Interventions for children and adolescents who stutter: A systematic review, meta-analysis, and evidence map

• Published in: Journal of fluency disorders Vol. 70; p. 105843
• Main Authors: Brignell, Amanda, Krahe, Michelle, Downes, Martin, Kefalianos, Elaina, Reilly, Sheena, Morgan, Angela
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2021; Elsevier Science Ltd
• Subjects: Adolescent; Adolescents; Child; Child development; Child, Preschool; Humans; Intervention; Medical personnel; Meta-analysis; Preschool children; Randomized Controlled Trials as Topic; Speech therapy; Stuttering; Stuttering - therapy; Systematic review; Systematic Reviews as Topic; Teenagers; Therapeutics; Systematic review; Stuttering; Child; Adolescent; Therapeutics
• ISSN: 0094-730X; 1873-801X
• DOI: 10.1016/j.jfludis.2021.105843

[Display omitted] •The LP and DCM are effective in reducing stuttering in preschool children.•Quality of evidence was rated moderate risk of bias for included interventions.•Therapy delivered via telehealth or group format is non-inferior to standard format.•High-level evidence for school-aged children and adolescents who stutter is absent.•Future research should address the evidence gaps identified in this review. This systematic review critically appraises and maps the evidence for stuttering interventions in childhood and adolescence. We examine the effectiveness of speech-focused treatments, the efficacy of alternative treatment delivery methods and identify gaps in the research evidence. Nine electronic databases and three clinical trial registries were searched for systematic reviews, randomised controlled trials (RCTs) and studies that applied an intervention with children (2–18 years) who stutter. Pharmacological interventions were excluded. Primary outcomes were a measure of stuttering severity and quality assessments were conducted on all included studies. Eight RCTs met inclusion criteria and were analysed. Intervention approaches included direct (i.e. Lidcombe Program; LP) and indirect treatments (e.g. Demands and Capacities Model; DCM). All studies had moderate risk of bias. Treatment delivery methods included individual face-to-face, telehealth and group-based therapy. Both LP and DCM approaches were effective in reducing stuttering in preschool aged children. LP had the highest level of evidence (pooled effect size=-3.8, CI -7.3 to -0.3 for LP). There was no high-level evidence for interventions with school-aged children or adolescents. Alternative methods of delivery were as effective as individual face-to-face intervention. The findings of this systematic review and evidence mapping are useful for clinicians, researchers and service providers seeking to understand the existing research to support the advancement of interventions for children and adolescence who stutter. Findings could be used to inform further research and support clinical decision-making.