Verbal Contingencies in the Lidcombe Program: A Noninferiority Trial

Purpose: The Lidcombe Program is an efficacious and effective intervention for early stuttering. The treatment is based on parent verbal response contingent stimulation procedures, which are assumed to be responsible for treatment effect. The present trial tested this assumption. Method: The design...

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Published in:Journal of speech, language, and hearing research language, and hearing research, 2020-10, Vol.63 (10), p.3419-3431
Main Authors: Donaghy, Michelle, O'Brian, Sue, Onslow, Mark, Lowe, Robyn, Jones, Mark, Menzies, Ross G
Format: Article
Language:English
Subjects:
Care and treatment
Children & youth
Clinical trials
Contingency Management
Foreign Countries
Intervention
Language Acquisition
Methods
Outcomes of Treatment
Parent-child relations
Parents
Parents & parenting
Patient outcomes
Positive Reinforcement
Preschool children
Program Effectiveness
Randomized Controlled Trials
Speech
Speech Therapy
Stimulation
Stuttering
Syllables
Verbal Communication
Young Children
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Summary:Purpose: The Lidcombe Program is an efficacious and effective intervention for early stuttering. The treatment is based on parent verbal response contingent stimulation procedures, which are assumed to be responsible for treatment effect. The present trial tested this assumption. Method: The design was a parallel, open plan, noninferiority randomized controlled trial. In the experimental arm, the five Lidcombe Program verbal contingencies were removed from parent instruction. The primary outcome was beyond-clinic percentage syllables stuttered at 18-month follow-up. Seventy-four children and their parents were randomized to one of the two treatment arms. Results: Findings of noninferiority were inconclusive for the primary outcome of stuttering severity, based on a margin of 1.0 percentage syllables stuttered. Conclusions: The inconclusive finding of noninferiority means it is possible that verbal contingencies make some contribution to the Lidcombe Program treatment effect. However, considering all primary and secondary outcomes, an overriding impression from the trial is a similarity of outcomes between the control and experimental arms. The clinical applications of the trial are discussed, along with further research that is needed.
ISSN:1092-4388
1558-9102
DOI:10.1044/2020_JSLHR-20-00155