The state of the art in non‐pharmacological interventions for developmental stuttering. Part 1: a systematic review of effectiveness

Abstract

BackgroundThe growing range of available treatment options for people who stutter presents a challenge for clinicians, service managers and commissioners, who need to have access to the best available treatment evidence to guide them in providing the most appropriate interventions. While a number of reviews of interventions for specific populations or a specific type of intervention have been carried out, a broad‐based systematic review across all forms of intervention for adults and children was needed to provide evidence to underpin future guidelines, inform the implementation of effective treatments and identify future research priorities.AimsTo identify and synthesize the published research evidence on the clinical effectiveness of the broad range of non‐pharmacological interventions for the management of developmental stuttering.Methods & ProceduresA systematic review of the literature reporting interventions for developmental stuttering was carried out between August 2013 and April 2014. Searches were not limited by language or location, but were restricted by date to studies published from 1990 onwards. Methods for the identification of relevant studies included electronic database searching, reference list checking, citation searching and hand searching of key journals. Appraisal of study quality was performed using a tool based on established criteria for considering risk of bias. Due to heterogeneity in intervention content and outcomes, a narrative synthesis was completed.Main ContributionThe review included all available types of intervention and found that most may be of benefit to at least some people who stutter. There was evidence, however, of considerable individual variation in response to these interventions. The review indicated that effects could be maintained following all types of interventions (although this was weakest with regard to feedback and technology interventions).ConclusionsThis review highlights a need for greater consensus with regard to the key outcomes used to evaluate stuttering interventions, and also a need for enhanced understanding of the process whereby interventions effect change. Further analysis of the variation in effectiveness for different individuals or groups is needed in order to identify who may benefit most from which intervention.

The state of the art in non-pharmacological interventions for developmental stuttering. Part 2: qualitative evidence synthesis of views and experiences

“…An information specialist developed a search strategy to address the research question comprehensively. The full search strategies are presented in an accompanying paper (Baxter et al 2015).…”

“…In a companion paper, Baxter et al . () review the available effectiveness evidence published between 1990 and 2014. The synthesis includes a typology of interventions and outcomes for all age groups.…”

“…A large body of research has been carried out to assess the effectiveness of non-pharmacological interventions for people who stutter (PWS). In a companion paper, Baxter et al (2015) review the available effectiveness evidence published between 1990 and 2014. The synthesis includes a typology of interventions and outcomes for all age groups.…”

The working alliance in stuttering treatment: a neglected variable?

“…Stuttering's variability and unpredictability suggest that it can be regarded as a complex disorder Kuhn 2009, Ward 2018), and flexible therapeutic approaches are needed to deal with this complexity (Baxter et al 2015).…”

Fluência de fala e alteração do feedback auditivo: comparação entre medidas objetivas e perceptuais

“…Estudos extensos de meta-análise das pesquisas clínicas publicadas na literatura com gagueira 93,94 , o que sugere falta de consenso entre pesquisadores e clínicos da área sobre quais seriam os tratamentos de maior significância clínica. Esses estudos também destacam que há uma variedade de formas de medir os resultados pós-terapia além das medidas objetivas da performance de fluência de fala, e que elas podem ser igualmente relevantes para os pacientes -por exemplo, medidas de qualidade de vida e de funcionalidade da comunicação.…”