Pollard Ryan, Ellis John B, Finan Don, Ramig Peter R
University of Colorado at Boulder, Boulder, CO 80309, USA.
J Speech Lang Hear Res. 2009 Apr;52(2):516-33. doi: 10.1044/1092-4388(2008/07-0204). Epub 2008 Aug 11.
Effects of the SpeechEasy when used under extraclinical conditions over several months were investigated. Primary purposes were to help establish Phase I level information about the therapeutic utility of the SpeechEasy and to compare those results with previous findings obtained in laboratory and clinical settings.
Eleven adults who stutter participated. A nonrandomized ABA group design was utilized. Speech samples were collected every 2 weeks in extraclinical environments. Qualitative data were collected through weekly written logs and an exit questionnaire.
Group analyses revealed a statistically significant effect of the SpeechEasy immediately postfitting but no treatment effect across 4 months' time. Individual responses varied greatly with regard to stuttering frequency and subjective impressions. Relatively more stuttering reduction occurred during oral reading than during formulated speech.
Based on this protocol, Phase II trials are not indicated. However, positive individual responses and self-reports suggest some clinical utility for the SpeechEasy. The use of more challenging sampling procedures strengthened external validity and captured more modest altered auditory feedback effects compared with those previously reported in laboratory settings. Device use coincided more so with positive subjective impressions than with measurable fluency improvement, highlighting challenges facing clinicians when implementing principles of evidence-based practice, including client-based preferences.
研究SpeechEasy在临床外条件下使用数月的效果。主要目的是帮助建立关于SpeechEasy治疗效用的I期水平信息,并将这些结果与之前在实验室和临床环境中获得的发现进行比较。
11名口吃成年人参与。采用非随机ABA组设计。每2周在临床外环境中收集言语样本。通过每周的书面日志和一份出院调查问卷收集定性数据。
组分析显示,佩戴SpeechEasy后立即有统计学上显著的效果,但在4个月的时间里没有治疗效果。个体在口吃频率和主观印象方面的反应差异很大。与定式言语相比,口头阅读时口吃减少相对更多。
基于此方案,不建议进行II期试验。然而,个体的积极反应和自我报告表明SpeechEasy具有一定的临床效用。与之前在实验室环境中报告的相比,使用更具挑战性的采样程序增强了外部效度,并捕捉到了更适度的听觉反馈改变效果。设备的使用与积极的主观印象更为一致,而不是与可测量的流畅度改善一致,这凸显了临床医生在实施循证实践原则(包括基于患者的偏好)时面临的挑战。