Critical Need for Stuttering Reimbursement

By: Kellan Mallory, Erin Dial, Whitney Wright, Kendra Markwell

Stuttering is a speech disorder in which there is an increase of disruptions in a person’s speech. These disfluencies can consist of blocks (no sound coming out), repetitions (repeating the same sound, syllable, or word), prolongations (making sounds longer), and interjections (“uh,” “um”). Additionally, individuals who stutter may also have increased tension in their neck and face as well as secondary behaviors associated with their stuttering (e.g., eye blinking, foot tapping). Most importantly, a person may experience negative thoughts/emotions related to stuttering and a negative impact on social, academic, or vocational interaction. According to the The Stuttering Foundation (2018), the disorder affects 70 million people worldwide and 3 million people in the United States alone.
         Though the exact cause of stuttering is unknown for each individual, research heavily indicates neurophysiological and genetic factors. This is supported by the incidence of individuals who stutter with a family history of stuttering. Despite popular belief, stuttering is not caused by emotional instability or parenting style, but rather genetic and neurological predisposition. However, temperament and environment can certainly impact a person’s reactions to stuttering.
       Currently, reimbursement for stuttering therapy is largely non-existent. This is likely due to the misconception that stuttering is a psychological disorder rather than a genetic and neurophysiological condition. However, research indicates that stuttering therapy by a speech-language pathologist is effective in providing individuals who stutter with strategies to use in order to decrease disfluencies. Additionally, more recent research discusses the importance of targeting negative reactions in relation to stuttering. This tends to be the most important aspect of stuttering due to the social and emotional impact stuttering can have on individuals. A study by Craig, Blumgart, and Tran (2009) found that stuttering negatively impacts vitality, social, emotional, and mental functioning in adults who stutter, and that the impact on quality of life is comparable to the impact from other medical diagnoses such as TBI or coronary heart disease (2009). Further, these findings have significant therapeutic implications for children who stutter. It is reasonable to assume the negative impact of stuttering may be due to stuttering becoming a chronic condition arising from childhood. Therefore, it is imperative that treatment access continues to improve for children and adults who stutter so that stuttering may have less of an impact on quality of life as children transition to adults.
            Studies show that stuttering has a negative impact on daily life activities in adults and children. In the work setting, research has found that adults who stutter have a decreased likelihood of getting a job and being promoted due to the negative perceptions held by many employers. In school settings, children who stutter were associated with lower test scores and an increased likelihood of being held back a grade. However, with speech therapy the negative effects associated with stuttering have been found to decrease significantly. In the workplace, individuals who received speech therapy and experienced a reduction in stuttering as a result were promoted within 10 months after receiving treatment. In the school setting, timely treatment for stuttering was found to improve the academic performance of children. (Conture, 1996).

Speech therapy has been found to improve patient attitudes about their stuttering through counseling techniques. Speech-language pathologists teach their patients how to be more accepting of their stuttering and to limit stuttering's influence on their lives. They also help desensitize patients from their fear of stuttering by having them participate in activities that push them outside of their comfort zone. These activities promote transfer the of their new skills to real life speaking situations (Irani, 2012). In addition to emotional gains, patients who stutter learn various techniques which help them to decrease the amount of disfluencies they experience.

Speech therapy for stuttering must become more accessible and affordable for patients. Insurance reimbursement for speech therapy is important for all individuals, so they can learn to manage their stuttering effectively and not let it interfere with their ability to have a successful and happy life. 
 

References
 
American Speech-Language-Hearing Association. (n.d.). Childhood fluency disorders. Retrieved from: https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935336&section=Causes
 
Conture, E. (1996). Treatment efficacy: Stuttering. Journal of Speech and Hearing Research, 39(5), 18-26.
 
Craig, A., Blumgart, E., & Tran, Y. (2009). The impact of stuttering on the quality of life in adults who stutter. Journal of Fluency Disorders, 34, 61-71.
 
Irani, F., Gabel, R., Daniels, D., & Hughes, F. (2012). The long-term effectiveness of stuttering therapy: A mixed methods study. Journal of Fluency Disorders, 37(3), 164-178.
 
Onslow, M., Costa, L., Andrews, C., Harrison, E., & Packman, A. (1996). Speech outcomes of a prolonged speech-treatment for stuttering. Journal of Speech, Language, and Hearing Research, 39, 735-749.
 
The Stuttering Foundation. (n.d.). FAQ. Retrieved from: https://www.stutteringhelp.org/faq