JCPSLP Vol 19 No 2 2017

9-months post-commencement point was 1.5 (SD = 0.9; Range = 1–3). At this time point, 80% of the children were reported to have an SR = 2 or less. The repeated measures GEE analyses for the assessment time effect indicated for both %SS (Wald X 2 (2) = 95.410, p < 0.001) and SR (Wald X 2 (2) = 175.251, p < 0.001) that there was a statistically significant effect over the three assessment times. The time-specific comparisons indicated a significant reduction in stuttering with a large effect size between the baseline scores at the initial assessment (T1) and the 6-months post-commencement assessment (T2) for both %SS (Wald X 2 (1) = 56.71, p < 0.001, effect size 1.71) and SR (Wald X 2 (1) = 88.69, p < 0.001, effect size 2.26). Subsequently, there was only a non-significant change, with a negligible effect size, between the 6-months post-commencement (T2) and 9-months post commencement assessment (T3) for both %SS ( X 2 (1) = 0.655, p = 0.42, effect size 0.23) ) and SR ( X 2 (1) = 0.48, p = 0.49, effect size 0.23) (see Table 3).

12

1

8

6

Mean %SS Figure 1. Mean clinician percentage syllable stuttered (%SS) at initial assessment (n = 19), 6 months (n = 14) and 9 months (n = 10) post-commencement of group treatment 4 2 0 Initial assessment 6 months post- commencement 9 months post commencement

Table 3. Intention to treat analysis using generalised estimating equation method

comparing clinician percentage syllables stuttered (%SS) and parent–clinician agreed severity rating (SR) initial assessment (T1), 6 months (T2) and 9 months (T3) post-commencement

8

7

N

df

p

Effect size

Wald X 2

6

5

%SS 19, 14, 10 T1 vs T2 56.707 1 <.001 1.71

T2 vs T3 .655

1 .418 .23

4

The %SS scores were comparable to the parent–clinician agreed severity ratings (SR) taken within clinic at the same points. The SR scale from 1 = no stutter to 10 = extremely severe stuttering was used. A guideline update (Packman et al., 2015) has subsequently changed the scale from 0 to 9. The mean SR for all the children assessed at the Mean SR Figure 2. Mean parent–clinician severity rating (SR) at initial assessment (n = 19), 6 months (n = 14) and 9 months (n = 10) post-commencement of group treatment 3 2 1 0 Initial assessment 6 months post- commencement 9 months post commencement

SR 19, 14, 10 T1 vs T2 88.692 1 <.001 2.26

T2 vs T3 .479

1 .489 .27

Discussion This clinician-led trial is the first to investigate the short-term treatment outcomes of the LP rolling-group model in community settings. Across all measures, the community- based SLPs achieved clinical outcomes similar to those benchmarks published in the literature: mean clinician hours to completion of Stage 1 (Arnott et al., 2014), median number of clinical visits and weeks to attain Stage 2 (Arnott et al., 2014; O’Brian et al., 2013; Rousseau, Packman, Onslow, Harrison, & Jones, 2007) and percentage of syllables stuttered (%SS) at criteria for Stage 2 (Arnott et al., 2014; de Sonneville-Koedoot et al., 2015; Jones et al., 2005). Stuttering severity levels exhibited a statistically significant reduction between pre-treatment and 6-months

Table 2. Clinician percent syllables stuttered (%SS) and parent–clinician agreed severity rating (SR) at initial assessment, 6 and 9 months post-commencement assessment

Severity measure Assessment

n

Mean

SD

Min

Max

%SS

Initial assessment

19

7.4

3.9

2.6

17.0

6 months post-commencement

14

1.4

1.7

0

5.0

9 months post-commencement

10

1.3

2.1

0

5.3

SR

Initial assessment

19

5.3

1.6

3

8

6 months post-commencement

14

1.6

1.0

1

4

9 months post-commencement

10

1.5

.9

1

3

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JCPSLP Volume 19, Number 2 2017

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