BMJ, doi: 10.1136/bmj.38520.451840.E0, (Published 11 August 2005)

PAPERS

Randomised controlled trial of the Lidcombe programme of early stuttering intervention

Mark Jones ¹, Mark Onslow ^2*, Ann Packman ², Shelley Williams ³, Tika Ormond ⁴, Ilsa Schwarz ⁵, Val Gebski ⁶

¹ Queensland Clinical Trials Centre, University of Queensland, Princess Alexandra Hospital, Woollongabba, Queensland 4102, Australia
² Australian Stuttering Research Centre, University of Sydney, Lidcombe, NSW 2141, Australia
³ Stuttering Treatment and Research Trust, Parnell, Auckland 1001, New Zealand
⁴ Department of Communication Disorders, University of Canterbury, Christchurch 8020, New Zealand
⁵ Department of Audiology and Speech Pathology, University of Tennessee, Knoxville, Tennessee 37996, USA
⁶ National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Camperdown, NSW 2050, Australia

^* Correspondence to: m.onslow{at}fhs.usyd.edu.au.

Objectives To evaluate the efficacy of the Lidcombe programme of early stuttering intervention by comparison to a control group.

Design A pragmatic, open plan, parallel group, randomised controlled trial with blinded outcome assessment.

Setting Two public speech clinics in New Zealand.

Participants Stuttering preschool children who presented to the speech clinics for treatment. Inclusion criteria were age 3-6 years and frequency of stuttering of at least 2% syllables stuttered. Exclusion criteria were onset of stuttering during the six months before recruitment and treatment for stuttering during the previous 12 months. 54 participants were randomised: 29 to the Lidcombe programme arm and 25 to the control arm. 12 of the participants were girls.

Intervention Lidcombe programme of early stuttering intervention.

Main outcome measures Frequency of stuttering was measured as the proportion of syllables stuttered, from audiotaped recordings of participants' conversational speech outside the clinic. Parents in both arms of the trial collected speech samples in three different speaking situations before randomisation and at three, six, and nine months after randomisation.

Results Analysis showed a highly significant difference (P=0.003) at nine months after randomisation. The mean proportion of syllables stuttered at nine months after randomisation was 1.5% (SD 1.4) for the treatment arm and 3.9% (SD 3.5) for the control arm, giving an effect size of 2.3% of syllables stuttered (95% confidence interval 0.8 to 3.9). This effect size was more than double the minimum clinically worthwhile difference specified in the trial protocol.

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

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(Accepted 8 June 2005)
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