Direct versus Indirect Treatment for Preschool Children who Stutter: The RESTART Randomized Trial

Stuttering is a common childhood disorder. There is limited high quality evidence regarding options for best treatment. The aim of the study was to compare the effectiveness of direct treatment with indirect treatment in preschool children who stutter. In this multicenter randomized controlled trial...

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Veröffentlicht in:PloS one Jg. 10; H. 7; S. e0133758
Hauptverfasser: de Sonneville-Koedoot, Caroline, Stolk, Elly, Rietveld, Toni, Franken, Marie-Christine
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Public Library of Science 28.07.2015
Public Library of Science (PLoS)
Schlagworte:
Behavior Therapy
Child
Child, Preschool
Children
Children & youth
Clinical trials
Consortia
Data recovery
Early Intervention, Educational
Emotional behavior
Female
Follow-Up Studies
Humans
Intervention
Male
Medical research
Otolaryngology
Parents
Parents & parenting
Pediatrics
Preschool children
Psychotherapy
Quality of Life
Speech
Speech disorders
Speech Production Measurement
Speech Therapy
Stuttering - psychology
Stuttering - therapy
Syllables
Treatment Outcome
ISSN:1932-6203, 1932-6203
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Zusammenfassung:Stuttering is a common childhood disorder. There is limited high quality evidence regarding options for best treatment. The aim of the study was to compare the effectiveness of direct treatment with indirect treatment in preschool children who stutter. In this multicenter randomized controlled trial with an 18 month follow-up, preschool children who stutter who were referred for treatment were randomized to direct treatment (Lidcombe Program; n = 99) or indirect treatment (RESTART-DCM treatment; n = 100). Main inclusion criteria were age 3-6 years, ≥3% syllables stuttered (%SS), and time since onset ≥6 months. The primary outcome was the percentage of non-stuttering children at 18 months. Secondary outcomes included stuttering frequency (%SS), stuttering severity ratings by the parents and therapist, severity rating by the child, health-related quality of life, emotional and behavioral problems, and speech attitude. Percentage of non-stuttering children for direct treatment was 76.5% (65/85) versus 71.4% (65/91) for indirect treatment (Odds Ratio (OR), 0.6; 95% CI, 0.1-2.4, p = .42). At 3 months, children treated by direct treatment showed a greater decline in %SS (significant interaction time x therapy: β = -1.89; t(282.82) = -2.807, p = .005). At 18 months, stuttering frequency was 1.2% (SD 2.1) for direct treatment and 1.5% (SD 2.1) for indirect treatment. Direct treatment had slightly better scores on most other secondary outcome measures, but no differences between treatment approaches were significant. Direct treatment decreased stuttering more quickly during the first three months of treatment. At 18 months, however, clinical outcomes for direct and indirect treatment were comparable. These results imply that at 18 months post treatment onset, both treatments are roughly equal in treating developmental stuttering in ways that surpass expectations of natural recovery. Follow-up data are needed to confirm these findings in the longer term. isrctn.org ISRCTN24362190.
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ObjectType-Evidence Based Healthcare-1
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Competing Interests: The authors have declared that no competing interests exist.
Conceived and designed the experiments: MCF ES. Performed the experiments: CdeS MCF ES. Analyzed the data: CdeS TR. Wrote the paper: CdeS ES TR MCF.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0133758