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American Institute of Sloppiness?

Posted Jun 23 2009 12:00am
You can read on the American Institute for Stuttering website on early intervention
Some of the most important and innovative work now being done in stuttering is early intervention treatment. It is cost effective, in both financial and emotional terms. It is almost unconscionable for a child to be denied it. Recent research now supports our common sense that tells us to intervene early. We now know that
The sooner a child receives treatment, the shorter the treatment time will be and the greater the likelihood for lasting gains in fluency.

Early intervention treatment with the critical involvement of parents and caretakers can prevent a lifetime of potential shame and debilitation. The goal is to reverse the course of stuttering and resolve it before it becomes chronic and “hard-wired.”
The statement is typical for the sloppy and confident manner in which early intervention is glorified. Looks very professional and solid at a first glance, doesn't it? But dig a bit deeper, and every single sentence falls apart. It is symptomatic of the field of "evidence"-based intervention. Here is my dissection
Some of the most important and innovative work now being done in stuttering is early intervention treatment.
Who did what? Too vague. Important and innovative sounds really great doesn't it?

It is cost effective, in both financial and emotional terms.
In which way? Where is the calculation? Surely no treatment is cheaper? Especially because the 80% who recover are treated at financial and emotion costs? Statements are made without any supporting argument.

It is almost unconscionable for a child to be denied it.
Wow. Can you feel the guilt? Pure propaganda. Puts pressures on parents. Anyone not agreeing is guilty of a crime against their child.

Recent research now supports our common sense that tells us to intervene early.
Name the research! In fact, recent research has shown that Lidcombe is NOT as effective as thought, but no-one ever talks about the latest study. You cannot just make statements like this. How can anyone check your claims? Is the common sense not to wait because most would recover anyway?

We now know that: The sooner a child receives treatment, the shorter the treatment time will be and the greater the likelihood for lasting gains in fluency.
Now my brain goes hyper. This statement is a classical example of correlation-causality fallacy. The statement itself is probably correct but the implied message is not. Let me give you a few pointers. First of all, do you mean "sooner to onset" or "sooner as in age".

Re onset, the longer from onset of stuttering, the most likely you keep on stuttering. It is obvious, because the proportion of kids who recover goes down to zero as a function of time from onset. So the longer the onset, the less kids who recover are in the sample, so those in the sample are more and more likely NOT to recover! Can you see where I get at? It is a mirage! Yes, there is a relationship, but there is a trivial explanation!

Re age, girls start speaking earlier than boys by an average of 6 months (my guess). Girls are much more likely to recover without clinical intervention. If I remember correctly, girls and boys are roughly as likely to start stutter (or may half as likely), but many more boys do not recover. So the sex ratio of 1:4.5 only happens after natural recovery and not at onset. So the earlier you pick up the child the more likely it is a girl and the more likely it will recover. Again the effect can be explained without any reference to treatment whatsoever.

Early intervention treatment with the critical involvement of parents and caretakers can prevent a lifetime of potential shame and debilitation.
So here is the first sentence up to debilitation that I moderately agree on if the therapist is good. You can certainly work on attitude of all involved for those that keep on stuttering. But to be honest the "prevent a lifetime of" is too strong. Even though I know a lot about my stuttering: I still feel discomfort, embarrassment, shame and all other things occasionally but it is not running my life any more or holding me back big time.

The goal is to reverse the course of stuttering and resolve it before it becomes chronic and “hard-wired.
They clearly did not read the latest brain imaging by Chang et al as explained in a post . Even recovered kids have this hard-wired in their brain. Their brains are different, but they managed somehow to deal with stuttering.

Please read the passage again
Some of the most important and innovative work now being done in stuttering is early intervention treatment. It is cost effective, in both financial and emotional terms. It is almost unconscionable for a child to be denied it. Recent research now supports our common sense that tells us to intervene early. We now know that:
The sooner a child receives treatment, the shorter the treatment time will be and the greater the likelihood for lasting gains in fluency.
Early intervention treatment with the critical involvement of parents and caretakers can prevent a lifetime of potential shame and debilitation. The goal is to reverse the course of stuttering and resolve it before it becomes chronic and “hard-wired.”


Can you feel the intellectual hollowness and sloppiness of the text? That's what we all need to fight to improve the level of debate!
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