Response to “Putting the cart before the horse". A cost effectiveness analysis of treatments for stuttering in young children requires evidence that the treatments analyzed were effective

Abstract Purpose To investigate the validity of findings from a recent study reported in this journal by de Sonneville-Koedoot, Bouwmans, Franken, and Stolk (2015) on the cost effectiveness of two programs for treating young children who stutter. Methods The de Sonneville-Koedoot, Bouwmans et al. study was based directly on the results obtained in an earlier study, known as the RESTART-study, which compared the outcomes from the Lidcombe Program and a Demands and Capacities Model program. The methodology of the RESTART-study was critically reviewed. Results The absence of an untreated control group in the RESTART-study makes the results of that study uninterpretable. An inappropriate comparison made with the Yairi and Ambrose (2005) Illinois Study findings failed to resolve the control group problem. Furthermore, the criteria used to classify treated children as “non-stuttering” was also shown to be confounded. The foregoing problems meant that neither treatment program could be shown to be more effective than no treatment. Conclusion de Sonneville-Koedoot, Bouwmans et al’s findings, which compared the cost effectiveness of two treatments for young children who stutter, have no value for clinical management because the treatments investigated were not shown to be more effective than no treatment.