A phase II clinical trial of self-imposed time-out treatment for stuttering in adults and adolescents.
OBJECTIVE
This study reports the development and clinical trial of a new treatment program for persistent developmental stuttering in adolescents and adults. The treatment is based on the operant procedure of self-imposed time-out. This involves the person stopping speaking for a short period after each stutter.


METHODS
Twenty-two participants completed Stage 1 (Instatement and Generalisation) of the program and 18 completed Stage 2 (Maintenance) of the program. Stuttering outcome was measured from independent audio and video recordings made outside and inside the clinic, before and after treatment. Speech naturalness was measured at the end of Stage 1. Secondary analyses were conducted to investigate whether responsiveness to the program was related to stuttering severity or age. Participants completed an extensive self-report inventory at the end of treatment.


RESULTS
There was a range of responsiveness to the treatment, with more than half the participants reducing their stuttering by more than 50%. Participants with more severe types of stuttering appeared to respond better but no other predictors of responsiveness were identified. Speech sounded reasonably natural after treatment. Participants' perceptions of the treatment were for the most part positive with the majority reporting that the treatment was easier to use and more effective than treatment based on prolonged-speech.


CONCLUSIONS
The self-imposed time-out treatment program reported here is clearly effective for a significant number of adolescents and adults who stutter. Given that it does not require speech restructuring and the constant attention to speech that this involves, this could be a treatment of choice for those who are likely to respond. Consequently, further research is needed to determine which clients seeking behavioural treatment for their stuttering will benefit most from this program. Further research is also needed to determine the extent to which the effectiveness of time-out is increased when combined with other behavioural treatments.
Hewat
Sally
S
Australian Stuttering Research Centre, The University of Sydney, Australia. Sally.Hewat@newcastle.edu.au
Onslow
Mark
M
Packman
Ann
A
O'Brian
Sue
S
D000293:Adolescent; D000328:Adult; D003216:Conditioning, Operant; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013068:Speech Production Measurement; D013070:Speech Therapy / Q000379:methods*; D013342:Stuttering / Q000628:therapy*; D013637:Tape Recording; D016896:Treatment Outcome