Stuttering Research and Treatment Around the World: Sweden The seven-member speech-language pathology and treatment team to which we belong is located at the Department of Otolaryngology, Helsingborg Hospital, Helsingborg, Sweden. Our beautiful city lies along the shore of the three-mile strait between the North Sea and the Baltic Sea, just across the Hamlet Castle in Denmark. Health care ... World Beat
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World Beat  |   October 01, 2005
Stuttering Research and Treatment Around the World: Sweden
Author Notes
  • Cecilia Lundström, attended the University of Lund, Sweden, in the 1970s and holds a MSc degree in speech pathology and therapy. She has had a deep interest in stuttering for 30 years and daily sees children and adults with a stuttering problem in her work at the Department of Otolaryngology, Helsingborg Hospital, Sweden. She also supervises students in the speech-language pathology program at the University of Lund. Contact her at cecilia.lundstrom@helsingborgslasarett.se
    Cecilia Lundström, attended the University of Lund, Sweden, in the 1970s and holds a MSc degree in speech pathology and therapy. She has had a deep interest in stuttering for 30 years and daily sees children and adults with a stuttering problem in her work at the Department of Otolaryngology, Helsingborg Hospital, Sweden. She also supervises students in the speech-language pathology program at the University of Lund. Contact her at cecilia.lundstrom@helsingborgslasarett.se×
  • Marie Garsten, attended the University of Lund, Sweden, in the 1970s and holds a MSc degree in speech pathology and therapy. She has had a deep interest in stuttering for 30 years and daily sees children and adults with a stuttering problem in her work at the Department of Otolaryngology, Helsingborg Hospital, Sweden. She also supervises students in the speech-language pathology program at the University of Lund. Contact her at marie.garsten@helsingborgslasarett.se
    Marie Garsten, attended the University of Lund, Sweden, in the 1970s and holds a MSc degree in speech pathology and therapy. She has had a deep interest in stuttering for 30 years and daily sees children and adults with a stuttering problem in her work at the Department of Otolaryngology, Helsingborg Hospital, Sweden. She also supervises students in the speech-language pathology program at the University of Lund. Contact her at marie.garsten@helsingborgslasarett.se×
Article Information
Speech, Voice & Prosodic Disorders / Fluency Disorders / World Beat
World Beat   |   October 01, 2005
Stuttering Research and Treatment Around the World: Sweden
The ASHA Leader, October 2005, Vol. 10, 36-37. doi:10.1044/leader.WB7.10142005.36
The ASHA Leader, October 2005, Vol. 10, 36-37. doi:10.1044/leader.WB7.10142005.36
The seven-member speech-language pathology and treatment team to which we belong is located at the Department of Otolaryngology, Helsingborg Hospital, Helsingborg, Sweden. Our beautiful city lies along the shore of the three-mile strait between the North Sea and the Baltic Sea, just across the Hamlet Castle in Denmark.
Health care in Sweden is generally funded by public resources through each county’s Health Care Council. Health services for children are free while adults are charged modest fees. Speech, language, and hearing services typically are provided at the county council’s hospital by professionals in the field; children and adults usually are seen for treatment once a week. For the treatment of disorders such as cleft palate, dysphagia, and aphasia, the SLP often works in teams that include other health specialists.
There are also private clinics, especially in larger cities such as Stockholm and Gothenburg. The private sector, however, is very small. Currently, we estimate that the country’s population of nine million is served by approximately 900 SLPs. Similar to the United States, many speech-language clinicians in Sweden are generalists, working with individuals who exhibit a wide range of communication disorders. Although opportunities to specialize in a particular disorder have increased in Sweden, a focus on stuttering is still rare.
Registered professionals in communication disorders are trained in speech and language and hold a Master of Medical Science degree in Speech Pathology and Therapy. Education programs are available at five universities. Audiologists are a specialized group with a different education.
The Swedish Association of Logopedists (SLOF) is the national body with which most of the country`s professionals in communication disorders are affiliated. The association is a member of the European organization, Comité Permanent de Liaison des Orthophonistes-Logopèdes de l´Union Européenne (CPLOL), and is also an affiliated member of the International Association of Logopedics and Phoniatrics (IALP). The Swedish association holds a biennial national congress for its members.
Treatment
During the past 50 years, stuttering treatment in Sweden has been influenced greatly by the knowledge and scientific literature in the United States and other English-speaking countries. For example, the writings of Wendell Johnson, Charles Van Riper, Joseph Sheehan, and Carl Dell had great impact on our approaches to treatment.
Currently, the theoretical groundwork of Swedish stuttering treatment is a multifactorial view of the disorder. The treatment integrates elements of the traditional Van Riper modification of stuttering and modification of emotional reactions techniques and the more recent fluency-shaping techniques. The Van Riper influence was important during the early 1970s when a national intensive treatment program, administered by the University Hospital in Gothenburg, was developed by psychologist Anders Lundberg, phoniatrician Rune Stenborg, SLP Lennart Larsson and others.
This intensive treatment program offers a good supplement to the treatment available at local hospitals. The intensive treatment is divided into three sections of approximately one week each spread over a year. Started as a program for adults, it has expanded to include children and their parents. Additionally, the Swedish Stutterers Organisation offers an intensive, one-week summer camp treatment program for teenagers. The organization also sponsors self-help groups for adults, mostly with a focus on fluency shaping with breathing exercises and slow speech. The participants are also trained to apply the techniques in daily life.
Parents with children who stutter are encouraged to contact a speech and language clinician as early as possible. They can often choose between several alternatives depending on their individual problems and needs. The options could be consultation for parents, direct treatment for the child, group treatment for children and possibilities for the parents to join parent support groups. Fluency-shaping programs for children are not common in Sweden but some clinicians have been trained in the Lidcombe program while others work with fluency shaping as part of an integrated approach.
Research
Swedish scientists (e.g., Gunnar Fant, Johan Sundberg, Ulrika Nettelbladt, Britta Hammarberg, Lena Hartelius) have made internationally recognized research contributions to speech, voice, and language science. The field of stuttering has seen modest, though growing, research activities. For example, during the past five years the authors of this article, within the division of Logopedics at the Helsingborg Hospital, have been active participants in a biological genetic study of stuttering funded by the United States National Institutes of Health. We have had a formal subcontract, through the University of Illinois, collecting blood samples from selected families for genotyping purposes. These findings should be published in the near future. Also Per Alm of Lund University has been conducting an extensive research program on the neurobiology of stuttering. In 2003 and 2004 Lund and Umeå Universities had three master’s theses about stuttering covering the following topics: prediction of chronic stuttering, teachers’ attitudes to stuttering, and cognitive treatment and stuttering.
Still, contacts with clinics and researchers in other countries are of great importance to us. We continue to cross the Atlantic Ocean to update and maintain our professional knowledge as well as to receive inspiration, and during the last two decades our interaction with Ehud Yairi, Ed Conture, Ellen Kelly, Barry Guitar, Karin Wexler, and others has been extremely rewarding.
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October 2005
Volume 10, Issue 14