Thursday, October 02, 2008

Lidcombe treatment of choice?

Susan Block replied to my comments on her statement that "Lidcombe should be the treatment of choice" (see her ISAD article here):
I think we have discussed some of your comments before. It is the case, in my opinion that it has the best evidence to date for preschool children. The Franken et al study was almost impossible to replicate as their comparative treatment was not well defined. I think it is the case in the Jones et al study that the children in the Lidcombe treatment group made so much positive change that they could not justify maintaining children in a control group.

And I replied:
It is reasonable for you to say "in my opinion that it has the best evidence to date for preschool children". However. First, you actually wrote "should be the treatment of choice" implying a moral imperative i.e. it would be irresponsible for therapists not to use Lidcombe? Is it? Second, I repeat again that the trial described in Jones et al 2005 has a follow-up study Jones et al 2007 which you do not cite but in my opinion should. As I am sure you teach to your students, a treatment should be evaluated based on long-term outcome data and not short-term sucess. And the Jones et al 2007 paints a much more sober picture (apart from methodological issues). Have you read it? Regarding your comment "The Franken et al study was almost impossible to replicate as their comparitatve tretment was not well defined.", it is not relevant whether the trial is replicable or not for it to be true or not. In fact assuming the comparative treatment was completely ill-defined and chaotic, it managed to do as well as Lidcombe. This actually supports the alternative view that any treatment will be succesful. In any case, a new trial with a larger sample and extra care of defining the comparative treatment is under way. Regarding replicability, the same is true for the Lidcombe trial, because as you yourself say "it is the case in the Jones et al study that the children in the Lidcombe treatment group made so much positive change that they could not justify maintaining children in a control group.". We can never repeat it again with a control group! Would you therefore argue that it is not valid?

4 comments:

Anonymous said...

The Aussie Lidcombe Group and supporters will not adddress what others consider to be questionable. They have the Lidcombe cure. No more stuttering for children! If the therapy fails, it is the result of either a poorly trained therapist or the parents decision to not follow through.

Tom ...You ought to know that their research is without error! Why? Because that is what their research tells them.

Don't you get it?

Anonymous said...

Willing to wager if Block will answer your questions without going off ISAD Conference Line?

Will she -- or any of the other Assie Experts -- duel with you?

Me thinks not...

Anonymous said...

WOW! Block answered one of your questions on the ISAD.

I lost the wager...

Guess she told you...Now do you get it? She has undisputeable RESEARCH to support her claim that LIDCOMBE is the cure.

No more questions anymore...just accept the "facts"... The experts are never wrong...ever. Get it?

Tom Weidig said...

Answered??

No, she did answer at all, she repeated her statements but did not address my counter arguments.

Tom