Non-pharmacological interventions for stuttering in children six years and younger

This new review assessed the immediate and long-term effects of non-pharmacological interventions for stuttering on speech outcomes, communication attitudes, quality of life and potential adverse effects in children aged six years and younger.

The review authors included four studies involving 151 participants aged between two and six years. All studies compared the Lidcombe Program to a wait-list control group. In three studies, the parent and their child visited a speech and language therapist in a clinic, where the parents were taught how to conduct the treatment at home; one study conducted clinic visits by telephone. Two studies were conducted in Australia, and one apiece in Germany and New Zealand. Two studies lasted 9 months, one 16 weeks and one 12 weeks. One study was funded by the National Health and Medical Research Council of Australia, and one was partially funded by the Rotary Club, Wiesbaden, Germany. One study did not report funding sources and another reported that they did not receive any funding for the trial.

Results

All four studies reported the effects of treatment on stuttering frequency. One study also reported on speech efficiency, defined as articulation rate. No study reported on stuttering severity; communication attitudes; emotional (how a child recognizes, expresses, and manages feelings), cognitive (how a child thinks, explores and works problems out) or psychosocial (how a child's individual needs link to the needs or demands of society) development; or adverse effects.

The review authors found very low-certainty evidence that the Lidcombe Program may reduce stuttering frequency in young children compared to a waitlist control group at post-test, 12 weeks, 16 weeks and 9 months postrandomization. They also found moderate-certainty evidence from one study that the Lidcombe Program may increase speech efficiency in young children. Lastly, they found only one study that followed the children up to five years after treatment started; however, the results for most of the children in the control group were missing and therefore they do not know if the benefits of the treatment lasted over time.

The evidence is current to September 2020.

Conclusions

The review authors concluded that the Lidcombe Program may result in lower stuttering frequency and higher speech efficiency than a wait-list control group in children aged up to six years at post-test. However, they noted that the studies were at high risk of bias, and due to the very low and moderate certainty of the evidence, advised that the results should be interpreted with caution. Further studies are needed to evaluate the immediate and long-term effects of other non-pharmacological interventions for stuttering compared to no intervention or a wait-list control group.

Read the full review here on the Cochrane Library.