Palin stuttering therapy for school aged children and usual treatment: a randomised controlled trial feasibility study

Abstract

Background: Despite a clear need for and evidence-based therapy for some children who stutter aged 8–14, there is no high-level evidence of effectiveness, with Speech and Language Therapists rating knowledge and confidence low. One programme which might address these needs, increase availability of services and improve outcomes, is Palin Stammering Therapy for School aged Children (Palin STSC(8ð€€€ 14)). Aim: To investigate the feasibility of conducting a definitive randomised controlled trial comparing Palin STSC(8ð€€€ 14) with usual treatment. Objectives were to establish: recruitment and retention rates; appropriateness of the outcome measures; acceptability of the research and Palin STSC(8ð€€€ 14) therapy; treatment fidelity; and, appropriateness of the cost-effectiveness measures. Method: A two-arm, cluster-randomised trial, with randomisation of therapists, stratified by service. Children aged 8;0–14;11, and their parent(s), were allocated to therapist and completed questionnaires pre-therapy and six months later. Assessments were selected for their potential to measure or predict therapy outcome. Therapists completed measures at the start and end of the trial. A process analysis was conducted, incorporating semi-structured interviews and treatment fidelity examination. Results: Recruitment targets were exceeded (Children n = 67; SLTs n = 37). Research processes were largely acceptable, as was Palin STSC(8ð€€€ 14) therapy. Treatment fidelity was high, with SLT adherence at 85.7 % Mean number of sessions per child for Palin STSC(8ð€€€ 14) was 6.9 compared to 3.5 for usual treatment. Conclusions: The feasibility targets were met. Based on recruitment, retention and adherence rates and our outcome measures, a full-scale randomised controlled trial appears feasible and warranted to assess the effectiveness of Palin STSC(8ð€€€ 14).