The Efficacy of Addition of Atomoxetine to Speech Therapy on the Stuttering Severity of Children Aged 4-12 Years; a Double-Blind Controlled Randomized Clinical Trial
Iranian Journal of Child Neurology,
Vol. 16 No. 3 (2022),
16 July 2022
,
Page 47-56
https://doi.org/10.22037/ijcn.v16i3.34450
Abstract
Objectives
Stuttering is a common problem at all ages and it is thus required to treat this problem since childhood. Atomoxetine is currently used for the treatment of attention deficit hyperactivity disorder (ADHD) and can also be effective for the treatment of stuttering due to its selective inhibition of norepinephrine reuptake and dopaminergic properties. Therefore, this randomized clinical trial (RCT) aimed to evaluate the effect of Atomoxetine on children’s stuttering.
Materials & Methods
Children aged 4–12 years, diagnosed with stuttering, who referred to pediatric neurology clinic, were randomly divided into experimental (N=50) and control (N=50) groups. One group received atomoxetine plus speech therapy and the other group only speech therapy. Both groups completed the Stuttering Severity Questionnaire (SSI4) at baseline (on the first visit) and three months after the intervention.
Results
Most (67%) were boy; 24% aged <60mo,46% 60–95mo,and 30% >95mo. About half (52%) had a positive family history of stuttering. Stuttering severity was highest at ages of 60–95mo, in left–handed children,those who used formula,and those who felt insecure in the family; but was not different based on child’s sex, concomitant ADHD, multilingualism, facial or movement tics, based on sleeping hours, and using teats. Mean stuttering severity reduced in both groups (P<.001) with a greater decrease in the experimental group, compared to the control group (P=.011).
Conclusion
Atomoxetine,plus speech therapy,is effective for the treatment of children’s stuttering and can be used as a complementary treatment strategy in these patients.
- Stuttering; Speech Therapy; Atomoxetine
How to Cite
References
Wieland EA, McAuley JD, Dilley LC, Chang S-E. Evidence for a rhythm perception deficit in children who stutter. Brain and Language.
;144:26-34
Yairi E, Ambrose N. Epidemiology of stuttering: 21st century advances. Journal of fluency disorders. 2013;38(2):66-87.
Shin M, Chon H, Lee J. Family history of stuttering in Korean children who stutter. Communication Sciences & Disorders. 2011;16(3):304-11.
Choi D, Conture EG, Tumanova V, Clark CE, Walden TA, Jones RM. Young children’s family history of stuttering and their articulation, language and attentional abilities: An exploratory study. Journal of communication disorders. 2018;71:22-36.
Howell P, Davis S. Predicting persistence of and recovery from stuttering by the teenage years based on information gathered at age 8 years. Journal of Developmental & Behavioral Pediatrics. 2011;32(3):196-205.
Blomgren M. Behavioral treatments for children and adults who stutter: a review. Psychology research and behavior management. 2013;6:9.
Perez HR, Stoeckle JH. Stuttering: clinical and research update. Canadian family physician. 2016;62(6):479-84.
Hammerness P, McCarthy K, Mancuso E, Gendron C, Geller D. Atomoxetine for the treatment of attention-deficit/hyperactivity disorder in children and adolescents: a review. Neuropsychiatric disease and treatment. 2009;5:215.
Schwartz S, Correll CU. Efficacy and safety of atomoxetine in children and adolescents with attention-deficit/hyperactivity disorder: results from a comprehensive meta-analysis and metaregression. Journal of the American Academy of Child & Adolescent Psychiatry. 2014;53(2):174-87.
Hanwella R, Senanayake M, de Silva V. Comparative efficacy and acceptability of methylphenidate and atomoxetine in treatment of attention deficit hyperactivity disorder in children and adolescents: a meta-analysis. BMC psychiatry. 2011;11(1):176.
Donaher J, Richels C. Traits of attention deficit/hyperactivity disorder in school-age children who stutter. Journal of fluency disorders. 2012;37(4):242-52.
Druker K, Hennessey N, Mazzucchelli T, Beilby J. Elevated attention deficit hyperactivity disorder symptoms in children who stutter. Journal of fluency disorders. 2019;59:80-90.
Lee H, Sim H, Lee E, Choi D. Disfluency characteristics of children with attention-deficit/hyperactivity disorder symptoms. Journal of communication disorders. 2017;65:54-64.
Conture EG. Treatment efficacy: stuttering. Journal of Speech, Language, and Hearing Research. 1996;39(5):S18-S26.
Tahmasebi N, Shafie B, Karimi H, Mazaheri M. A Persian-version of the stuttering severity instrument-version four (SSI-4): how the new additions to SSI-4 complement its stuttering severity score? Journal of communication disorders. 2018;74:1-9.
Donaghy MA, Smith KA. Management options for pediatric patients who stutter: current challenges and future directions. Pediatric health, medicine and therapeutics. 2016;7:71.
Smith KA, Iverach L, O’Brian S, Kefalianos E, Reilly S. Anxiety of children and adolescents who stutter: A review. Journal of fluency disorders. 2014;40:22-34.
Blood GW, Blood IM. Long-term consequences of childhood bullying in adults who stutter: Social anxiety, fear of negative evaluation, self-esteem, and satisfaction with life. Journal of fluency disorders. 2016;50:72-84.
Bajaj G, Varghese AL, Bhat JS, Deepthi J. Assessment of quality of life of people who stutter: A cross-sectional study. Rehabilitation Process and Outcome. 2014;3:RPO. S19058.
Boey R. Essentials of epidemiology and phenomenology of stuttering–consequences for clinical SLP practice. Logopedija. 2012;3(1):1-11.
Hughes CD. An Investigation of Family Relationships for People who Stutter: Bowling Green State University; 2007.
Ajdacic-Gross V, Vetter S, Müller M, Kawohl W, Frey F, Lupi G, et al. Risk factors for stuttering: a secondary analysis of a large data base. European archives of psychiatry and clinical neuroscience. 2010;260(4):279-86.
Mahurin-Smith J, Ambrose NG. Breastfeeding may protect against persistent stuttering. Journal of communication disorders. 2013;46(4):351-60.
Smith JM. Breastfeeding and language outcomes: A review of the literature. Journal of communication disorders. 2015;57:29-40.
Nogueira PR, Oliveira CMCd, Giacheti CM, Moretti-Ferreira D. Familial persistent developmental stuttering: disfluencies and prevalence. Revista CEFAC. 2015;17(5):1441-8.
Smith A, Weber C. How stuttering develops: The multifactorial dynamic pathways theory. Journal of Speech, Language, and Hearing Research. 2017;60(9):2483-505.
Chang S-E, Garnett EO, Etchell A, Chow HM. Functional and neuroanatomical bases of developmental stuttering: current insights. The Neuroscientist. 2019;25(6):566-82.
Kushner HI. Retraining left-handers and the aetiology of stuttering: the rise and fall of an intriguing theory. Laterality: Asymmetries of Body, Brain and Cognition. 2012;17(6):673-93.
Packman A. Theory and therapy in stuttering: A complex relationship. Journal of fluency disorders. 2012;37(4):225-33.
Kalinowski J, Saltuklaroglu T, Dayalu VN, Guntupalli V. Is it possible for speech therapy to improve upon natural recovery rates in children who stutter? International journal of language & communication disorders. 2005;40(3):349-58.
Boyle MP. Mindfulness training in stuttering therapy: A tutorial for speech-language pathologists. Journal of fluency disorders. 2011;36(2):122-9.
Irani F, Gabel R, Daniels D, Hughes S. The long term effectiveness of intensive stuttering therapy: A mixed methods study. Journal of fluency disorders. 2012;37(3):164-78.
Maguire GA, Yeh CY, Ito BS. Overview of the diagnosis and treatment of stuttering. Journal of Experimental & Clinical Medicine. 2012;4(2):92-7.
Donaher J, Healey EC, Zobell A. The effects of ADHD medication changes on a child who stutters. Perspectives on Fluency and Fluency Disorders. 2009;19(3):95-8.
- Abstract Viewed: 578 times