Speech fluency disorders in childhood and adolescence

Persistent speech fluency disorders, mostly stuttering and less frequently cluttering, occur in approximately 1% of children and adolescents. They considerably impair the social participation and quality of life of those affected. The German interdisciplinary evidence-based S3 guidelines provide information about the pathogenesis, diagnostics and treatment of speech fluency disorders and contain asystematic review on the efficacy of stuttering treatment. For preschool children the Lidcombe therapy shows the best evidence of efficacy. Strong evidence also exists for an indirect approach. For adolescents and recently for children aged 6-12 years old there is ahigh level of evidence for speech restructuring methods, such as fluency shaping. There is weak evidence for stuttering modification procedures and for combined speech restructuring and stuttering modification approaches. Negative evidence exists for the eclectic, unspecified stuttering therapies, breathing regulation, and hypnosis, which are frequently applied in Germany. An early start of treatment is decisive.