わが国における言語聴覚療法のエビデンス—システマティックレビューによる検討—発達性吃音に対する言語聴覚療法のエビデンス

A systematic review of evidence on the effectiveness of speech-language hearing therapy for developmental stuttering in Japan

【目的】「発達性吃音に対するわが国の言語聴覚士による言語聴覚療法（介入・指導・支援）は，心身機能・活動・参加に対してどのようなアウトカムをもたらすか」という研究疑問（以下，RQ）に応えるべく，システマティックレビューを実施した．

【方法】RQを基に，適格基準を設け，医中誌Web，メディカルオンライン，医書.jp，PubMed，および，ハンドサーチにより文献を収集，1次・2次スクリーニングを実施し，採択された文献について質の評価を実施した．

【結果】39文献が採択された．非ランダム化比較試験1件，症例対照研究1件，クロスオーバー研究1件，単一事例研究23件，ケースシリーズ研究13件であった．介入法は多岐にわたり，多くの文献で，発話症状の軽減を主な介入効果とし，思春期以降は心理態度面への効果を含め，一定の肯定的結果を示していた．サンプルサイズが不十分であったため，結果の数値的統合は困難であった．

　Objective：The purpose of this study is to summarize the evidence of speech-language-hearing therapy for developmental stuttering in Japan through a systematic review. The research question (RQ) is “What are the outcomes of speech-language-hearing therapy (intervention, instruction, and support) by speech-language-hearing therapists in Japan for developmental stuttering in terms of physical and mental function, activity, and participation?”

　Methods：Based on the RQ, eligibility criteria were established, and the literature was searched using Ichushi-Web, Medical Online, Isho.jp, PubMed, and hand-search.

　After first and second screening, qualitative analyses were conducted.

　Results：A total of 39 references were accepted. Study designs included 1 nonrandomized controlled trial, 1 case-control study, 1 crossover study, 23 single case studies, and 13 case series studies. Intervention methods varied widely, and most of the literature showed some positive results, with the reduction of speech symptoms as the main intervention effect. After puberty, positive results included those on psycho-attitudinal aspects. Numerical integration of results was difficult due to inadequate sample sizes.