From: Anne Bothe
Date: 10/21/00
Time: 11:32:36 AM
Remote Name: 128.192.22.206
Hi, Erin and Amy!
Do I think that parents should have a say in whether their children receive direct or indirect treatment? Yes, because I believe that parents should have a say in just about everything that happens to their own children. I also believe, though, that parents deserve to be told that the research literature about treatments for children's stuttering shows that direct treatments can reduce or eliminate children's stuttering, often in a matter of a months, whereas there simply is not such evidence for indirect procedures.
How accurate do I feel our findings are, given that we had only 8 children in the main study and only 5 who continued in the second treatment part? This depends a little on what you mean by "accurate," but my general answer is very accurate, and thanks for asking, and let's see if I can explain my answer. First, the main part of our study was designed using single-subject experimental design, which means that we had all the design features of relatively stable baselines, repeated counterbalanced conditions, and so on -- so, as a scientist, I can look at the data from the first part of the study and say yes, pretty much, this experiment shows me that these children's stuttering reduced under certain conditions and did not reduce under certain other conditions. For the treatment part, the second phase, the worst possible explanation I could make of the results would be that only 5 of 8 children responded to the initial shortterm "trial" (in the first part of the study) of a direct approach, and then those 5 just happened to reduce their stuttering for some other, completely unrelated reason at about the same time that they happened to begin getting this treatment -- you've probably studied threats to the internal validity of a study, that's what I'm talking about: maybe we have one big history/maturation/test-practice interaction going here. I think that's relatively unlikely, given that all 5 responded so well, but you could still argue with me that there were only 5 of them, if what you mean by "accurate" findings is more a question of external validity, or whether these results can be generalized to and across other children. My answer there is based more on the fact that my study was not showing anything new -- these 5 children were really just replicating an effect that's been reported over and over in empirical and clinical forums for several decades. The biggest numbers that I'm aware of from one research program are from Dr. Onslow's team -- they've treated hundreds of children using similar parent-administered consequences over the last 10 years or so, and they consistently report that the vast majority of the children stop stuttering. They even report that they've gotten these hundreds of children to a maintenance phase in a median of about 11-12 weeks of treatment -- my work hasn't yet been able to replicate that very short time, a difference that I think we could explain with some relatively arcane measurement details that I will spare you, but my general point is that there are hundreds of kids in our literature who have had positive responses to similar treatments, so my findings just fit right in.
Thanks for your questions!