Benefits of Adding a Psychomotor Therapy Over a Combined-Approach Treatment in Adults who Stutter: A Randomized Controlled Trial

Background

Few previous randomized trials investigated whether additional therapies could improve the efficacy of the standard combined-approach (stuttering modification and fluency shaping) treatment in adults who stutter (AWS).

Aims

To evaluate in a randomized controlled clinical trial whether the addition of a psychomotor therapy over a standard combined-approach treatment could improve the efficacy of treatment in young AWS.

Methods & Procedures

A total of 47 young AWS (mean age = 24 years, 79% males) with at least moderate stuttering (evaluated by the stuttering severity instrument—3, SSI-3 ≥ 21 points) were randomized to either a standard combined-approach treatment (24 AWS, control group, 16 sessions of 40 min over 8 weeks) or to standard treatment plus the psychomotor therapy (23 AWS, intervention group, adding 20 min of psychomotor training after each session). Stuttering improvement was assessed by reductions in SSI-3 scores, examined using Wilcoxon tests. The primary outcome was the difference in SSI-3 reductions between the control and intervention groups, evaluated by Mann–Whitney tests.

Outcomes & Results

Control and psychomotor intervention groups were well-balanced in most baseline characteristics, including stuttering severity (mean SSI-3 score = 32.6 points). After treatment both groups significantly reduced SSI-3 (mean absolute reduction = 10.1 points, 95% confidence interval (CI) = 8.5–11.7 points, p < 0.001), without any significant difference between the two groups (mean difference = 1.0 point, 95% CI = −2.2 to −4.2 points, p = 0.39). Also, there were no significant differences between the groups in relative percentage reductions, or in the proportion of individuals who reached a > 30% reduction or a post-treatment SSI-3 < 20 points. There were also no significant differences in separate SSI-3 components (frequency and duration of stuttering events and physical concomitants).

Conclusions & Implications

This randomized controlled trial did not demonstrate any benefit of adding a psychomotor therapy over a standard combined-approach treatment in young AWS.

Trial Registration

ReBEC, identifier number RBR-6YY755.

WHAT THIS PAPER ADDS

What is already known on the subject

• Two types of strategies to treat stuttering have been most widely used: stuttering management and fluency shaping. Although there is no consensus in the literature about the best strategy to treat stuttering, in general, comprehensive (combined) approaches seem to provide the best results. Furthermore, the development of psychomotor factors can help the individual to perform more efficient linguistic operations, thus favouring the development of its own communication and potentially improving stuttering.

What this paper adds to the existing knowledge

• This randomized controlled trial did not demonstrate any benefit of adding a psychomotor therapy over a standard combined-approach treatment in young AWS. In addition to these results, this paper reinforces that the traditional speech–language treatment is highly effective in improving stuttering severity.

What are the potential or actual clinical implications of this work?

• A psychomotor therapy did not improve the efficacy of the traditional combined-approach stuttering treatment in AWS, and it shall not be used. Otherwise, it reinforces the efficacy of the standard speech–language treatment even in AWS with a long-standing history of stuttering, which supports the effective approaches in clinical practice of speech–language pathologists worldwide.