CARE Model Therapy for Stuttering

Overseen by Courtney T Byrd, PhD

Age: Any Age

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: University of Texas at Austin

No Placebo Group

Approved in 1 Jurisdiction

Trial Summary

What is the purpose of this trial?

This trial is testing online therapy sessions and specialized training for speech therapists to help people who stutter. It focuses on both monolingual and multilingual speakers. The goal is to improve their speech fluency by addressing various factors like speech patterns, language skills, and psychological aspects.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment for stuttering?

The Lidcombe Program, a treatment for early stuttering, showed that children had a significant reduction in stuttering after 9 months, especially when speech-language pathologists received formal training. This suggests that structured and well-supported speech therapy can be effective in reducing stuttering. ^{1 2 3 4 5}

What makes the CARE Model treatment for stuttering unique?

The CARE Model treatment for stuttering is unique because it likely incorporates a comprehensive, person-centered approach similar to models used in other conditions, focusing on individualized care and possibly integrating various supportive therapies in one setting, which is not typical for stuttering treatments. ^{6 7 8 9 10}

Research Team

Courtney T Byrd, PhD

Principal Investigator

The University of Texas at Austin

Eligibility Criteria

This trial is for children (2-17 years) and adults (18+ years) who stutter. Eligible participants are those recognized by caregivers or self-reported as individuals who stutter, have been diagnosed by a speech-language pathologist, or show a certain level of disfluency in their speech.

Inclusion Criteria

Criterion: Adults aged 18 and older who stutter and have received a formal diagnosis from a certified speech-language pathologist, or show specific stuttering-like behaviors during speech, or have a high score on a stuttering severity test.

My child, aged 2-17, shows signs of stuttering and meets the study's criteria.

Exclusion Criteria

There are no exclusion criteria for persons who stutter.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo interdisciplinary, telehealth, and speech-language pathology treatment methods specific to fluency disorders

11 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• The Blank Center CARE Model(TM) for Individuals who Stutter (Behavioral Intervention)

Trial Overview The study is examining the Blank Center CARE Model(TM), focusing on how it can help people who stutter. It looks at contributions to stuttering and evaluates telehealth treatments and training methods for fluency disorders.

Participant Groups

Group I: Blank Center CARE Model (Communication, Advocacy, Resilience, Education) Experimental Treatment 1 Intervention

Who Is Running the Clinical Trial?

University of Texas at Austin

Lead Sponsor

Trials

387

Recruited

86,100+

Dr. Elly Barry

University of Texas at Austin

Chief Medical Officer

MD from Harvard Medical School

Dr. Brian Windsor

University of Texas at Austin

Chief Executive Officer since 2023

PhD in Molecular Biology from the University of Texas at Austin

Findings from Research

Children and adolescents who stutter experience a moderate negative impact on their quality of life, as assessed by the Overall Assessment of the Speaker's Experience of Stuttering--School-Age (OASES-S).

There is a positive correlation between the severity of stuttering and its impact on quality of life, suggesting that more severe stuttering may lead to greater challenges in daily living, which can inform the development of targeted treatments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of stuttering on quality of life of children and adolescents. Chun, RY., Mendes, CD., Yaruss, JS., et al.[2019]

Speech restructuring interventions, such as the Camperdown Program, significantly reduced stuttering frequency in adults by 50-57%, although they did not achieve fluency levels comparable to those of individuals who do not stutter.

Transcranial direct current stimulation (tDCS) showed a smaller reduction in stuttering frequency (22-27%), and cognitive behavior therapy (CBT) was found to be an effective addition to speech restructuring, but the overall evidence for tDCS and psychological treatments remains limited.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A systematic review of interventions for adults who stutter. Brignell, A., Krahe, M., Downes, M., et al.[2020]

The Lidcombe Program for early stuttering showed promising effectiveness in community clinics, with children achieving a mean stuttering percentage of only 1.7% after 9 months of treatment.

Children treated by speech-language pathologists (SLPs) who received formal Lidcombe Program training had significantly better outcomes, achieving lower stuttering scores despite requiring more sessions, indicating the importance of proper training for effective treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of the Lidcombe Program for early stuttering in Australian community clinics. O'Brian, S., Iverach, L., Jones, M., et al.[2013]

Three core measures of treatment outcome for stuttering—stuttering rate, speech rate, and speech naturalness—are recommended for clinicians based on clinical trial data, emphasizing the need for direct speech measures in practice.

Severity ratings of stuttering are highlighted as valuable tools for clinicians, allowing for flexible and tailored outcome measurements that can enhance the assessment of treatment effectiveness in various settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Connecting stuttering management and measurement: I. Core speech measures of clinical process and outcome. Shenker, RC.[2016]

Stuttering is common in young children, but many recover naturally, making it difficult to predict who will need treatment; however, therapy during childhood is crucial for preventing chronic stuttering.

This review highlights evidence-based treatment options for stuttering in children and adolescents, while also addressing the clinical challenges faced in treating different developmental stages.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Management options for pediatric patients who stutter: current challenges and future directions. Donaghy, MA., Smith, KA.[2020]

The treatment center model aims to create a high-tech environment that attracts patients to academic medical centers, enhancing patient care and experience.

This model also focuses on retaining top clinicians by revising traditional academic structures and establishing appropriate goals and incentives for both the hospital and professional groups involved.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The treatment center: a model for competitive clinical practice. Nochomovitz, ML.[2000]

Specialized diabetes care (SDC) centers provide a comprehensive 'one-stop' approach to diabetes management, integrating medical care, education, nutrition, and lifestyle coaching, which leads to better patient outcomes.

The multidisciplinary team approach at SDC centers not only improves health results for patients but also helps reduce overall healthcare costs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Traditional or centralized models of diabetes care: the multidisciplinary diabetes team approach. Bratcher, CR., Bello, E.[2012]

The Culturally Competent Community Care (CCCC) model was developed to provide community health nurses with specific guidelines for delivering culturally competent care, which is essential for addressing health disparities among ethnic populations.

The model identifies key dimensions of culturally competent care—caring, cultural sensitivity, cultural knowledge, and cultural skills—and emphasizes their relationship with health outcomes, helping nurses better meet the health needs of diverse communities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A model for the delivery of culturally competent community care. Kim-Godwin, YS., Clarke, PN., Barton, L.[2019]

Implementing a sustainable patient-centered care (PCC) model is essential for improving healthcare in America, despite historical challenges and resistance from healthcare professionals who may view it as merely an economic tool.

The article emphasizes the importance of fostering strong relationships between healthcare providers and patients, suggesting that a cultural transformation is necessary to prioritize the needs of both parties in the healthcare system.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Why not person-centered care? The challenges of implementation. Hagenow, NR.[2019]

The South Calgary Health Centre (SCHC) has demonstrated high levels of staff and client satisfaction, indicating that it is functioning well as an integrated health service delivery model.

While the SCHC has not fully achieved its goal of complete clinical integration, the evaluation framework used to assess its performance has proven effective and may serve as a standard for future health center evaluations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Measuring key integration outcomes: a case study of a large urban health center. Suter, E., Hyman, M., Oelke, N.[2022]

References

1. Brazil pubmed.ncbi.nlm.nih.gov

The impact of stuttering on quality of life of children and adolescents. [2019]

2. United States pubmed.ncbi.nlm.nih.gov

A systematic review of interventions for adults who stutter. [2020]

3. England pubmed.ncbi.nlm.nih.gov

Effectiveness of the Lidcombe Program for early stuttering in Australian community clinics. [2013]

4. United States pubmed.ncbi.nlm.nih.gov

Connecting stuttering management and measurement: I. Core speech measures of clinical process and outcome. [2016]

5. New Zealand pubmed.ncbi.nlm.nih.gov

Management options for pediatric patients who stutter: current challenges and future directions. [2020]

6. United States pubmed.ncbi.nlm.nih.gov

The treatment center: a model for competitive clinical practice. [2000]

7. United States pubmed.ncbi.nlm.nih.gov

Traditional or centralized models of diabetes care: the multidisciplinary diabetes team approach. [2012]

8. England pubmed.ncbi.nlm.nih.gov

A model for the delivery of culturally competent community care. [2019]

9. United States pubmed.ncbi.nlm.nih.gov

Why not person-centered care? The challenges of implementation. [2019]

10. United States pubmed.ncbi.nlm.nih.gov

Measuring key integration outcomes: a case study of a large urban health center. [2022]