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The Classroom Communication Resource (CCR) Intervention to Change Grade 7 Peer's Attitudes Towards Children Who Stutter (CWS)

NCT ID: NCT03111524

Last Updated: 2017-11-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

453 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-10-15

Study Completion Date

2018-08-31

Brief Summary

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Children who stutter (CWS) are at high risk of being teased and bullied in primary school because of the negative peer attitudes and perceptions towards stuttering. Their experiences can lead to long-term negative psychosocial consequences which can in turn affect academic performance. There is little evidence to determine if classroom-based interventions are effective in changing peer attitudes to stuttering. This study is designed to assess whether a classroom-based CCR intervention versus usual practice in schools will lead to positive shift in attitudes about stuttering at 6-months among grade 7 students.

Detailed Description

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Children who stutter (CWS) are placed at risk for being teased and bullied in Primary school (Blood \& Blood, 2004; Blood, Boyle, Blood \& Nalesnik, 2010; Evans, Healy, Kawai \& Rowland, 2008; Langevin, Kleitman, Packman \& Onslow, 2009) due to negative peer attitudes and perceptions (Blood \& Blood, 2004; Blood et al., 2010; Evans at al., 2008; Langevin et al., 2009). Negative attitudes and interactions result in CWS being viewed as different or disabled leading to social rejection (Evans et al., 2008). Social rejection may lead to long term negative consequences such as reduced academic and social interactions, depression, and negative self-perceptions (Ferguson, Miguel, Kilburn \& Sanchez, 2007; Hawker \& Boulton, 2000) and are harmful if not urgently addressed. This is prevalent in the adolescent population due to stress and rapid changes of emotion at this age (Evans et al, 2008). Attitudes and perceptions overlap (Foster, 2006) which is useful as negative peer attitudes may lead to negative perceptions towards CWS (Blood \& Blood, 2004; Blood et al., 2010; Evans et al., 2008; Langevin et al., 2009). While the relationships between attitudes, attitude change and behaviour change are complex and multifaceted (Prochaska, Redding \& Evers 2008), this study focusseson f attitude as the precursor for change. (Scott, 2000). This study does not focus on behaviour change. Attitudes are described as an individual's evaluation of issues, objects and other individuals. The evaluation of another person or object can be positive or negative (Petty, Wegener \& Tormala, 2003) Furthermore, attitude formation is known to continuously change over time, (Krahe \& Altwasser, 2006) as it is learnt and shaped (Foster, 2006).

The International Classification and Functioning of Disability (ICF) framework (Murphy, Yaruss \& Quesal., 2007) considers holistic management of the CWS. It advocates for classroom-based interventions to reduce teasing and bullying (Merrell, Gueldner , Ross \& Isava., 2008; Murphy et al., 2007; Langevin, 2009) because children spend a large amount of time with teachers (Blank et al, 2009). Classroom-based interventions also empowers teachers. International public education addresses stuttering-related stigma (Scott, 2000) through reducing the debilitating nature of stuttering and improving social environments and reactions (St Louis, 2011). These publicised campaigns have not documented effectiveness. However, the potential for classroom-based interventions to change attitudes to stuttering are emerging. Survey of Human Attributes- Stuttering (POSHA-S) showed that negative attitudes are prevalent in school-aged children (Flynn \& St Louis, 2011) A follow-up study conducted in South Africa, using the POSHA-S, showed that teachers were requesting assistance with managing negative attitudes to stuttering (Abrahams, 2015). The Teasing and Bullying: Unacceptable Behaviour (TAB) included teacher administered activities and yielded positive results pre- and post- intervention (; Langevin, 2009; Langevin \& Prasad, 2012). The TAB was however not suitable for South African classrooms due to time and technology constraints as well as contextual, cultural and linguistic differences. This led to the development of the South African specific intervention, the CCR intervention. It was developed and has been refined since 2009 as part of a series of the University of Cape Town projects. The CCR intervention yielded positive results at 1 month post-intervention within the lower and higher quintile population respectively (Kathard et al.,2014 \& Walters, 2015) and more so at 6 months post-intervention (Badroodien, 2015). The feasibility study thus reported potential effectiveness of the CCR intervention at 1 and 6 months post-intervention (Badroodien, 2015). The findings were however inconclusive as it called for a more rigorous design method. The findings also reported that a RCT was feasible despite concerns regarding the retention of participants. A RCT was thus recommended as the next stage in these projects (Badroodien, 2015) The CCR intervention addresses prosocial behaviours and skills, including but not limited to the promotion of positive behaviour change, peer support and resilience through intervention (Blank et al, 2009) in the areas of Positive Social Distance (PSD), Verbal Interaction (VI) and Social Pressure (SP) in the CCR intervention. The areas of PSD, VI and SP are additionally measured where PSD represents the overall ease, acceptance of and comfort a child feels when around CWS (Langevin, 2009; e.g. 'I would let a child who stutters hang out with us'). VI evaluates peer's negative thoughts, emotions and feelings, e.g. frustration experienced towards a CWS (Langevin et al., 2009). SP evaluates general thoughts regarding CWS through examining social pressure and subjective norms (Langevin, 2009). An example is 'I would be ashamed to be seen with a child who stutters'. The promotion of these prosocial behaviours and skills may facilitate the prevention of anxiety and depression (Blank et al, 2009). In post-apartheid schools are unequal particularly in relation to resources. IN an attempt to address such inequality, a system based on the National Norms and Standards for school funding policy was developed to classify schools in relation to resources..) . (Motala, 2006) using the National Norms and Standards for School Funding (NNSSF) policy (Mestry \& Ndhlovu, 2014). Lower quintiles one, two and three are no fee paying schools (Department of Education, 2009; Sayed \& Motala, 2012).Higher quintiles four and five are fee-paying schools that are better resourced (Department of Education, 2009; Sayed \& Motala, 2012). This study therefore aims to compare the treatment effect in the low and high quintiles, explored as a subgroup in this study

Conditions

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Stuttering in Adolescence Bullying of Child

Keywords

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stuttering children who stutter peer attitudes classroom-based intervention teasing bullying

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

10 schools are included. The schools are assigned to control versus intervention groups
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
The Principal investigator is blinded to the study. The researcher is able to observe while the research assistants are aware of who is in the control versus intervention groups.

Study Groups

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Intervention school 1

All participants complete the questionnaire at baseline. The Classroom Communication Resource Intervention is administered by the teacher. The participants observe the intervention which is a social story (read by the teacher), the class performs a role-play (same plot as the story) and then the teacher facilitates and leads a semi-structured discussion. The intervention takes place in 1 classroom lesson only. No further intervention is completed.

Group Type ACTIVE_COMPARATOR

Classroom Communication Resource

Intervention Type OTHER

The Classroom Communication Resource intervention is a classroom- and group-based interventions administered by teachers. It includes a social story, role-play and teacher-led discussion

Intervention school 2

All participants complete the questionnaire at baseline. The Classroom Communication Resource Intervention is administered by the teacher.The participants observe the intervention which is a social story (read by the teacher), the class performs a role-play (same plot as the story) and then the teacher facilitates and leads a semi-structured discussion. The intervention takes place in 1 classroom lesson only. No further intervention is completed.

Group Type ACTIVE_COMPARATOR

Classroom Communication Resource

Intervention Type OTHER

The Classroom Communication Resource intervention is a classroom- and group-based interventions administered by teachers. It includes a social story, role-play and teacher-led discussion

Intervention school 3

All participants complete the questionnaire at baseline. The Classroom Communication Resource Intervention is administered by the teacher. The participants observe the intervention which is a social story (read by the teacher), the class performs a role-play (same plot as the story) and then the teacher facilitates and leads a semi-structured discussion. The intervention takes place in 1 classroom lesson only. No further intervention is completed.

Group Type ACTIVE_COMPARATOR

Classroom Communication Resource

Intervention Type OTHER

The Classroom Communication Resource intervention is a classroom- and group-based interventions administered by teachers. It includes a social story, role-play and teacher-led discussion

Intervention school 4

All participants complete the questionnaire at baseline. The Classroom Communication Resource Intervention is administered by the teacher. The participants observe the intervention which is a social story (read by the teacher), the class performs a role-play (same plot as the story) and then the teacher facilitates and leads a semi-structured discussion. The intervention takes place in 1 classroom lesson only. No further intervention is completed.

Group Type ACTIVE_COMPARATOR

Classroom Communication Resource

Intervention Type OTHER

The Classroom Communication Resource intervention is a classroom- and group-based interventions administered by teachers. It includes a social story, role-play and teacher-led discussion

Intervention school 5

All participants complete the questionnaire at baseline. The Classroom Communication Resource Intervention is administered by the teacher. The participants observe the intervention which is a social story (read by the teacher), the class performs a role-play (same plot as the story) and then the teacher facilitates and leads a semi-structured discussion. The intervention takes place in 1 classroom lesson only. No further intervention is completed.

Group Type ACTIVE_COMPARATOR

Classroom Communication Resource

Intervention Type OTHER

The Classroom Communication Resource intervention is a classroom- and group-based interventions administered by teachers. It includes a social story, role-play and teacher-led discussion

control school 1

All participants complete the questionnaire at baseline. The Classroom Communication Resource Intervention is not administered by the teacher.

Group Type PLACEBO_COMPARATOR

No intervention

Intervention Type OTHER

No intervention is administered in this group as these are control groups

control school 2

All participants complete the questionnaire at baseline. The Classroom Communication Resource Intervention is not administered by the teacher.

Group Type PLACEBO_COMPARATOR

No intervention

Intervention Type OTHER

No intervention is administered in this group as these are control groups

control school 3

All participants complete the questionnaire at baseline. The Classroom Communication Resource Intervention is not administered by the teacher.

Group Type PLACEBO_COMPARATOR

No intervention

Intervention Type OTHER

No intervention is administered in this group as these are control groups

control school 4

All participants complete the questionnaire at baseline. The Classroom Communication Resource Intervention is not administered by the teacher.

Group Type PLACEBO_COMPARATOR

No intervention

Intervention Type OTHER

No intervention is administered in this group as these are control groups

control school 5

All participants complete the questionnaire at baseline. The Classroom Communication Resource Intervention is not administered by the teacher.

Group Type PLACEBO_COMPARATOR

No intervention

Intervention Type OTHER

No intervention is administered in this group as these are control groups

Interventions

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Classroom Communication Resource

The Classroom Communication Resource intervention is a classroom- and group-based interventions administered by teachers. It includes a social story, role-play and teacher-led discussion

Intervention Type OTHER

No intervention

No intervention is administered in this group as these are control groups

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

Eligible participants for the primary objective of this study include grade 7 mixed- gender participants aged 11 and older attending public schools within the Cape Metro urban area across the lower (two and three) and higher (four and five) quintiles where the Language of learning and teaching (LoLT) is English.

Exclusion Criteria

Participants in private schools, in grades 1-6 within the Cape Metro urban area with a LoLT other than English .
Minimum Eligible Age

11 Years

Maximum Eligible Age

17 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Cape Town

OTHER

Sponsor Role collaborator

National Research Fund - South Africa

UNKNOWN

Sponsor Role collaborator

Rizwana Mallick

OTHER

Sponsor Role lead

Responsible Party

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Rizwana Mallick

PhD student; investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Lehana Thabane

Role: STUDY_CHAIR

McMaster University

References

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Borhan S, Mallick R, Pillay M, Kathard H, Thabane L. Sensitivity of methods for analyzing continuous outcome from stratified cluster randomized trials - an empirical comparison study. Contemp Clin Trials Commun. 2019 Jul 5;15:100405. doi: 10.1016/j.conctc.2019.100405. eCollection 2019 Sep.

Reference Type DERIVED
PMID: 31338480 (View on PubMed)

Mallick R, Kathard H, Borhan ASM, Pillay M, Thabane L. A cluster randomised trial of a classroom communication resource program to change peer attitudes towards children who stutter among grade 7 students. Trials. 2018 Nov 29;19(1):664. doi: 10.1186/s13063-018-3043-3.

Reference Type DERIVED
PMID: 30497490 (View on PubMed)

Mallick R, Kathard H, Thabane L, Pillay M. The Classroom Communication Resource (CCR) intervention to change peer's attitudes towards children who stutter (CWS): study protocol for a randomised controlled trial. Trials. 2018 Jan 17;19(1):43. doi: 10.1186/s13063-017-2365-x.

Reference Type DERIVED
PMID: 29343283 (View on PubMed)

Other Identifiers

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PhD protocol 2017

Identifier Type: -

Identifier Source: org_study_id