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评估针对学龄儿童的佩林口吃疗法(佩林STSC 8 - 14):一项将佩林STSC(8 - 14)与常规治疗进行比较的可行性随机对照试验方案。

Evaluating Palin Stammering Therapy for School Children (Palin STSC 8-14): protocol for a feasibility randomised controlled trial comparing Palin STSC(8-14) with usual treatment.

作者信息

Millard S K, Murphy S, Barton G, Leathersich M, Mills G, Rixon L, Shepstone L, Sims E, Joffe V

机构信息

The Michael Palin Centre for Stammering, Whittington Hospital NHS Trust, London, UK.

Unversity of Bedfordshire, Luton, UK.

出版信息

Pilot Feasibility Stud. 2022 Sep 16;8(1):210. doi: 10.1186/s40814-022-01158-1.

Abstract

BACKGROUND

Having a stammer can have a significant effect on a child's social, emotional and educational development. With approximately 66,000 children in the UK having a stammer, there is a need to establish an adequate evidence base to inform clinical practice. We describe a feasibility trial to explore the effectiveness of a new therapy programme for children aged 8-14: Palin Stammering Therapy for School Children (Palin STSC(8-14)). Preliminary data from the Michael Palin Centre, where the programme was developed, indicate that Palin STSC(8-14) is effective in reducing stammering frequency and impact for children, with beneficial effects for parents too. We will investigate the feasibility of the methods required for a definitive randomised controlled trial to investigate the application of this therapy by NHS speech and language therapists (SLTs), compared with 'treatment as usual' (TAU), beyond the specialist context in which it was developed.

METHODS

This is a two-arm feasibility cluster-randomised controlled trial of Palin STSC(8-14) with TAU control arm, and randomisation at the level of the SLT. Quantitative and qualitative data will be collected to examine the following: the recruitment and retention of therapists and families, the acceptability of the research processes and the therapeutic intervention and the appropriateness of the therapy outcome measures. Assessments will be completed by children and parents at baseline and 6 months later, including measures of stammering severity; the impact of child's stammering on both children and parents; child temperament, behaviour and peer relations, anxiety; quality of life; and economic outcomes. There will also be a qualitative process evaluation, including interviews with parents, children, SLTs and SLT managers to explore the acceptability of both the research and therapy methods. Treatment fidelity will be examined through analysis of therapy session records and recordings.

DISCUSSION

The findings of this feasibility trial will inform the decision as to whether to progress to a full-scale randomised controlled trial to explore the effectiveness of Palin STSC(8-14) when compared to Treatment as Usual in NHS SLT services. There is a strong need for an evidence-based intervention for school age children who stammer.

TRIAL REGISTRATION

ISRCTN. ISRCTN17058884 . Registered on 18 December 2019.

摘要

背景

口吃会对儿童的社交、情感和教育发展产生重大影响。在英国,约有66000名儿童口吃,因此需要建立充分的证据基础,为临床实践提供依据。我们描述了一项可行性试验,以探究一种针对8至14岁儿童的新治疗方案——学龄儿童佩林口吃疗法(Palin STSC(8 - 14))的有效性。该方案研发于迈克尔·佩林中心,其初步数据表明,Palin STSC(8 - 14)在降低儿童口吃频率和影响方面有效,对家长也有有益效果。我们将研究开展一项确定性随机对照试验所需方法的可行性,该试验旨在调查英国国家医疗服务体系(NHS)的言语和语言治疗师(SLT)应用这种疗法的效果,并与“常规治疗”(TAU)进行比较,研究范围超出其研发的专业背景。

方法

这是一项双臂可行性整群随机对照试验,将Palin STSC(8 - 14)与TAU对照组进行比较,并在SLT层面进行随机分组。将收集定量和定性数据,以检查以下方面:治疗师和家庭的招募与留存情况、研究过程和治疗干预的可接受性以及治疗结果测量的适宜性。儿童和家长将在基线时及6个月后完成评估,包括口吃严重程度的测量;儿童口吃对儿童和家长双方的影响;儿童气质、行为和同伴关系、焦虑情况;生活质量;以及经济结果。还将进行定性过程评估,包括对家长、儿童、SLT和SLT管理人员的访谈,以探究研究方法和治疗方法的可接受性。将通过分析治疗会话记录和录音来检查治疗的保真度。

讨论

这项可行性试验的结果将为是否推进全面随机对照试验提供决策依据,该全面试验旨在探究与NHS的SLT服务中的常规治疗相比,Palin STSC(8 - 14)的有效性。对于口吃的学龄儿童,迫切需要一种基于证据的干预措施。

试验注册

ISRCTN。ISRCTN17058884。于2019年12月18日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dea5/9479243/243ca1d4d790/40814_2022_1158_Fig1_HTML.jpg

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