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对口吃早期干预的利德combe计划随机对照试验的长期随访。

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

作者信息

Jones Mark, Onslow Mark, Packman Ann, O'Brian Sue, Hearne Anna, Williams Shelley, Ormond Tika, Schwarz Ilsa

机构信息

Queensland Clinical Trials Centre, University of Queensland, Brisbane, QLD, Australia.

出版信息

Int J Lang Commun Disord. 2008 Nov-Dec;43(6):649-61. doi: 10.1080/13682820801895599.

Abstract

BACKGROUND

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.

AIMS

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.

摘要

背景

在“利德combe早期口吃干预计划”中,家长在日常情境中针对流畅言语和口吃言语给出言语反馈。2005年在新西兰两家公立言语诊所对学龄前儿童开展的该计划的一项随机对照试验表明,随机分组9个月后,治疗组达到临床最小口吃水平的几率比对照组高出7倍多。

目的

对试验中的儿童进行随访,以确定该计划的长期扩展结果。

方法与步骤

一名未参与原试验的经验丰富的言语治疗师通过电话与孩子们交谈,使用电话录音插孔对对话进行录音。除了收集孩子们的言语样本外,还收集了家长的报告,以便在客观数据和来自各种情境的报告之间取得平衡。

结果

在此次随访时,孩子们的年龄在7至12岁之间,自2005年试验随机分组后平均过去了5年。治疗组的29名儿童中有20名、对照组(未治疗)的25名儿童中有8名能够取得联系。在治疗组的儿童中,有1名(5%)未完成治疗,19名成功完成治疗且口吃频率为零或接近零。3名(16%)成功完成治疗的儿童在言语低于1%音节口吃2年或更长时间后复发。由于找到的对照组儿童数量不足,且其中一些在完成试验后接受了治疗,因此无法与对照组进行有意义的比较。

结论与启示

大多数学龄前儿童能够成功完成利德combe计划,并在数年时间里保持低于1%音节口吃。然而,少数儿童确实会复发,需要家长重新采用治疗程序。

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