What is it, and will it work for my child?
The Lidcombe Program is a direct behavioral therapy used in the treatment of children aged 3-6 who stutter. In clinical trials, the Lidcombe Program has been shown to be an effective early intervention program for stuttering. It consists of two stages: in Stage One, parents are trained in providing treatment in the home environment during daily practice sessions and natural conversation. During Stage One, there are weekly sessions with a clinician, who provides support to the family and works directly with the child. Stage One continues until fluent speech has been achieved and maintained for a few weeks. In Stage Two, the focus of treatment is on maintaining fluent speech over time. Sessions with the clinician are gradually faded, given that fluent speech is maintained. Stage Two ensures that any relapses in stuttering can be addressed immediately and effectively, with support from the clinician.
Elements of the Lidcombe Program include:
Sessions with a clinician: In stage one, you will meet with a speech- language pathologist once a week to learn strategies for improving fluency, go over the previous week's severity ratings, and troubleshoot any problems that have arisen. In stage two, sessions with the clinician are gradually faded.
Daily practice sessions with your child: Initially, you will complete daily 10-15 minute practice sessions with your child. During these sessions, you will provide verbal contingencies for stutter-free speech and unambiguous stuttering. Practice sessions are gradually faded as verbal contingencies are added to natural conversation.
Verbal contingencies: Verbal contingencies are feedback you give to your child about his or her speech. Verbal contingencies are provided for both stutter-free speech and unambiguous stuttering. Overall, the feedback you give to your child will be very positive. This means that you will be providing more verbal contingencies for stutter-free speech than for unambiguous stuttering.
Daily stuttering severity ratings: For the duration of the program, you will assign a stuttering severity rating (SSR) to your child's speech every single day. SSRs are given on a scale ranging from zero to nine, with zero being no stuttering and nine being extremely severe stuttering. The SSR is an important aspect of the Lidcombe program, and is used to track progress.
Why parent training?
It is important to note that in the Lidcombe Program, parents are trained to essentially administer the treatment to their children. If you're wondering, why can't the therapist just do the treatment? It's because the most effective treatment for childhood onset stuttering is one that can be administered throughout the week, in natural contexts, by the people who spend the most time with a child. It is not uncommon for children who stutter to become completely fluent during their weekly sessions with a speech therapist, while parents report high levels of stuttering throughout the rest of the week.
Parent training is also essential because of the high rates of relapse in childhood stuttering. Approximately 50% of all children who enter stage two of the Lidcombe Program, meaning stuttering severity was very low for several weeks, will experience a relapse. Because parents are trained in administering the treatment, slight adjustments to the program can be made when a relapse occurs to ensure that stuttering severity returns to prior low levels.
Does it work?
Simply put, yes. Clinical trials have shown that, when administered correctly by a trained clinician, the Lidcombe Program works to eliminate stuttering in young children.
How long will it take?
On average, it takes around 12 weeks of weekly sessions for stuttering severity to reach very low levels; however, there is quite a bit of variability in the length of time it takes for the program to be completed. From start to finish (stages one and two), expect to be working with a speech-language pathologist for around a year to ensure that your child will maintain fluent speech over time.
Is it right for my child?
The Lidcombe Program works for children under the age of six who are stuttering. It may not be right for your child if you do not have the time to administer the treatment each day, your child is too young and cannot participate in the practice sessions, or your child has comorbidities (e.g., autism, down syndrome) that may impact the effectiveness of the treatment. In general, I wait until a child is around age four or has been stuttering for close to six months before using the Lidcombe Program. Prior to that time, it may be best to wait or administer indirect treatment.
If you are curious about the Lidcombe Program and whether it will work for your child, schedule a free phone consultation with me at Springboard Speech Therapy today.