Evidence-based treatment and stuttering--historical perspective.

PURPOSE: To illustrate the way in which both fluency shaping (FS) and stuttering management (SM) treatments for developmental stuttering in adults are evidence based.

METHOD: A brief review of the history and development of FS and SM is provided. It illustrates that both can be justified as evidence-based treatments, each treatment seeking evidence of a different kind: FS seeks evidence concerning treatment outcome, and SM seeks evidence concerning the nature of the stutter event.

CONCLUSION

Although outcome evidence provides the principal support for FS, support for SM comes principally from a cognitive learning model of defensive behavior as applied to the nature of the stutter event. Neither approach can claim anything like uniform success with adults who stutter. However, self-management and modeling are strategies common to both approaches and have shown consistently positive effects on outcome. It is argued that both strategies merit additional treatment efficacy study. Cognitive behavior theory may provide a useful framework for this research.