Syllable-Timed Speech Treatment for School-Age Children Who Stutter: A Phase I Trial

Andrews, Cheryl; O’Brian, Sue; Harrison, Elisabeth; Onslow, Mark; Packman, Ann; Menzies, Ross G.

doi:10.1044/0161-1461(2012/11-0038)

Cited by 35 publications

(46 citation statements)

References 43 publications

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“…31,37,38,45,46,49,53,[62][63][64]84,85,89,90,104,106,107,114 The content of these interventions is focused on the mechanisms of speech production (breathing, vocal fold vibration, articulation of sounds) with reduction in the severity or frequency of stuttering achieved by altering speech motor patterns. People who stutter may be taught to change their speech pattern, for example by prolonging sounds, reducing speech rate or making articulation more soft or smooth.…”

Section: Speech Motor Interventionsmentioning

confidence: 99%

“…Many studies highlighted that there was considerable individual variation in outcome 31,38,52 with some linking this to baseline level of severity (e.g. O'Brian et al…”

Section: Measurement Of Effectivenessmentioning

confidence: 99%

“…The paper judged at lower risk of bias 104 evaluated STS and reported a mean stuttering reduction of 96% in beyond-clinic conversations from pre-treatment 6% of syllables that are stuttered to 12-month follow-up 0.2% of syllables that are stuttered (large ES 1.8). In another evaluation of STS, Andrews et al 31 found the group mean percentage of syllables that are stuttered reduced from 14.4% at baseline to 6.7% at follow-up (p = 0.015, medium ES 0.7). Data on self-reported severity, situation avoidance and quality of life confirmed these positive outcomes, but the authors noted considerable individual variation in response to the intervention.…”

mentioning

confidence: 95%

“…These papers reported effectiveness in terms of p-values or ESs rather than percentage change. 24,[30][31][32]37,48,51,73,74,82,91,104,106,116 In the 'feedback and technology' group, an ES of 0.14 was reported for stuttering (during monologue only) in one paper, 119 and an ES of 1.1 for reduction of stuttering frequency in another 48 and statistically significant changes were reported in nine papers. 4,35,52,56,92,118,120,124,125 In the 'cognitive' group, an ES of 0.74 for reduction in stuttering was found in one study 30 and three papers reported statistically significant differences.…”

mentioning

confidence: 99%

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Non-pharmacological treatments for stuttering in children and adults: a systematic review and evaluation of clinical effectiveness, and exploration of barriers to successful outcomes

Baxter

Johnson

Blank

et al. 2016

Health Technol Assess

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BackgroundDespite many years of research, there is no certainty regarding the cause of stuttering. Although numerous interventions have been developed, a broad-based systematic review across all forms of intervention for adults and children was needed including views and perceptions of people who stutter.ObjectiveThe aims of the study were to report the clinical effectiveness of interventions for people who stutter (or clutter), to examine evidence regarding the views of people who stutter and the views of professionals regarding interventions.Data sourcesA systematic review of quantitative and qualitative literature was carried out between August 2013 and April 2014. The following electronic databases were searched: (1) MEDLINE, (2) EMBASE, (3) The Cochrane Library (including The Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, Health Technology Assessment Database and NHS Economic Evaluations Database), (4) PsycINFO, (5) Science Citation Index, (6) Social Science Citation Index, (7) Cumulative Index to Nursing and Allied Health Literature, (8) ASSIA, (9) Linguistics and Language Behavior Abstracts, (10) Sociological Abstracts and (11) the EPPI Centre. Reference lists of included papers and other reviews were screened and also key journals in the subject area were hand-searched.Review methodsThe searches aimed to identify (1) evidence of clinical effectiveness in populations of pre-school children, school-aged children, adolescents and adults, and (2) data relating to perceptions of barriers and facilitators to intervention clinical effectiveness among staff and people who stutter. A metasynthesis of the two linked elements via development of a conceptual model was also carried out to provide further interpretation of the review findings.ResultsA systematic search of the literature identified a large number of potentially relevant studies. Of these, 111 studies examining the clinical effectiveness of interventions, 25 qualitative papers and one mixed-methods paper met the criteria for inclusion in this review. Review of the effectiveness literature indicated evidence of positive outcomes across all types of interventions. Virtually all evidence we identified reported at least some positive effect for some participants. However, there was evidence of considerable individual variation in outcome for study participants. The qualitative literature highlighted the need for programmes to be tailored to individual need with variation at the levels of the intervention, the individual and interpersonal/social elements. Metasynthesis of the data highlighted the complexity of elements that need to be considered in evaluation of long-term impacts following stuttering interventions.LimitationsAround two-thirds of the studies were considered to be at higher risk of bias. The heterogeneous nature and variability in outcomes meant that we were unable to complete a meta-analysis.ConclusionsAlthough much of the evidence we identified was from studies at risk of bias, it is suggested that most available interventions for stuttering may be of benefit to at least some people who stutter. There is a requirement for greater clarity regarding what the core outcomes following stuttering intervention should be and also enhanced understanding of the process whereby interventions effect change. Further analysis of those for whom interventions have not produced a significant benefit may provide additional insights into the complex intervention–outcomes pathway.Study registrationThis study is registered as PROSPERO CRD42013004861.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Section: Speech Motor Interventionsmentioning

confidence: 99%

“…Many studies highlighted that there was considerable individual variation in outcome 31,38,52 with some linking this to baseline level of severity (e.g. O'Brian et al…”

Section: Measurement Of Effectivenessmentioning

confidence: 99%

mentioning

confidence: 95%

mentioning

confidence: 99%

See 2 more Smart Citations

Non-pharmacological treatments for stuttering in children and adults: a systematic review and evaluation of clinical effectiveness, and exploration of barriers to successful outcomes

Baxter

Johnson

Blank

et al. 2016

Health Technol Assess

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show abstract

“…As referred to above in the description of the development of the P&A model, reducing the variability of contrastive syllabic stress is thought to be an active agent in prolonged speech and rhythmic speech, two of the most widely used fluency enhancing treatments for adults who stutter. Treatments based on rhythmic speech have also been developed recently for children who stutter (Andrews et al, 2012;Trajkowski et al, 2011) According to the P&A model, then, these changes can be seen as reducing the frequency with which the relevant features of spoken language trigger stuttering.…”

Section: Direct Treatment Proceduresmentioning

confidence: 99%