Stuttering

Intl J Lang & Comm Disor

Lowe

2019

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Background The Rotterdam Evaluation Study of Stuttering Therapy randomized trial (RESTART) was seminal, comparing the Lidcombe Program with RESTART Demands and Capacities Model‐based treatment (RESTART‐DCM) for pre‐school age children who stutter. Aims To critique the methods of the RESTART trial to develop guidelines for its systematic replication and extension. Beyond that, to contribute to the refinement of existing methodological guidelines for early stuttering intervention. Method The discussion is organized around methodological issues of primary outcomes, treatment completion, clinician allegiance, treatment fidelity, age exclusions and no‐treatment control reasoning. Main Contribution We recommend six methodological guidelines to guide future clinical trials comparing the Lidcombe Program with RESTART‐DCM, which can be applied to clinical trials of other early stuttering intervention methods: (1) incorporate a continuous measure of primary outcome; (2) ensure that all children in clinical trials have completed treatment; (3) eliminate potential bias due to clinician allegiance; (4) establish treatment fidelity within and beyond the clinic; (5) include children younger than 3 years in clinical trials; and (6) establish an estimate of treatment effect size at some stage of treatment development. Conclusion In addition to guiding future clinical research comparing RESTART‐DCM and Lidcombe Program treatment, these recommendations may extend to influence positively other treatment developments for early stuttering.

“…, Onslow et al . ). Extended follow‐ups of children treated during the pre‐school years have provided evidence of sustained treatment benefits (Jones et al .…”

Section: The Restart Clinical Trialmentioning

confidence: 97%

After the RESTART trial: six guidelines for clinical trials of early stuttering intervention

Intl J Lang & Comm Disor

Lowe

2019

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“…The efficacy of the Lidcombe Program has been demonstrated with a series of Phase I, Phase II and Phase III clinical trials . To date, there have been two successful Phase III randomised controlled trials of the treatment with a no‐treatment control group: one with New Zealand pre‐schoolers and one with German pre‐schoolers .…”

Section: Treatment Of Childhood Stutteringmentioning

confidence: 99%

“…To date, there have been two successful Phase III randomised controlled trials of the treatment with a no‐treatment control group: one with New Zealand pre‐schoolers and one with German pre‐schoolers . A meta‐analysis ( n = 136) of Lidcombe Program clinical trials and short exposure experiments showed an odds ratio of 7.7 . There is evidence that children successfully treated with this method in clinical trials are able to produce speech that is perceptually normal .…”

Section: Treatment Of Childhood Stutteringmentioning

confidence: 99%

Management of childhood stuttering

J Paediatrics Child Health

O’Brian

2012

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Stuttering is a speech disorder that begins during the first years of life and is among the most prevalent of developmental disorders. It appears to be a problem with neural processing of speech involving genetics. Onset typically occurs during the first years of life, shortly after language development begins. Clinical presentation during childhood is interrupted and effortful speech production, often with rapid onset. If not corrected during early childhood, it becomes intractable and can cause psychological, social, educational and occupational problems. There is evidence from replicated clinical trials to support early intervention during the pre-school years. Meta-analysis of studies indicates that children who receive early intervention during the pre-school years are 7.7 times more likely to have resolution of their stuttering. Early intervention is recommended with a speech pathologist. Some children who begin to stutter will recover without such intervention. However, the number of such recoveries is currently not known, and it is not possible to predict which children are likely to recover naturally. Consequently, the current best practice is for speech pathologists to monitor children for signs of natural recovery for up to 1 year before beginning treatment.

“…2019) and an estimated effect size of 7.5 (Onslow et al . 2012) based on four comparisons of the treatment with a no treatment control group. There is evidence of its translation to clinical communities (O'Brian et al .…”

Section: Introductionmentioning

confidence: 99%

Predictors of Lidcombe Program treatment dropout and outcome for early stuttering

Park

Intl J Lang & Comm Disor

Lowe

et al. 2020

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Background: Information is available about what predicts Lidcombe Program treatment time, but nothing is known about what predicts treatment prognosis. Aims: To investigate the predictors of treatment dropout and treatment outcome for children who were treated for early stuttering with the Lidcombe Program (N = 277). Methods & Procedures: A total of 32 variables were used as predictors in regression analyses of short-and mediumterm Lidcombe Program outcome, and of treatment dropout. Outcomes & Results: Regression analyses associated children who have better language skills and easy temperament with better treatment outcome, although only a small portion of the variance of treatment outcome was accounted for by these variables. There was an association between treatment dropout and parental scores on a personality screening tool relating to their impulsivity. Conclusions & Implications: Variables identified as predictors of Lidcombe Program treatment outcome were statistically significant, but not clinically significant. They did not account for a clinically substantive portion of treatment outcomes. Findings about parental impulsivity and their relationship with intervention drop-out require replication with prospective methods and comprehensive assessment of parent psychological status. This is particularly important because parents are involved in conducting all early interventions.