Stuttering treatment research 1970-2005. I: Systematic review incorporating trial quality assessment of behavioral, cognitive, and related approaches

Review published: 2006.

Bibliographic details: Bothe A K, Davidow J H, Bramlett R E, Ingham R J. Stuttering treatment research 1970-2005. I: Systematic review incorporating trial quality assessment of behavioral, cognitive, and related approaches. American Journal of Speech-Language Pathology 2006; 15(4): 321-341. [PubMed]

Quality assessment

This review concluded that some non-pharmacological therapies may help patients to reduce stuttering and/or improve social, emotional or cognitive variables. The authors? conclusions are in line with the evidence presented, but should be treated with caution in view of the small sample sizes and non-comparative design of many of the included studies. Full critical summary

Abstract

PURPOSE: To complete a systematic review, with trial quality assessment, of published research about behavioral, cognitive, and related treatments for developmental stuttering. Goals included the identification of treatment recommendations and research needs based on the available high-quality evidence about stuttering treatment for preschoolers, school-age children, adolescents, and adults.

METHOD: Multiple readers reviewed 162 articles published between 1970 and 2005, using a written data extraction instrument developed as a synthesis of existing standards and recommendations. Articles were then assessed using 5 methodological criteria and 4 outcomes criteria, also developed from previously published recommendations.

RESULTS: Analyses found 39 articles that met at least 4 of the 5 methodological criteria and were considered to have met a trial quality inclusion criterion for the purposes of this review. Analysis of those articles identified a range of stuttering treatments that met speech-related and/or social, emotional, or cognitive outcomes criteria.

CONCLUSIONS: Review of studies that met the trial quality inclusion criterion established for this review suggested that response-contingent principles are the predominant feature of the most powerful treatment procedures for young children who stutter. The most powerful treatments for adults, with respect to both speech outcomes and social, emotional, or cognitive outcomes, appear to combine variants of prolonged speech, self-management, response contingencies, and other infrastructural variables. Other specific clinical recommendations for each age group are provided, as are suggestions for future research.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Para os interessados em gagueira

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews.

Stuttering treatment research 1970-2005 - II: systematic review incorporating trial quality assessment of pharmacological approaches

Review published: 2006.

Bibliographic details: Bothe A K, Davidow J H, Bramlett R E, Franic D M, Ingham R J. Stuttering treatment research 1970-2005 - II: systematic review incorporating trial quality assessment of pharmacological approaches. American Journal of Speech-Language Pathology 2006; 15(4): 342-352. [PubMed]

Quality assessment

This review found no evidence of positive results from the pharmacological treatment of stuttering. The review had methodological and reporting limitations but, overall, the authors? conclusions are in line with the evidence presented and seem appropriate. Full critical summary

Abstract

PURPOSE: To complete a systematic review, incorporating trial quality assessment, of published research about pharmacological treatments for stuttering. Goals included the identification of treatment recommendations and research needs based on the available high-quality evidence.

METHOD: Multiple readers reviewed 31 articles published between 1970 and 2005, using a written data extraction instrument developed as a synthesis of existing standards and recommendations. Articles were then assessed using 5 methodological criteria and 4 outcomes criteria, also developed from previously published recommendations.

RESULTS: None of the 31 articles met more than 3 of the 5 methodological criteria (M = 1.74). Four articles provided data to support a claim of short-term improvement in social, emotional, or cognitive variables. One article provided data to show that stuttering frequency was reduced to less than 5%, and 4 additional articles provided data to show that stuttering may have been reduced by at least half. Among the articles that met the trial quality inclusion criterion for the second stage of this review, none provided uncomplicated positive reports.

CONCLUSIONS: None of the pharmacological agents tested for stuttering have been shown in methodologically sound reports to improve stuttering frequency to below 5%, to reduce stuttering by at least half, or to improve relevant social, emotional, or cognitive variables. These findings raise questions about the logic supporting the continued use of current pharmacological agents for stuttering.