Palin STSC (8-14)
Research type
Research Study
Full title
Evaluating Palin Stammering Therapy for School Children (Palin STSC 8-14) versus Treatment as Usual: a feasibility trial
IRAS ID
251914
Contact name
Sharon Millard
Contact email
Sponsor organisation
Whittington Hospital NHS Trust
Duration of Study in the UK
1 years, 11 months, 31 days
Research summary
Research Summary
Stammering can have a long term impact on a child’s development, with reduced self-esteem, increased anxiety, difficulties participating in class or making friends. Approximately 66,000 school-aged children in England stammer and we need a therapy programme that is effective, cost-effective, and available to families through their local services.
One approach, Palin Stammering Therapy for School Children (8-14) (Palin STSC) aims to help children to be more confident communicators. The therapy focuses on building skills in three areas: communication skills; managing unhelpful thoughts and emotions; and, speech tools to reduce struggle when speaking. Parents are involved throughout and research shows this approach is effective when delivered at the Michael Palin Centre, where it was developed.
To find out whether Palin STSC would be as helpful for children attending other clinics for stammering, we need to test it with lots of people. Firstly, we need to carry out a small study with a few people, to see whether a larger study could work. This is the purpose of this study.
Speech and language therapists who agree to take part will be randomly placed into one of two groups. Those in the Palin STSC group will be trained in the programme, and those in the other group will carry out treatment as they usually would. Families are randomly allocated to a therapy and complete questionnaires before therapy and six months later. Interviews will be conducted with some therapists, parents and children.
This study will tell us if the research and therapy methods are acceptable, how many therapists and children are likely to take part and whether therapists are able to carry out the programme in local clinics. We can then decide whether and how to carry out a large study to find out if Palin STSC is helpful to families outside the Michael Palin Centre.
Summary of Results
This summary was written in consultation with the trial Advisory Group.
AIMS:
The purpose of this research was to find out if it would be possible to run a large study to look at the effectiveness of Palin Stammering Therapy for School aged Children (Palin STSC(8-14), compared to what is usually delivered. Palin STSC(8-14) is a 10-week therapy programme which begins with a detailed assessment and then each therapy session is attended by parent(s) and child. The aim of the therapy is to encourage confident communication in children, reduce the impact of stammering and to help parents to feel more knowledgeable about supporting their child.Before we can run a large research study to find out whether this is more or less effective than therapy that is already available, we had to do a smaller study to find out if that would be possible. We wanted to find out:
1) whether speech and language therapists (SLTs), children who stammer and their parents are willing to take part in this research and this therapy;
2) whether the assessments we have selected are appropriate;
3) if the research methods are acceptable;
4) if Palin STSC(8-14) is acceptable;
5) whether speech and language therapists are able to deliver the therapy in their clinics following the training; and,
6) the costs of conducting a full trial and delivering the new therapyFull details about the feasibility trial can be found here: https://eur03.safelinks.protection.outlook.com/?url=https%3A%2F%2Fu2790089.ct.sendgrid.net%2Fls%2Fclick%3Fupn%3DXv3JSvJ-2B3M71ppf7N9agbQdxzo1OD8U50W-2FH50-2BzuqHYyhAptSX1IFbdaqkSRw1uPnxAaFUXiUQUbWbmxA-2FEuZOgPAX9c6lsonNgHtgIoa-2B-2BeJmfrCXluqVrqGiiWYvPhwgl_E1aO2-2BZlVOSJJV-2FajQqskegTd6IRomHYTi-2Fbt8SH3YK7VSEGe6RmDQTDWM8rEQELP20WX-2FEJ7DkAPyM25BkKARiyIO4HjoI6Z-2BJySoP9js-2F382c1jVD22nSyUnyAjdUwlTjKtt2ofPxXtcVPLAvl2mRm9c1P7Dq6sK9AJnmup-2BvxCIHwx3oUi-2FmWWW8b5IkgKHDDnCwQ8fMfnUYtPbAUzg-3D-3D&data=05%7C01%7Capprovals%40hra.nhs.uk%7C25094dcce3fe442dcd3208dacbe5183d%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638046482056643975%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=Jjtjkdojt7Eh3KPDSUL0am4z9O%2BtQkpvpLE3EiIQiAc%3D&reserved=0
FINDINGS
In summary, we found that:
1) SLTs, parents and children are willing to be involved in a study like this. We recruited more SLTs, children and parents than we expected, demonstrating a clear need for this therapy and this research.2) The feedback about the assessments was mixed. Some people found the questionnaires challenging:
e.g. "just repetitive. It just kept saying the same thing. It was just a bit annoying" (child)
"Hard because there was a lot of them" (child) while others found them a helpful way to learn more about stammering and how it is being experienced:
e.g. "What was really nice about those questionnaires that we did is actually spending that time with him, going through them, and actually looking at how we did feel" (parent)
“It gave him control, which I think is really good, especially for a child of his age… that gave him confidence as well.”
3) Overall, our participants found the research methods to be acceptable and the SLTs completed almost all of the questionnaires and information requested at the start and the end of the trial. Parents and children found it harder to complete all of the assessments. There were most problems with the postal questionnaire and we will make some changes for the full trial as a result.4) SLTs, children and families enjoyed the Palin STSC(8-14) therapy and mostly found it helpful.
E.g. “It was a good experience for the both of us and I guess it was a learning curve for both of us as well. We really thoroughly enjoyed it”. (parent)
“I didn't mind having the therapy. I found it useful.” (child)Although, it is apparent that the children need to be engaged in the process for there to be an impact and not all wanted/were ready for therapy.
5) We changed our training of Palin STSC(8-14) from face-to-face workshops to a series of webinars because of the pandemic. This turned out to be very helpful, enabling more SLTs to take part. When we watched the therapy recordings, it was clear that the teaching was successful and that the SLTs were able to implement what they had learnt into their everyday clinics.
6) We have found out how much it will cost to deliver Palin STSC(8-14) in comparison to usual treatment, which is usually shorter.
NEXT STEPS
We are not able to say whether one therapy is better than another at this stage, because this feasibility study was not set up to do that. But, with all the information that we now have, we are confident that we can set up and run a large-scale study to look into that. We intend to apply for funding to do that over the next few months.REC name
London - Bloomsbury Research Ethics Committee
REC reference
19/LO/0933
Date of REC Opinion
17 Jun 2019
REC opinion
Favourable Opinion