Table 2 Pilot study of Classroom Communication Resource (CCR)
Aims/objectives | To determine: 1. Recruitment rates of schools and participants, and the dropout rate of participants 2. Treatment effect of attitudes towards stuttering among grade 7 learners based on the Stuttering Resource Outcome Measure (SROM) |
Context | Schools in higher and lower quintiles in the Western Cape metropolitan area participated in the study where the language of teaching and learning was English |
Problem | The CCR intervention had been developed and refined to make it contextually relevant in the following ways: • It was shortened to one lesson because teachers did not have time to administer a multi-lesson program over several weeks. However, teachers were willing to continue discussions as and when the need arose • It could be administered in parts, e.g., story, roleplay, and discussion pieces to make it manageable for teachers and learners to engage with. Through exploration of learners’ experiences of stuttering as well as cognitive debriefing with learners, the CCR was modified to use concepts sensitive to the realities of learners. The cognitive debriefing sessions examined overall understanding and use of vocabulary and terms to improve the questionnaire. For example, “play time” was changed to “break time”. These modifications allowed the questionnaire to become more culturally and linguistically appropriate • It was adapted to be linguistically appropriate, i.e., children in South Africa who were learning English as an additional language • It encouraged a generative conversation between learners and teachers from diverse cultural contexts to participate and express their different worldviews that extended beyond stuttering around inclusion, acceptance, and diversity However, the researchers did not know its potential treatment effect over a longitudinal period and how feasible it would be to recruit and retain participants for an RCT |
Study design (include sample size) | The pilot study used a stratified cluster randomized design The sample size was 401 with 149 learners included in the CCR intervention and 252 learners in the usual practice (control group) For the treatment effect, the schools were randomized with teachers using the CCR or usual practice. The stuttering resource outcome measure (SROM) was used at baseline, 1 month, and 6 months post-intervention The recruitment took place at the school level and then at the individual level. The dropout rate was noted at baseline and at 1 and 6 months post-intervention |
Findings | The recruitment rate for school recruitment was 82% as 9 of the 11 schools invited participated in the study. While 601 learners were eligible and invited to participate in the study, 449 were recruited with 183 randomized to the treatment group and 266 to the control group. The drop-out rates for the learners at baseline were 23% (n = 34) in the intervention group and 6% (n = 15) in the control group At 1 month post-intervention and 6 months post-intervention, the drop-out rates declined further as follows: Intervention group: 7% (n = 10) at 1 month and 7% (n = 10) 6 months post-intervention Control group: 6% (n = 15) at 1 month and 17% (n = 44) 6 months post-intervention This outcome indicated that there were several procedural refinements required to improve the retention rate. These improvements included improved communication for consent, reduction in frequency of testing, and changing the test schedule to align with school activities Treatment effect estimate: the study found that the treatment effect was evident at the 6-month interval rather than the 1-month interval |
What happened since the conclusion of the study | A randomized control trial was conducted as well as a further qualitative study with teachers to explore their experiences of the intervention. The RCT showed no statistically significant results at 6 months post-intervention with valuable input from teachers regarding how best to integrate the intervention within the curriculum. The CCR is available online for use by therapists and teachers |