Tuesday, July 08, 2008

Highlights from Oxford

I am currently in London on my way back to Luxembourg. Let me post the highlights from the conferences as I see them. I will talk details in future posts. If you have pictures of the conference, please send them to me!

1) Per Alm gave a scathing review talk on the emerging field of study that claim that certain temperamental traits are important causal components of stuttering. Specifically, he raises serious concerns about a study by the Conture group, and, on top, he said that the results of their likely-to-be flawed study have been misinterpreted and exaggerated by the Washington Post which have also found its way to the BSA (British Stammering Association) website. To summarise, the supposed evidence is evidence of bad methodology.

2) Dave Franklin from the Pagoclone group (and colleague of Stuttering Drug Tsar Jerry Maguire at Irvine) presented a poster with the results of the open label period of the Phase II Pagoclone. They claim that Pagoclone shows positive results in a subgroup and has less side effects. He handed out copies of the posters to everyone, and I am trying to get the permission to post the scanned handout here.

3) There is a widespread agreement that stuttering is a neurologically based disorder. Ann Smith pointedly asked in the final panel session whether it is not time to change from "the causes of stuttering are unknown" to "stuttering is a neurologically based disorder whose details are unknown". We all agreed.

4) Many speakers talked about very high rates of success of stutteringin early intervention, but barely mentioned the natural recovery rate. Many strongly believe that early intervention is effective above natural recovery. I can see improvements being possible but I am just not convinced that the vast majority recover fully.

5) Mark Onslow talked about a large scale longitudinal study of 1000 children starting before onset of stuttering. This should be a very interesting study, unless they mess it up statistically as they did with the BMJ study.

6) No new imaging, genetics, or theoretical developments.

7) Two talks were enlightening as they explained well concepts that I find lacking in stuttering research and therapy but are important to see the big pictures. Paul Dolan gave a good conceptually introduction to health economics, but I did not talk about specifics. Kuhn and Packman talked about complexity theory, and the complex brain with its self-regulating loops. But are these concepts applicable to help real understanding? I doubt it, and if not not by the speakers.


Norbert @ BSA said...

Tom - you mention that there were no new developments in imaging. I thought Per's description of the Chang (2008) study, highlighting the fact that pre-school children with a severe stammer are actually *more* likely to achieve fluency through right-hemispheric compensation of a left-hemisphere deficiency than children with a mild or moderate stammer fascinating. It underlines Yairi's research which demonstrated that children with sudden, and severe onset are more likely to recover than children whose onset is less dramatic.

I, too, found Anne Smith's findings and her view of pre-school stammering as a symptom of an abnormal neurological development fascinating. All we need now is to develop the clapping test for general use in clinics! :-)

Tom Weidig said...

Hi Norbert,

I have spoken about the Chang et al. studies at great length both when it first came out some months ago and when Chang talked about it at the Paris workshop. Therefore it is not real new news for me. I also think that it is important to wait for replication as this is a more subtle effect. Per clearly highlighted this effect despite moderate confidence so I am wondering whether he does not have more information from yet unpublished research?

I never looked closely at the Yairi research. Maybe I should.

Her view is not that new! I have held it for many years! ;-) I am not so sure about the clapping test, because after the talk I put it to her that the differences are group differences so not all recovering kids are better than non-recovered kids. But one might be able to give a likelihood. And she agreed.

Tom Weidig said...

And how do we reconcile the Chang finding with the findings that clapping is worse in recovering kids?

Ora said...

Have you had a chance to evaluate the new results for pagoclone? What do you think?

O said...

Have you heard rumors about phase III for pagoclone ?

Tom Weidig said...

No, I haven't hear anything. I heard someone say that there is a Phase II follow-up study, and that they are still looking for financing...

Ora said...

Re. pagoclone, Dr. Gerald Maguire spoke at the NSA convention in late June. A lot of his presentation was on pagoclone. The tone was generally positive. His slide show said "Phase 3 study is in the final planning stages". During his talk, he said "we're hopeful that we'll have an announcement by the end of 2008".

O said...

Thanks Ora, how did you get this information ?