Thursday, July 17, 2008

Follow-up study to Lidcombe outcome study

The follow-up study of the Lidcombe random control trial is out. I do not have the full article and can only read the abstract. But the results are less than sensational: three out of 19 kids have relapsed leading to a recovery rate of 84% which is statistically close to natural recovery. What happened to the claim that Lidcombe makes all kids fluent?? And their design has failed as well as they write:
Meaningful comparison with the control group was not possible because an insufficient number of control children.
So where is the control group check then?? They are not even able to compare to a control group to see whether natural recovery is as effective. How can they claim to have done a random control trial???
I need to read the full article for more precise comments.

Extended follow-up of a randomized controlled trial of the Lidcombe Program of Early Stuttering Intervention.

Queensland Clinical Trials Centre, University of Queensland, Brisbane, QLD, Australia.
In the Lidcombe Program of Early Stuttering Intervention, parents present verbal contingencies for stutter-free and stuttered speech in everyday situations. A previous randomized controlled trial of the programme with preschool-age children from 2005, conducted in two public speech clinics in New Zealand, showed that the odds of attaining clinically minimal levels of stuttering 9 months after randomization were more than seven times greater for the treatment group than for the control group.
To follow up the children in the trial to determine extended long-term outcomes of the programme. Methods & Procedures: An experienced speech-language therapist who was not involved in the original trial talked with the children on the telephone, audio recording the conversations using a telephone recording jack. Parental reports were gathered in addition to the children's speech samples in order to obtain a balance of objective data and reports from a wide range of situations.
Outcomes & Results:
At the time of this follow-up, the children were aged 7-12 years, with a mean of 5 years post-randomization in the 2005 trial. Twenty of the 29 children in the treatment arm and eight of the 25 children in the control (no treatment) arm were able to be contacted. Of the children in the treatment group, one (5%) failed to complete treatment and 19 had completed treatment successfully and had zero or near-zero frequency of stuttering. Three of the children (16%) who had completed treatment successfully had relapsed after 2 or more years of speech that was below 1% syllables stuttered. Meaningful comparison with the control group was not possible because an insufficient number of control children were located and some of them received treatment after completing the trial.
Conclusions & Implications:
The majority of preschool children are able to complete the Lidcombe Program successfully and remain below 1% syllables stuttered for a number of years. However, a minority of children do relapse and will require their parents to reinstate the treatment procedures.
PMID: 18608610 [PubMed - as supplied by publisher]

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