Druker Kerianne, Mazzucchelli Trevor, Hennessey Neville, Beilby Janet
School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia.
School of Psychology, Curtin University, Perth, Western Australia, Australia.
J Speech Lang Hear Res. 2020 Sep 15;63(9):2894-2912. doi: 10.1044/2020_JSLHR-19-00310. Epub 2020 Aug 19.
Purpose This study reports findings from a clinical trial that implemented an early stuttering treatment program integrated with evidence-based parenting support (EBPS) to children who stutter (CWS) with concomitant self-regulation challenges manifested in elevated attention-deficit/hyperactivity disorder (eADHD) symptoms and compared those outcomes to CWS receiving stuttering treatment without EBPS. Method Participants were 76 preschool CWS and their parent(s). Thirty-six of these children presented with eADHD and were quasirandomized into two groups: stuttering treatment only (eADHD) or stuttering treatment integrated with EBPS (eADHD). The remaining children did not meet criteria for eADHD symptoms and received stuttering treatment only (No-eADHD). Pre, post, and 3-month follow-up measures of stuttering treatment outcomes as well as treatment effects on measures of child behavior difficulties and parenting practices were examined. Results Significant reduction in stuttering was found for all groups. However, the eADHD group showed a greater reduction in stuttering frequency than the eADHD group, and at follow-up, stuttering frequencies in the eADHD group matched those of children in the No-eADHD group, while stuttering in the eADHD group remained significantly higher. Children with eADHD symptoms who received the integrated program also required significantly less stuttering intervention time than those children with eADHD symptoms who received stuttering treatment only. Families in the eADHD group reported large and significant improvements in child behavior and parenting practices. Conclusion This study provides support for an early treatment program for CWS. The integrated stuttering and self-regulation management program for CWS with eADHD symptoms proved successful for fluency and behavioral improvements, which were sustained at follow-up.
目的 本研究报告了一项临床试验的结果，该试验对伴有注意力缺陷/多动障碍（eADHD）症状且存在自我调节挑战的口吃儿童（CWS）实施了一项与循证育儿支持（EBPS）相结合的早期口吃治疗方案，并将这些结果与接受无EBPS口吃治疗的CWS进行了比较。方法 参与者为76名学龄前CWS及其父母。其中36名儿童表现出eADHD症状，并被准随机分为两组：仅接受口吃治疗（eADHD组）或接受与EBPS相结合的口吃治疗（eADHD组）。其余儿童不符合eADHD症状标准，仅接受口吃治疗（无eADHD组）。对口吃治疗结果的治疗前、治疗后和3个月随访测量以及对儿童行为困难和育儿实践测量的治疗效果进行了检查。结果 所有组的口吃均有显著减少。然而，eADHD组的口吃频率降低幅度大于eADHD组，且在随访时，eADHD组的口吃频率与无eADHD组儿童的口吃频率相当，而eADHD组的口吃频率仍显著更高。接受综合方案的有eADHD症状的儿童比仅接受口吃治疗的有eADHD症状的儿童所需的口吃干预时间也显著更少。eADHD组的家庭报告称儿童行为和育儿实践有大幅且显著的改善。结论 本研究为CWS的早期治疗方案提供了支持。针对有eADHD症状的CWS的口吃与自我调节综合管理方案在流畅性和行为改善方面被证明是成功的，且在随访时仍持续有效。
