2003 IFA Congress: Montreal, Canada


It is with great pleasure that we present the Proceedings of the Fourth World Congress on Fluency Disorders. We believe that the articles in the Proceedings provide a microcosm of the global interest in stuttering and disorders of fluency. The range of topics is truly inspiring - there are treatment research studies and descriptive reports of various approaches to interventions; there are scientific reports of physiological and neurophysiological research, including brain imaging; there are linguistic studies; there are studies of differences in both stuttering and attitudes to stuttering across culturally and linguistically diverse populations; there are well developed theoretical reports on the nature and cause of stuttering; and there are reports reflecting the growing importance and influence of self-help and advocacy groups around the globe.

Just as importantly, the articles in the Proceedings emanate from all the continents of the world (still no contributions from Antarctica!), with reports from both developed and developing countries. We believe that the Proceeding are truly inclusive, reflecting the mission of the International Fluency Association to raise awareness of disorders of fluency around the world and to encourage interactions among those committed to treatment and research of stuttering and those who stutter and their families.

A new feature of these Proceedings is that the manuscripts submitted for publication, subsequent to the Congress, were sent out for independent peer review of content. Manuscripts were sent to at least one reviewer. This proved to be a somewhat time- consuming process but we believe that it has been worthwhile. Many authors, of course, have already published in peer-reviewed journals and so were familiar with the process. Others who had not may have found the process rather daunting. One’s first experience of the degree of scrutiny involved in peer review can be rather confronting. However, our band of reviewers did a wonderful job, some even corresponding three and four times with more inexperienced authors working with them to bring their manuscripts up to generally accepted standards for international publication. We hope that this has been a positive experience for our less experienced colleagues, especially clinicians working in the field, and that they will feel more confident in future to present their often very commendable and valuable work in the public arena. We think readers will agree that we had a diverse and highly experienced band of reviewers who, incidentally, were all IFA members: Joe Attanasio, James Au-Yeung, Luc de Nil, Hans-Georg Bosshardt, Patrick Finn, Barry Guitar, Marilyn Langevin, Ludo Max, Meg Neilson, Howie Schwartz, Isabelle Rousseau, John Tetnowski, John van Borsel, and Amy Weiss. Thanks are in order, also, to Jane Kelly from the Australian Stuttering Research Centre, who coordinated the review process.

One of the issues that arose as a result of the review process was that of evidence- based practice (EPB). As most people are aware, there is a growing move towards EBP, which states that clinicians are obliged to consider available research evidence in deciding when and how to intervene with people who stutter and their families. However, it is clear that there are many established and respected treatments for stuttering around the world for which there is no supporting evidence but which may well be effective. Treatment research requires considerable resources which are beyond the reach of many in the field, especially clinicians working “at the coal face” in under-resourced communities. Our editorial decision, made with extensive consultation, was that it would not be equitable to restrict treatment reports to those for which there is evidence. Consequently, we accepted reports of established but unsupported treatments approaches, but requested that the authors acknowledge that supporting evidence is not yet available.

In relation to EPB, it is encouraging to see an increase in the development of procedures that measure treatment outcomes other than those based on stuttering counts. Clearly, some interventions are designed to change behaviors, attitudes, feelings and/or cognitive processes other than, or in addition to, stuttering behaviors per se. There is no reason why such changes cannot be measured in order to establish the effectiveness of the treatment in question. The provision of such outcome data will enable people who stutter, their families, and their clinicians, to consider the levels of evidence available for various interventions and empower them to make informed choices from the wide variety of treatment approaches confronting them.

In conclusion, we hope that these Proceeding will bring back many happy memories of Montreal in August. What a wonderful setting that city provided for the Fourth World Congress. The stimulating and collegial atmosphere, and the warmth and friendliness of the hosts, was conducive to the exchange of ideas and formation of new connections across countries, continents and cultures. We extend our congratulations to the organisers of the Congress, Rosalee Shenker, Lisa Avery, and Ann Meltzer, and their team, for providing a highly successful and most enjoyable Congress.

Ann Packman
Ann Meltzer
Herman Peters


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