Jones Mark, Onslow Mark, Packman Ann, Williams Shelley, Ormond Tika, Schwarz Ilsa, Gebski Val
Queensland Clinical Trials Centre, University of Queensland, Princess Alexandra Hospital, Woollongabba, Queensland 4102, Australia.
BMJ. 2005 Sep 24;331(7518):659. doi: 10.1136/bmj.38520.451840.E0. Epub 2005 Aug 11.
To evaluate the efficacy of the Lidcombe programme of early stuttering intervention by comparison to a control group.
A pragmatic, open plan, parallel group, randomised controlled trial with blinded outcome assessment.
Two public speech clinics in New Zealand.
Stuttering preschool children who presented to the speech clinics for treatment. Inclusion criteria were age 3-6 years and frequency of stuttering of at least 2% syllables stuttered. Exclusion criteria were onset of stuttering during the six months before recruitment and treatment for stuttering during the previous 12 months. 54 participants were randomised: 29 to the Lidcombe programme arm and 25 to the control arm. 12 of the participants were girls.
Lidcombe programme of early stuttering intervention.
Frequency of stuttering was measured as the proportion of syllables stuttered, from audiotaped recordings of participants' conversational speech outside the clinic. Parents in both arms of the trial collected speech samples in three different speaking situations before randomisation and at three, six, and nine months after randomisation.
Analysis showed a highly significant difference (P = 0.003) at nine months after randomisation. The mean proportion of syllables stuttered at nine months after randomisation was 1.5% (SD 1.4) for the treatment arm and 3.9% (SD 3.5) for the control arm, giving an effect size of 2.3% of syllables stuttered (95% confidence interval 0.8 to 3.9). This effect size was more than double the minimum clinically worthwhile difference specified in the trial protocol.
The results provide evidence from a randomised controlled trial to support early intervention for stuttering. The Lidcombe programme is an efficacious treatment for stuttering in children of preschool age.
通过与对照组比较，评估利德combe早期口吃干预方案的疗效。
一项实用、开放计划、平行组、随机对照试验，采用盲法结局评估。
新西兰的两家公立言语诊所。
到言语诊所接受治疗的口吃学龄前儿童。纳入标准为年龄3至6岁，口吃频率至少为2%的音节。排除标准为招募前六个月内开始口吃以及过去12个月内接受过口吃治疗。54名参与者被随机分组：29名进入利德combe方案组，25名进入对照组。其中12名参与者为女孩。
利德combe早期口吃干预方案。
口吃频率通过参与者诊所外对话语音的录音测量口吃音节的比例。试验两组的家长在随机分组前以及随机分组后三个月、六个月和九个月收集三种不同说话情境下的语音样本。
分析显示随机分组九个月后存在高度显著差异（P = 0.003）。随机分组九个月后，治疗组口吃音节的平均比例为1.5%（标准差1.4），对照组为3.9%（标准差3.5），口吃音节的效应量为2.3%（95%置信区间0.8至3.9）。该效应量超过了试验方案中规定的最小临床有意义差异的两倍。
结果提供了来自随机对照试验的证据，支持对口吃进行早期干预。利德combe方案是治疗学龄前儿童口吃的有效方法。
