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O'Brian S, Hayhow R, Jones M, Packman A, Iverach L, Onslow M, Menzies R. Lidcombe Program translation to community clinics in Australia and England. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:295-309. [PMID: 36114801 PMCID: PMC10946954 DOI: 10.1111/1460-6984.12785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 07/26/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Early intervention is essential healthcare for stuttering, and the translation of research findings to community settings is a potential roadblock to it. AIMS This study was designed to replicate and extend the Lidcombe Program community translation findings of O'Brian et al. (2013) but with larger participant numbers, incorporating clinicians (speech pathologists/speech anlanguage therapists) and their clients from Australia and England. METHODS & PROCEDURES Participants were 51 clinicians working in public and private clinics across Australia (n = 36) and England (n = 15), and 121 of their young stuttering clients and their families. Outcome measures were percentage of syllables stuttered (%SS), parent severity ratings at 9 months post-recruitment, number of clinic visits to complete Stage 1 of the Lidcombe Program, and therapist drift. OUTCOMES & RESULTS Community clinicians in both countries achieved similar outcomes to those from randomized controlled trials. Therapist drift emerged as an issue with community translation. Speech and language therapists in England attained outcomes 1.0%SS above the speech pathologists in Australia, although their scores were within the range attained in randomized trials. CONCLUSIONS & IMPLICATIONS Community clinicians from Australia and England can attain Lidcombe Program outcome benchmarks established in randomized trials. This finding is reassuring in light of the controlled conditions in clinical trials of the Lidcombe Program compared with its conduct in community practice. The long-term impact of therapist drift in community clinical practice with the Lidcombe Program has yet to be determined. WHAT THIS PAPER ADDS What is already known on the subject The Lidcombe Program is an efficacious early stuttering intervention. Translation to clinical communities has been studied with one Australian cohort. What this paper adds to existing knowledge A larger translation cohort is studied, comprising community clinicians and children in Australia and England. What are the potential or actual clinical implications of this work? Community clinicians from Australia and England can attain Lidcombe Program outcome benchmarks established in randomized trials. This finding is reassuring in light of the controlled conditions in clinical trials of the Lidcombe Program compared with its conduct in community practice.
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Affiliation(s)
- Sue O'Brian
- Australian Stuttering Research CentreUniversity of Technology SydneyNSWAustralia
- Former location of Australian Stuttering Research Centre at University of SydneyNSWAustralia
| | - Rosemarie Hayhow
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS TrustBristolUK
| | | | - Ann Packman
- Australian Stuttering Research CentreUniversity of Technology SydneyNSWAustralia
- Former location of Australian Stuttering Research Centre at University of SydneyNSWAustralia
| | - Lisa Iverach
- Former location of Australian Stuttering Research Centre at University of SydneyNSWAustralia
- Present Address: University of SydneyNSWAustralia
| | - Mark Onslow
- Australian Stuttering Research CentreUniversity of Technology SydneyNSWAustralia
- Former location of Australian Stuttering Research Centre at University of SydneyNSWAustralia
| | - Ross Menzies
- Australian Stuttering Research CentreUniversity of Technology SydneyNSWAustralia
- Former location of Australian Stuttering Research Centre at University of SydneyNSWAustralia
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Mohammadi H, Maazinezhad S, Lorestani E, Zakiei A, Dürsteler KM, Brühl AB, Sadeghi-Bahmani D, Brand S. Sleep Problems, Social Anxiety and Stuttering Severity in Adults Who Do and Adults Who Do Not Stutter. J Clin Med 2022; 12:jcm12010161. [PMID: 36614966 PMCID: PMC9821465 DOI: 10.3390/jcm12010161] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/11/2022] [Accepted: 12/18/2022] [Indexed: 12/28/2022] Open
Abstract
Background: While there is sufficient evidence that children and adolescents who stutter reported more impaired sleep compared to children and adolescents who did not stutter, findings among adults who stutter (AWS) were scarce. Furthermore, stuttering is associated with issues related to verbal communication in a social context. As such, it was conceivable that AWS reported higher scores for social anxiety, compared to adults who do not stutter (AWNS). In the present study, we tested whether AWS reported higher sleep complaints compared to AWNS. We further tested whether scores for social anxiety and stuttering independently predicted sleep disturbances. Methods: A total of 110 AWS (mean age; 28.25 years, 27.30% females) and 162 AWNS (mean age; 29.40 years, 51.20% females) completed a series of self-rating questionnaires covering sociodemographic information, sleep disturbances and social anxiety. Adults with stuttering further completed a questionnaire on stuttering. Results: Compared to AWNS, AWS reported a shorter sleep duration, a lower sleep efficiency, higher scores for drug use in terms of sleep-promoting medications (significant p-values and medium effect sizes), and an overall higher PSQI score (significant p-values and large effect size), when controlling for age and social anxiety. Next, while p-values were always significant for subjective sleep quality, sleep disturbances, and daytime functioning, when controlling for age and social anxiety, their effect sizes were trivial or small. For sleep latency, the p-value was not significant and the effect size was trivial. Among AWS, higher scores for stuttering and older age, but not social anxiety, predicted higher sleep disturbances. The association between higher sleep disturbances and higher stuttering severity was greatest among those AWS with highest scores for social anxiety. Conclusions: When compared to AWNS, AWS self-reported higher sleep disturbances, which were associated with older age, and higher scores for stuttering severity, but not with social anxiety. Adults who stutter might be routinely asked for their sleep quality.
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Affiliation(s)
- Hiwa Mohammadi
- Neuroscience Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
- Sleep Disorders Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
| | - Soroush Maazinezhad
- Sleep Disorders Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
| | - Elaheh Lorestani
- Department of Psychology, Tarbiat Modares University, Tehran 1411713116, Iran
| | - Ali Zakiei
- Sleep Disorders Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
| | - Kenneth M. Dürsteler
- Department of Addictive Disorders, Psychiatric University Clinic Basel, 4002 Basel, Switzerland
- Department for Psychiatry, Psychotherapy and Psychosomatic, Psychiatric Hospital, University of Zurich, 3002 Zurich, Switzerland
| | - Annette Beatrix Brühl
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland
| | | | - Serge Brand
- Sleep Disorders Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland
- Division of Sport and Psychosocial Health, Department of Sport, Exercise, and Health, University of Basel, 4052 Basel, Switzerland
- Substance Abuse Prevention Research Center and Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran 1417466191, Iran
- Center for Disaster Psychiatry and Disaster Psychology, Psychiatric University Hospital Basel, 4002 Basel, Switzerland
- Correspondence:
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Mark VW. Functional neurological disorder: Extending the diagnosis to other disorders, and proposing an alternate disease term—Attentionally-modifiable disorder. NeuroRehabilitation 2022; 50:179-207. [DOI: 10.3233/nre-228003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: The term “functional neurological disorder,” or “FND,” applies to disorders whose occurrence of neurological symptoms fluctuate with the patient’s attention to them. However, many other disorders that are not called “FND” nonetheless can also follow this pattern. Consequently, guidelines are unclear for diagnosing “FND.” OBJECTIVE: To review the neurological conditions that follow this pattern, but which have not so far been termed “FND,” to understand their overlap with conditions that have been termed “FND,” and to discuss the rationale for why FND has not been diagnosed for them. METHOD: A systematic review of the PubMed literature registry using the terms “fluctuation,” “inconsistency,” or “attention” did not yield much in the way of these candidate disorders. Consequently, this review instead relied on the author’s personal library of peer-reviewed studies of disorders that have resembled FND but which were not termed this way, due to his longstanding interest in this problem. Consequently, this approach was not systematic and was subjective regarding disease inclusion. RESULTS: This review identified numerous, diverse conditions that generally involve fluctuating neurological symptoms that can vary with the person’s attention to them, but which have not been called “FND.” The literature was unclear for reasons for not referring to “FND” in these instances. CONCLUSION: Most likely because of historical biases, the use of the term “FND” has been unnecessarily restricted. Because at its core FND is an attentionally-influenced disorder that can respond well to behavioral treatments, the field of neurological rehabilitation could benefit by extending the range of conditions that could be considered as “FND” and referred for similar behavioral treatments. Because the term “FND” has been viewed unfavorably by some patients and clinical practitioners and whose treatment is not implied, the alternative term attentionally-modifiable disorder is proposed.
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Affiliation(s)
- Victor W. Mark
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
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