Craig A, Hancock K, Chang E, McCready C, Shepley A, McCaul A, Costello D, Harding S, Kehren R, Masel C, Reilly K
Department of Health Sciences University of Technology, Sydney, Australia.
J Speech Hear Res. 1996 Aug;39(4):808-26. doi: 10.1044/jshr.3904.808.
This paper presents the results of a controlled trial of child stuttering treatment. The aim of the study was, first, to compare the effectiveness of three viable treatments, and, second, to compare these three treatments to a no-treatment control composed of children who stuttered of a similar age and sex ratio who were on treatment waiting lists. The three treatments investigated included intensive smooth speech, intensive electromyography feedback, and home-based smooth speech. The children/adolescents were assessed across three speaking contexts on measures of percentage syllables stuttered (% SS) and syllables spoken per minute (SPM) and outcomes were assessed 12 months later. Repeated measures analyses of variance demonstrated significant differences between the control group and all three treatment groups across time on conversations in the clinic, on the telephone, and at home (although home measures were not taken for the intensive smooth speech group). Although the controls' stuttering did not change across time, the treatment groups' stuttering was decreased to very low levels posttreatment (less than 1% syllables stuttered on average), with mean improvement in stuttering frequency of at least 85% to 90% across all assessment contexts. Stuttering did not increase significantly up to 3 months and one year posttreatment in the experimental groups, although levels did rise across time (less than 3% syllables stuttered on average). Speech naturalness results showed increasing naturalness across time as rated by the clinician and parent. This was not the case for the controls. The children were also less anxious across time following treatment. The results suggest that all three treatments for children aged 9-14 who stutter were very successful in the long term for over 70% of the group, though the EMG feedback and home-based treatments were superior when percentages falling below a cutoff point (2%SS) were used to discriminate between groups. Implications for child/adolescent treatment in the community are discussed. Long-term outcomes will be assessed up to 5 years after the treatment.
本文介绍了一项儿童口吃治疗对照试验的结果。该研究的目的，一是比较三种可行治疗方法的有效性，二是将这三种治疗方法与由年龄和性别比例相似、在治疗等候名单上的口吃儿童组成的不治疗对照组进行比较。所研究的三种治疗方法包括强化流畅言语、强化肌电图反馈和家庭流畅言语训练。对儿童/青少年在三种说话情境下进行口吃音节百分比（%SS）和每分钟说话音节数（SPM）的测量，并在12个月后评估结果。重复测量方差分析表明，在诊所、电话中和家中的对话中，对照组与所有三个治疗组在不同时间存在显著差异（尽管强化流畅言语组未进行家中测量）。虽然对照组的口吃情况随时间没有变化，但治疗组的口吃在治疗后降至非常低的水平（平均口吃音节少于1%），在所有评估情境下口吃频率平均改善至少85%至90%。在实验组中，治疗后3个月至1年口吃情况没有显著增加，尽管随着时间推移水平有所上升（平均口吃音节少于3%）。言语自然度结果显示，临床医生和家长评定的言语自然度随时间增加。对照组则并非如此。治疗后儿童的焦虑程度也随时间降低。结果表明，对于9至14岁的口吃儿童，所有三种治疗方法从长期来看对超过70%的群体都非常成功，不过当使用低于临界值（2%SS）的百分比来区分组时，肌电图反馈和家庭治疗更为优越。文中讨论了对社区儿童/青少年治疗的启示。将在治疗后5年内评估长期结果。
