JCPSLP Vol 21 No 2 2019 DIGITAL Edition

from 26 different Melbourne suburbs. Travel ranged from less than 1 kilometre (i.e., the same suburb) to 65 kilometres one-way (i.e., 130km return). The mean distance travelled one-way was 14km (28km return), and median 11km one-way (22km return). Seventy-five per cent of clients had not previously been assessed or treated by an SLP for stuttering. Of the 25% who had been assessed, 70% were of preschool age (under 6). Three of the clients previously assessed were seeking a second opinion for a stuttering diagnosis provided by another SLP, and seven attended the clinic as they were unable to receive ongoing treatment at the initial service they attended (where the service was a community health service or school-based). In the initial assessment

National Health and Medical Research Council clinical trial definition for outcome measures (SPA, 2017). Results Client demographics A total of 40 files that met the inclusion criteria were obtained in the five-year file audit. Client age ranged from 2 years to 9 years, 11 months (table 1). There were 22 males (55%) and 18 females (45%). Thirty-six clients (90%) spoke English as their only language, one child (2.5%) was bilingual, two clients (5%) spoke English as a second language, and language status was not recorded for one child (2.5%). Clients travelled to the metropolitan practice

Table 1. Client demographics by age at assessment

Age in years

N (% of file audit)

Gender (male:female)

Previous assessment

Previous treatment

Not aware of public options

Family language other than English

Preschool (77.5%)

2;0–2;11

8 (20%)

5:3

0

0

7

0

3;0–3;11 11 (27.5%)

3:8

3

0

6

1

4;0–4;11

8 (20%)

4:4

0

0

6

0

5;0–5;11

6 (15%)

5:1

4

1

0

1

School-aged (22.5%)

6;0–6;11 3 (7.5%)

2:1

0

0

0

1

7;0–7;11

0 (0%)

0

0

0

0

0

8;0–8;11 3 (7.5%)

2:1

2

2

0

0

9;0–9;11 1 (2.5%)

0:1

0

0

0

1

Table 2. Community caseload clinical trial eligibility

Clinical trial criterion that clients did not meet

NHMRC Classification 1

NHMRC Ranking 2

Trial criterion (n = clients who met eligibility)

Age group (age)

Examples of clinical trial evidence 2000–2016

Preschool (under 6 years old)

Arnott et al. (2014), Bridgman et al. (2016) 3 Jones et al. (2005), Rousseau et al. (2007), Trajkovski et al. (2011)

II II II III

B B B B

45% n = 15/33

Stuttering less than 6 months (n = 1) Wanting to treat twins concurrently (n = 2) Concomitant conditions including: • speech sound disorder (n = 4) • language delay or disorder (n = 2) • cognitive or behavioural disorder (n = 2) • medical condition (n = 2) Received treatment within preceding 6 or 12 months (n = 1) Limited child or parent English / English not primary language spoken within the home (n = 3) Stuttering frequency less than 1% or 2%SS (1) Concomitant conditions including: • Diagnosed ASD (n = 1) Received treatment within preceding 6 or 12 months (n = 3) Limited child or parent English (n = 1)

III

D

School-aged (6;0–12;0)

Andrews et al., (2012; 2016)

IV

D

29% n = 2/7

Notes: n = 40; 1 NHMRC Classification: II = RCT with no treatment or benchmark treatment group, III = non--randomised trial, IV = non-randomised case study 2 NHMRC Ranking: B = Good, D = Poor 3 Did not have minimum stuttering frequency as eligibility criterion

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JCPSLP Volume 21, Number 2 2019

Journal of Clinical Practice in Speech-Language Pathology