Communication Disorders Ph.D. Dissertations

A Mixed Methods Approach to Evaluating Treatment Outcomes for an Eclectic Approach to Intensive Stuttering Therapy

Date of Award

2010

Document Type

Dissertation

Degree Name

Doctor of Philosophy (Ph.D.)

Department

Communication Disorders/Speech-Language Pathology

First Advisor

Rodney Gabel (Advisor)

Second Advisor

Alex Goberman (Committee Member)

Third Advisor

Roger Colcord (Committee Member)

Fourth Advisor

Trinka Messenheimer (Committee Member)

Abstract

The purpose of this study was to evaluate treatment outcomes of the Intensive Clinic for Adolescents and Adults Who Stutter, offered at Bowling Green State University. The study used a mixed methods design to evaluate treatment effectiveness from a user's perspective within an evidence-based framework. The core method in this mixed methods design was a qualitative, phenomenological approach to recount participants' experiences at the intensive clinic. Toward this end, the primary investigator engaged in semi-structured interviews with seven participants who had attended the intensive clinic between 2003 and 2008. The study gathered objective clinical data concurrently. Clinical data included archival records and current measures on a variety of assessments to evaluate stuttering severity and attitudes toward communication. All semi-structured interviews were audio-recorded and video-taped. The primary investigator transcribed and analyzed the interviews using thematic analysis to determine major themes within and across participants. Credibility was established by providing participants' a copy of the analysis to validate, clarify, or question the results. Additionally, two independent investigators recoded all statements from the transcripts. Their codes were compared with the codes generated by the primary investigator to establish reliability. The participants spoke at length about various aspects of the intensive clinic that were either helpful or not helpful to their individual experiences. The major themes generated from participant transcripts included the positive direct effects of: the duration and nature of the program; speech techniques learned and practiced at the intensive clinic; attitude change and counseling techniques used in therapy; and activities related to desensitization and transfer. The participants also reported positive effects of their personal motivation/readiness to attend the program and clinician attitudes during the program. Participants recommended adding more structure to outdoor activities completed during the program and the inclusion of a structured follow-up program. Clinical data corroborates qualitative themes and indicates that the participants made measurable clinical gains on all measures of stuttering severity and attitude change following the intensive clinic. These changes were maintained at the time of the interview. Future directions for the clinic and related research are discussed in light of the current results.

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