Sunday, January 09, 2011

Predictions for 2011

I spoke with Peter from StutterTalk about our predictions for 2011. Here they are:

The King's Speech will alter public discourse:

The movie will put the spotlight on stuttering, and do more in terms of public discourse on stuttering than the last decades together. Stuttering will not be seen less as a matter of laugher, and more as a medical condition. This greater exposure might well lead to more funding for research or charities active in the field.

No difference between Lidcombe and Demands&Capacity treatment from Dutch study:

I had this on my list for last year, and according to my calculation the data is ready but not completely analysed and still private. In May 2009, the group had 106 kids enlisted for the trial. So by December 2010, these kids would have started treatment at least 18 months ago. So they already have DOUBLE the amount of kids with one-year after treatment data than as the Lidcombe study. Preliminary results should be there with a decent if impressive sample size.

But the whole publication is slowed done by the time it takes to analyse all the speech data (a complete nightmare if you ask a theorist like myself!), and by their obsession to have the complete sample (190 kids) done. Just think about it. Many groups publish with lousy 10, 20, or 50 kids, aka the Lidcombe group, and the Dutch group is too conscioutious and wait, effectively leaving us exposed to the weak but only research out there.

That reminds me of the saying: Good girls go to heaven, bad girls go everywhere! (or propagate the efficacy of their treatment with evidence-based practise with lousy sample size.)

So my prediction is like last year, that there is no difference. But they might not even publish in 2011. The data is there but maybe not for all 190 kids. But hey even 51 would be more than Lidcombe. I just hope that their group will keep up the efforts. I have seen many projects implode like the PEVOS project.

Pagoclone will be stopped for good and more information on the placebo group

It's not really a prediction, because the trial has been stopped. I guess the prediction or hope is that they publish the data of the study. I hope it won't take ages. And if a editor refuses because it's a null result, he/she should go to hell! As I said before, I want to see the placebo group, how much did they improve? If there is no measurement bias, the improvement should be low or zero. One open question is whether a subgroup have benefited, but even there I am not so sure.


Not much on genetics and neuro-imaging unless new technology

I am not sure much will happen in 2011, unless a new technology like MEEG will emerge. Genetics might find more genes. That's difficult to predict. But fundamentally, I don't think the neuro-imagers are going to have a breakthrough, because more theoretical work is needed.

So what are your predictions?

7 comments:

Anonymous said...

My prediction is that some of the new medications on the market for Bipolar/Schizophrenia will prove useful for people who stutter.

They are coming down the pipeline one after another, and Bipolar is a more common medical condition than stuttering.

If one medication gets approved for stuttering, the whole genre will fall like a house of cards, and many will be approved for stuttering.

Anonymous said...

^ Your last paragraph--Why do you think so? Where has this happened already that you think it might also happen with stuttering?

Just wondering, since I don't know myself . . .

Gerald Maguire, MD said...

I agree with the earlier post. Every dopamine blocking medication that has been studied in stuttering has yielded positive results, However, many of the older compounds have been associated with difficult side-effects such as muscle stiffness, sedation or weight gain. With newer compounds being released for Bipolar/Schizophrenia which have fewer side-effects, the future looks bright for at least one of these medications to receive approval for use in stuttering. The key will be convincing a pharmaceutical company to invest the significant funds it will require to navigate through the FDA process. Such an FDA approval will certainly change the nature of first-line stuttering treatment.

John said...

I predict that somebody will publich yet another study of stuttering in twins. They've been doing it for nearly half a century, so why should 2011 be any different.

Anonymous said...

@ the second post..

I think it might happen with stuttering for this reason.. A couple of the formerly only Schizophrenia/Bipolar medications are being FDA approved as ADD on medication for people taking SSRI antidepressants.

Quite a few people who stutter fight with social anxiety, and depression including myself.

It is going to be much easier to get a doc to prescribe Seroquel XR, Abilify, or another medication because they have been approved as add on treatments if you are already taking an SSRI.

Then patients are going to report their speech is improved somewhat. This alone might be enough for at least one drug company to tip and pay the money to study stuttering.

That, and publicity from the King's Speech can't hurt either.

Stuttering used to be quite the unknown disorder, and its victims are the object of ridicule. Now I think its tipping, and being understood by the mainstream for what is really is--

A neurological disorder..

Furthermore, I do not think that Seroquel XR or Abilify are the best drugs for treating stuttering, but new ones are coming down the pipe that will work better and most importantly have less side effects.

nicole hallborg said...

So I'm not sure if people read this or not anymore! But I'm looking for some support. My son is 4 1/2, we have been seeing speech for just over a year. Our therapist has suggested we take the sit back appracch. K is not recognizing he is stuttering and is very confident in his speech- he talks allll the time! Anyway, a year later and we have made no progress in his dysfluencys. I've been doing some research in the program, but my question is if he's not bothered/realizing he is stuttering is it more harmful to draw attention to it. He's a smart and very sensitive kid, I don't want him nervous or scared to talk.

nicole hallborg said...

So I'm not sure if people read this or not anymore! But I'm looking for some support. My son is 4 1/2, we have been seeing speech for just over a year. Our therapist has suggested we take the sit back appracch. K is not recognizing he is stuttering and is very confident in his speech- he talks allll the time! Anyway, a year later and we have made no progress in his dysfluencys. I've been doing some research in the program, but my question is if he's not bothered/realizing he is stuttering is it more harmful to draw attention to it. He's a smart and very sensitive kid, I don't want him nervous or scared to talk.