Comments on Yaruss, LaSalle, and Conture (1998)

In summary, Yaruss et al. have contributed to the literature a set of “recommendation categories” that were based on retrospective analyses of minimal information from children who might have stuttered, gathered originally by student clinicians in one training clinic who were entirely unaware that their data would be used to develop recommendations for other children in other clinics. These categories and recommendations might have led to inaccurate decisions about a significant minority of the children involved in this study (Yaruss et al.’s Footnote 1), but “suggested treatment recommendations” are nevertheless presented as “useful for clinicians to consider” (p. 73).Given some indications that delaying treatment for children who stutter may reduce the effectiveness of any eventual treatment (R. J. Ingham & Cordes, 1999), the decision not to recommend treatment after an initial stuttering evaluation is an important one. The evidence used to support such a decision should be strong, developed from well-designed, carefully executed, and conservatively interpreted studies. Yaruss et al. (1998) presented some information for clinicians to consider, and other relevant information has been presented in other recent forums (e.g., Curlee & Yairi, 1997, and commentaries). I suggest only that clinicians might also want to consider that the literature on stuttering assessment and diagnosis is already full of data-based information and some relatively carefully developed recommendations (see Adams, 1980; Costello & R. J. Ingham, 1984; Culatta & Goldberg, 1995; Curlee, 1993; J. C. Ingham & Riley, 1998; Ryan, 1992). It is critical to note, as well, that essentially all of these sources would recommend treatment for more children sooner than the recommendations presented by Yaruss et al. would do. The phrase “evidence-based treatment” has become popular in the time since Yaruss et al.’s (1998) article was published; the point for children who stutter, and for all of our other clients, is that all of our decisions and recommendations should always