Palin Stuttering Therapy for School aged Children and usual treatment: A randomised controlled trial feasibility study.

The trial was not designed or powered to show whether Palin STSC(8-14) works better than usual care, so the lack of a significant difference is not evidence that the two are equivalent. Follow-up data were thin: only 20 of the 54 families still in the trial completed the six-month assessments in full, and only 8 of 24 children in usual care and 12 of 32 in the Palin arm finished the study. More than a quarter of the children in the Palin arm (9 of 32) stopped therapy, one because of high distress during sessions; three others in that arm withdrew because stuttering was no longer a concern. Almost half the therapists taking part were stuttering specialists, and the authors say this may have helped them deliver the programme so faithfully; the results may not carry over to therapists with little stuttering training. Speech samples were scored by research assistants who knew which group each child was in and when the sample was taken, so those scores are not fully independent. Usual NHS treatment was whatever each therapist normally did, so the number and content of sessions varied between services; 'usual care' here is not one fixed comparison. The children recruited were mostly White British and did not reflect the ethnic mix of the areas taking part, and no translated materials or interpreters were available. Therapy often began later and ran on longer than planned because of holidays, sickness, COVID-19 restrictions and service pressures, leaving little time for children to consolidate new skills before the six-month follow-up. The study was suspended for nine months by the pandemic, and only one of the four sites and 4 of the 15 therapists recruited beforehand re-joined.

No funding source is stated in the paper. One author, Sharon Millard, is employed at the Michael Palin Centre for Stammering, where this therapy was developed, and is an editorial board member of the journal, though she was not involved in the editorial review or the decision to publish. No other competing interests are declared.

Do not read the significant result for parents' knowledge and confidence, or the authors' line about early indications of effectiveness, as evidence that Palin STSC(8-14) reduces stuttering or its impact. It was the only significant difference between the groups. The measures children completed, including stuttering severity and the impact of stuttering on their lives, showed no significant difference, and the trial was too small and was not designed to detect one.