Integration of Individualized Variables of School-age Children Who Stutter Into Intensive Stuttering Group Therapy and the Effect of Emotional Reactivity on Therapy Outcomes
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 11
- 主要终点
- The stuttering severity
研究概览
简要总结
The primary objectives of this investigation were two-fold: 1) to investigate whether implementation of individualized desensitization exercises in an intensive stuttering group therapy for school-age children who stutter is superior to the standard application of intensive stuttering group therapy, 2) to examine the relationship between exhibited emotional reactivity (positive and negative affect) and stuttering recovery rates. Secondary objectives included: 1) investigating whether cognitive, affective, linguistic and social scores differ with treatment and, 2) heart rate and skin conductance changes associated with the stuttered utterance during intensive stuttering group therapy activities.
Twelve children (8 to 12 years of age, with equal randomization [1:1]) randomized to two groups; 1) Study group, individualized desensitization exercises implemented in 2 weeks of intensive stuttering group therapy(n=6), 2) Control group, 2 weeks of standard intensive stuttering group therapy(n=6). Children were blinded to treatment arm. The first part of this study was a superiority trial of individualized desensitization exercises in intensive stuttering group therapy. The second part of the study was conducted with the study group during the daily therapy activities of intensive stuttering group therapy to investigate the emotion's effect on therapy outcomes with behavioral and physiological measures.
详细描述
The investigators hypothesized that (1) implementation of the usage of individualized desensitization exercises in an intensive stuttering group therapy created more effective treatment results than standard implementation of the desensitization exercises in an intensive stuttering group therapy in school-age children who stutter, (2) recovery rates will differ according to exhibited affects before stuttered utterances, (3) heart rate and skin conductivity findings before, during and after the stuttered utterances will differ from the general findings.
Children (n=12) were recruited and randomized in a 1:1 ratio either Control group (n=6) or Study group (n=6) by the study assistant. Randomization was stratified by sex, using a block size of two. For the first part of the study 6 study assessors (speech and language therapy interns who were experienced in the assessment procedure) who were not otherwise involved in the study, were participated in baseline and follow-up assessments. Children were blinded to treatment arm. Video recordings of assessments of the Turkish version of Stuttering Severity Scale-4 were made. Offline assessments of the stuttering severity were done by two research assistants. One of the research assistants was blinded to group assignment and was not otherwise involved in the studies. Video recordings of assessments were labeled by decimal numbers randomly. The masking of the data was done by the study assistant. The second part of the investigation conducted with children in the study group.
For the first part of the study, intervention and family training was applied by a professional therapist who has 7 years of experience in stuttering therapy. When children applied for the baseline assessments, parent training was applied. Training included; (a) general information on stuttering, (b) underlying facts, and (c) how to communicate with their children. At the training session, parents were given an information brochure for teachers of their child. Family training was conducted a month before intensive stuttering group therapy.
The intervention used a hybrid approach which was combined with the evidence-based techniques: speech reconstruction includes fluency shaping and stuttering modification; cognitive restructuring; emotional restructuring; desensitization; video self-modeling.
Standard therapy application included 7 components:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Participant)
入排标准
- 年龄范围
- 8 Years 至 12 Years（Child）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •very mild to moderate stuttering based on Stuttering Severity Instrument-4-Turkish Version
- •no history of intellectual, emotional, academic, hearing, neurological, physiological problems based on parental report
- •no history of speech and/or language problems other than stuttering
- •not to be received stuttering therapy during the previous six months.
排除标准
- 未提供
研究组 & 干预措施
Study Group
Intensive stuttering group therapy which was included individualized desensitization exercises was applied with the study group. Family training was applied with the parents a month before the therapy. Ten days (4.5 hours a day, a total of 45 hours therapy) of intensive stuttering group therapy was applied.
干预措施: individualized desensitization exercises (Behavioral)
Control Group
Standard intensive stuttering group therapy was applied with the control group. Family training was applied with the parents a month before the therapy. Ten days (4.5 hours a day, a total of 45 hours therapy) of intensive stuttering group therapy was applied.
干预措施: individualized desensitization exercises (Behavioral)
结局指标
主要结局
The stuttering severity
时间窗: One month before therapy to three months after therapy
Comparison of control group and study group by Turkish version of Stuttering Severity Instrument-4 score change.Stuttering Severity Instrument-4 is an instrument that measures stuttering severity of children in the age range of 6 to16 years. This instrument measures stuttering severity by 3 sub-items; 1)frequency, 2)duration, and 3)physical concominants. evaluates speech naturalness of the children's speech. Lowest available score on this instrument is 6 and is equivalent to very mild stuttering and 36\& higher points are equivalent to very severe stuttering.
Emotional reactivity (positive and negative affect) effect on therapy outcome
时间窗: Collected during first 3 days of the intensive stuttering group therapy to compare the therapy outcomes
Obtained by means coding behavioral analysis of positive and negative affect. Emotion facial action coding was used to code positive and negative affects. Positive affect coded when the following action units(AU) appeared; AU 12 (extraction of the lip corner) and AU 6 +12 (cheek up with the extraction of the lip corner). Positive affect may be accompanied by AU1 + 2 (eyebrow elevation), AU25 (mouth opening) or AU 26 (loosening of jaw). If AU12 occurs without AU6, AU12 should occur at least C severity in the intensity classification from 5 to likert type A to E If AU12 is present with AU6, the intensity of AU12 is B. For the acceptance of affect as negative; AU 9 (nose creasing); AU 10 (upper lip elevation); AU 14 (pitting); AU 15 (depression of the lip corner); it is necessary that at least one of the codes AU 20 (lips stretching) and AU 1 + 4 (lifting the eyebrows to the midline and approaching) occur at intensity B.
次要结局
- Heart rate changes(Collected during first 3 days of the intensive stuttering group therapy)
- Changes in cognitive, affective, linguistic and social scores(One month before therapy to three months after therapy)
- Skin conductance changes(Collected during first 3 days of the intensive stuttering group therapy)
研究者
Ilkem Kara
Research Assistant
Hacettepe University