  • 41 American Speech-Language-Hearing Association .Scope of practice in speech-language pathology [Scope of Practice]. Available at: http://www.asha.org/docs/html/SP2007-00283.html Accessed October 24, 2011
  • 42 Meyers A, Eisenman L. Student-led IEPs: take the first step.  Teach Except Child. 2005;  37 52-58
  • 43 Zipoli Jr R P, Kennedy M. Evidence-based practice among speech-language pathologists: attitudes, utilization, and barriers.  Am J Speech Lang Pathol. 2005;  14 208-220
  • 44 Nail-Chiwetalu B, Bernstein Ratner N. An assessment of the information-seeking abilities and needs of practicing speech-language pathologists.  J Med Libr Assoc. 2007;  95 182-188 e56-e57
  • 45 American Speech-Language-Hearing Association .Fluency disorders systematic reviews. Available at: http://www.asha.org/members/compendiumSearchResults.aspx?searchtext=fluencydisorders&type=1 Accessed October 24, 2011
  • 46 American Speech-Language-Hearing Association .Fluency disorders guidelines. Available at: http://www.asha.org/members/compendiumSearchResults.aspx?type=0&searchtext=FluencyDisorders Accessed October 24, 2011

Jennifer B WatsonPh.D. CCC-SLP 

Miller Speech and Hearing Clinic, Texas Christian University

TCU 297450, Fort Worth, TX 76129-0001

Email: j.watson@tcu.edu

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