Speech-Language Pathologists' Perceptions of Their Competence in Managing Stuttering: A Systematic Review with Narrative Synthesis.
Emma Alegre, Adriana Penman, Rachael Unicomb and 1 others
PMID 40249848WHAT IT FOUND
Speech therapists feel less confident treating stuttering than assessing it.
Confidence rises with more stuttering clients on caseloads and specific training like the Lidcombe Program, but drops when managing adults or complex co-occurring conditions.
Key findings
01SLPs report higher confidence in assessing stuttering than in treating it, particularly with children in US school settings.
02Perceived competence is strongly linked to caseload size and specific training, with specialists and Lidcombe-trained therapists reporting much higher self-efficacy.
03Confidence is lowest when working with adults and adolescents, or when facing complex cases with co-morbidities due to a lack of prescriptive treatment guidelines.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The review only includes self-reported data on 'perceived' competence, not actual clinical skill or treatment outcomes. Most studies were conducted in the United States, primarily with school-based SLPs, limiting generalizability to other regions or settings. There is a lack of data on competence in managing adults and adolescents who stutter. Many studies recruited participants from stuttering workshops or specialist groups, which may introduce response bias and not reflect the wider profession. Heterogeneity in how 'competence' was defined (confidence, self-efficacy, comfort) makes direct comparison difficult.
Declared interests
The authors report no conflicts of interest.
The easy way to misread this
Do not interpret higher self-reported confidence as evidence of better patient outcomes. The review measures how competent SLPs feel, not how effectively they treat stuttering. Additionally, because most data comes from US school-based SLPs, these findings may not apply to your specific caseload or regional practice context.