What will happen to my child after they complete Stage 1 of the Lidcombe Program stuttering treatment?

The Lidcombe Program has two stages. Stage 1 is about eliminating stuttering; Stage 2 is for the maintenance of stutter-free speech. We have Stage 2 because relapse (stuttering again) is common and most likely soon after entering Stage 2.

Here’s what clinical research tells us about this relapse. An audit of 25 files from clients seen at the Stuttering Unit in Bankstown, Sydney, found that around half of the clients were stuttering at a Stage 2 appointment, and action was taken to manage this (1). Most of these instances (75%) were within 8 weeks of starting Stage 2, that is, soon after the stuttering was eliminated. This shows us that Stage 2 is about quickly identifying and managing any reappearance of stuttering.

Parents sometimes ask me during Stage 2, “What happens next? Is this it?”.

As the Lidcombe Program is so thoroughly researched, we have answers to this. We know from a randomised-controlled trial that 9 months after starting treatment with the Lidcombe Program, preschool-age children who stutter are 7 times more likely to have clinically minimal stuttering than those who have not commenced treatment (2).

So what happens to these children an average of 5 years after they started treatment? It’s difficult to get the same comparison between those who were treated and those who were not treated because over the years many of the children who were originally in the no-treatment group went on to receive treatment.

However, of the 29 children who were treated in the original trial, 20 were able to be contacted around 5 years later (3). Of these 20 children, now aged 7 to 12 years, 19 had successfully completed the Lidcombe Program. That is, they had achieved and maintained (for at least 12 months) zero or near zero stuttering. However, 2 or more years after completing treatment 3 of the 19 relapsed.

What to make of this? The study showed that a couple of years after successfully completing the Lidcombe Program, stuttering can recur in a minority of children. The parents of these children would have needed to reinstate treatment procedures to control the stuttering.

So in sum, after completing Stage 1 of the Lidcombe Program treatment for stuttering, your child will be stutter-free. We need Stage 2 to ensure your child’s speech remains stutter-free. Some children may need further follow-up some years after treatment.

References
(1) Onslow, M., Packman, A., Harrison, E. (2003). The Lidcombe Program of Early Stuttering Intervention: A Clinician’s Guide. Austin, TX; Pro Ed.
(2) Jones, M., Onslow, M., Packman, A., et al. (2005). Randomised controlled trial of the Lidcombe Program of early stuttering intervention. BMJ 331, 659-661.
(3) Jones, M., Onslow, M., Packman, A., et al. (2008). Extended follow up of a randomised controlled trial of the Lidcombe Program of early stuttering intervention. Int. J. Lang. Comm. Dis. 43 (6), 649-661.