早期干扰－－治愈口吃

早期干扰－－治愈口吃

相关链接：BAIDU 

          口吃   口吃治疗 

    2005.9.26 英国医学杂志

    在9.24出版的这期杂志上，报道了一个随机化的临床试验，结果是：Lidcombe 法可以有效地治疗口吃。

    “口吃应在龄前阶段治疗，主要是原因是，孩子长大后，口吃变得十分难以控制”来自澳大利亚昆士兰州立大学的Mark Jones医学博士如是说，“一旦口吃变成慢性的，交流能力严重受损，带来破坏性的社会、感情和就业问题”。目前有几个用于早期治疗的方法，但有一个，Lidcombe 法已用于第一和第二阶段的临床试验。

（加工中，性急者请阅英文）

Sept. 26, 2005 — The Lidcombe method is an efficacious early intervention for treating stuttering, according to the results of a randomized trial reported in the Sept. 24 issue of the British Medical Journal.

    "Stuttering should be treated in the preschool years, primarily because it becomes less tractable as children get older," write Mark Jones, MD, from the University of Queensland in Australia, and colleagues. "Once stuttering becomes chronic, communication can be severely impaired, with devastating social, emotional, educational, and vocational effects. Several treatments for early stuttering are currently available, but only one, the Lidcombe programme, has been studied with phase I and II clinical trials."

    The Lidcombe method is a behavioral treatment developed specifically for stuttering in children younger than six years. It does not appear to change behaviors other than speech or affect the attachment of children and parents or use of language.

    In this open-plan, parallel group trial with blinded outcome assessment, 54 stuttering preschool children who presented to two public speech clinics in New Zealand for treatment were randomized to the Lidcombe programme (n = 29) or to the control group (n = 25). At baseline, frequency of stuttering was at least 2% of syllables stuttered. Age range was three to six years, and 12 of the participants were girls. Children with onset of stuttering during the six months before recruitment or treatment of stuttering during the previous 12 months were excluded.

    Parents audiotaped recordings of conversational speech outside the clinic. These were used to measure frequency of stuttering in three different speaking situations before randomization and at three, six, and nine months after randomization.

    At nine months after randomization, the mean proportion of syllables stuttered was 1.5% ± 1.4% for the treatment group and 3.9% ± 3.5% for the control group (effect size, 2.3% of syllables stuttered; 95% confidence interval, 0.8 - 3.9; P = .003). This effect size was more than double the minimum clinically worthwhile difference as specified before treatment in the trial protocol.

    "The results provide evidence from a randomised controlled trial to support early intervention for stuttering," the authors write. "The Lidcombe programme is an efficacious treatment for stuttering in children of preschool age."

    Study limitations include achieved sample size only half of that proposed, study dropout by seven (13%) of the 54 randomized participants, and postrandomization period of only nine months.

    "Waiting for an extended period to see if natural recovery occurs is not acceptable because it seems that the Lidcombe programme is less efficacious once children move into the school age years," the authors conclude. "In addition, delaying treatment until the school age years is not a viable option because of the negative social and cognitive consequences of stuttering at this age. If the disorder persists into the school age years a child is exposed to unacceptable risk of experiencing the disabling effects of chronic and intractable stuttering throughout life."

     This study had no funding, and the authors report no competing interests.

BMJ. 2005;331:659-661

GOOGLE: Stuttering