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Functional communication disorders: a systematic review of interventions to improve outcomes in adults

McKenzie, K. ORCID: 0000-0002-7922-5020, Behn, N. ORCID: 0000-0001-9356-9957, Rodgers, L. ORCID: 0000-0001-6585-7206 & Hilari, K. ORCID: 0000-0003-2091-4849 (2025). Functional communication disorders: a systematic review of interventions to improve outcomes in adults. Disability and Rehabilitation, doi: 10.1080/09638288.2025.2450776

Abstract

Purpose
To determine what evidence there is for the effectiveness/efficacy of interventions to improve outcomes in adults with Functional Communication Disorders (FCDs).

Materials and Methods
Seven electronic databases were searched via two platforms. The review was performed according to PRISMA guidelines. Population comprised adults with any specific communication diagnosis with a functional aetiology. We included studies of any type of behavioural intervention which targeted FCD, with any comparator. All outcomes related to communication were included. There were no restrictions on year or language of publication.

Results
Seven studies were included in the review. Studies used different interventions and outcome measures thus meta-analysis was not performed. Six studies described interventions for functional voice disorders and one for functional stuttering. Interventions tended to include elements of patient education, standard voice or speech therapy, and a psychological support component. Study quality was generally poor.

Conclusion
There is a lack of high-quality research to guide clinicians on evidence-based interventions for the full range of FCDs. There were some common themes within the interventions offered, but the overall poor quality of studies makes it difficult to draw conclusions on the effectiveness and efficacy of these interventions.

IMPLICATIONS FOR REHABILITATION
There is a lack of high-quality intervention studies on the full range of Functional Communication Disorder (FCD) presentations.

The strongest evidence base is for Functional Voice Disorders.

Generalisable evidence regarding the effectiveness and efficacy of Speech and Language Therapy interventions for FCDs is limited.

Literature recommends that intervention for FCDs should include patient education, techniques used in standard speech or voice therapy, and psychological support.

Publication Type: Article
Additional Information: This is an open access article distributed under the terms of the Creative Commons attribution license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Publisher Keywords: Functional neurological disorder, speech and language therapy, communication disorders, functional voice disorders, functional stuttering, systematic review
Subjects: P Language and Literature > P Philology. Linguistics
R Medicine > RC Internal medicine
Departments: School of Health & Psychological Sciences
School of Health & Psychological Sciences > Language & Communication Science
SWORD Depositor:
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