The Lidcombe Program
The Lidcombe Program is a behavioural treatment for children younger than 6 years who stutter.
In a few cases, it is also administered to children older than 6 years of age. It is a direct treatment method administered by parents at home and monitored through weekly sessions by the speech-language pathologist. It is important that a trained speech-language pathologist guides and supervises parents during the Lidcombe Program. This program involves the parent directly commenting on the child’s stutter, specifically the fluent utterances.
Details of the Program
In this program children and parents do not change their usual pattern of speech.
The treatment program begins with the parent using structured conversations. Parents use verbal contingencies where they comment or do not comment on the child’s fluent and stuttered speech.
As the child starts improving, structured conversations fade into unstructured conversations. The frequency of positive verbal reinforcements also gradually reduces as the child begins to perform better. This parent feedback needs to be generally positive.
The parent comments primarily when the child speaks without stuttering and only occasionally when the child stutters. The parent does not comment on the child’s speech all the time but chooses specific times during the day during which to give the child feedback. As well as learning how to give feedback effectively, the parent also learns to measure the child’s stuttering each day
Severity Rating Scale
Parents are taught to administer a stuttering severity scale where 0 =no stuttering and 9 = extremely severe stuttering. Severity ratings (SRs) are used to measure children’s stuttering in and outside the clinic.
It’s a quick and effective way for therapists and parents to communicate with each other about children’s stuttering severity. It enables progress toward the Lidcombe Program treatment goals to be evaluated constantly.
If progress is not satisfactory, then SR scores alert the clinician, and the problem can be resolved. Parents record SRs for the whole day to reflect the child’s typical speech for that day.
Format Of Lidcombe Program
The weekly clinical appointments (45 minutes), occur in the clinic or by telepractice(online sessions), using a webcam. In each appointment, the speech-language pathologist trains the parent on how to do the treatment and ensures that it is being done properly.
During Stage 1, the parent conducts the treatment each day and the parent and child attend the session once a week. This continues until stuttering either is gone or reaches an extremely low level.
Stage 2 of the program – or maintenance starts at this time and lasts around a year. The aim of Stage 2 is to keep stuttering from returning. The use of parent feedback during Stage 2 is reduced, as is the number of clinic visits, providing that stuttering remains at the low level it was at the start of Stage 2. This maintenance part of the program is essential because it is well known that stuttering may reappear after successful treatment.
All children and families are different, and the speech-language pathologist takes this into account when supervising the treatment. The essential features of the treatment as set out in the Lidcombe Program are adjusted to suit each child and family.
Lidcombe Program is progressing with the digital era. Increased access to the Internet is now common for parents, and it is possible for them to do the Lidcombe Program online.
Clinical trials of doing the treatment online or through teletherapy have shown it to be equally effective as in-person sessions. As parents need to visit the speech therapist every week during Stage 1 of treatment, it becomes convenient to do it online with children.
Also, parents get access to a qualified Lidcombe Program speech-language pathologist no matter where they live.
Online Lidcombe Program
Frequently Asked Questions About
Why do most Speech-Language Pathologists choose the Lidcombe Program?
The Lidcombe Program is safe and has the most evidence, including two independent, replicated phase III randomized controlled trials (Jones et al., 2005, Latterman et al., 2008 and O’Brian & Onslow, 2011);
It;'s easier to track a child’s progress in this program and make changes to therapy as needed;
It works: studies show the Lidcombe Program has reduced stuttering by almost 80% (Jones 2005).
Will my child be fluent after completing the program?
Clinical trials around the world have supported the use of the Lidcombe Program to treat pre-schoolers who stutter.
When should I start therapy?
Many children grow out of stuttering during the preschool years. This does not mean that you should not seek advice or treatment. It is not possible to know in advance whether your child will recover without treatment, so if your child begins stuttering it is recommended that you seek the advice of a speech pathologist as soon as possible. The speech pathologist will advise you whether treatment is needed and when it should begin.
What if he/she starts to stutter again?
After your child has little or no stuttering, another important part of the Lidcombe Program begins. This is called maintenance. You will visit the speech pathologist occasionally for around one year. During these months the speech pathologist will show you how to do all you can to ensure that stuttering does not re-appear. You will need to continue treatment during the maintenance period, although not as much as before.
Can a parent who does not attend the clinic visits give verbal contingencies to the child?
No, only parents who have attended some clinic visits should give the verbal contingencies. To ensure that the Lidcombe Program works properly, the speech-language pathologist needs to train every parent who will give verbal contingencies.
How long does the Lidcombe Program take?
Children differ in the time they take to complete the Lidcombe Program. However, on average it takes about 12 visits to the clinic to get to the point where stuttering has gone or is at an extremely low level. After that, three more clinic visits are required to be sure, and then Stage 2 begins, where the parent and child make fewer visits to the speech clinic. Children with more severe stuttering will generally take a little longer.
Is the Lidcombe Program better than natural recovery?
It is known that some children will recover from stuttering without needing formal treatment. However, treatment should normally begin within one year after the onset of stuttering during the preschool years. If treatment is delayed any longer there is a risk that treatment will not be effective. Recent research has shown that not many children will recover from stuttering within that one-year period after onset.
Normally, the speech-language pathologist will wait for up to one year, more commonly six months, to see if a preschooler’s stuttering will resolve on its own. However, there is good evidence that when the decision is made to begin Lidcombe Program treatment that it is much better than natural recovery. With what is called a meta-analysis, it has been shown that a stuttering child who receives the Lidcombe Program has seven or eight times better odds of not stuttering than a child who does not receive the Lidcombe Program.
“Honestly we were a little apprehensive about starting this program because we weren't sure if we will be able to do a good job but thanks to Ms. Sanya and her constant guidance and encouragement the year went by in a breeze and now my son is fluent and we haven't seen a relapse. This program isn't talked about so much but after doing my own research I realized it is effective and parents all over the world are adopting it. Thank you once again to Sounderic and Ms. Sanya. Highly recommend them and Lidcombe program.” Mrs. Neetu, mother of a 4-year-old.