Stuttering treatment

Lidcombe Program

I use the Lidcombe Program to treat stuttering in preschool-age children because it is the only treatment for early stuttering supported by randomised controlled trials, the gold-standard in medical research. (Jones, M, Onslow, M, Packman, A, et al. (2005). Randomised controlled trial of the Lidcombe programme of early stuttering intervention. British Medical Journal 331, 659-661; Lattermann, C, Euler, HA, Neumann, K. (2008). A randomized control trial to investigate the impact of the Lidcombe Program on early stuttering in German-speaking preschoolers. Journal of Fluency Disorders 33, 52-65.)

There are two stages in the Lidcombe Program. Stage 1 is complete when there has been no stuttering for 3 consecutive weeks. Stage 2 is complete when stutter-free speech has been maintained for 12 months.

Parents are central to the Lidcombe Program. During stage 1 parents are trained to elicit and reinforce stutter-free speech each day at home. Stage 2 of the program involves periodic appointments for at least 12 months to prevent relapse.

Children enjoy the Lidcombe Program. Children experience the “therapy” as a “game”, a fun or special time with the parent(s) working with them. One parent commented to me that the Lidcombe Program was the best thing to happen to them because not only did it eliminate his son’s stuttering but also it prompted them to prioritise quality time together.

The Lidcombe Program is also effective in school-age children who stutter.

Speech Restructuring

Speech restructuring involves learning to talk with a new speech pattern. Two of these speech patterns are prolonged speech and smooth speech.

The speech pattern masks the stuttered speech such that stutters do not occur. Although the listener is not aware that the person is speaking differently, the speaker is consciously altering their speech pattern.

Speech restructuring in one form or another has been used to manage stuttering since early reports of the disorder. Demosthenes is reported to have spoken with pebbles in his mouth to reduce the stuttering. This seems to be a form of speech restructuring as the pebbles would have altered his usual articulation of sounds.

More recently speech restructuring has been taught in various formats: group and individual; intensive and weekly; programmed instruction and nonprogrammed instruction. The Camperdown Program was developed at the Australian Stuttering Research Centre from research investigating the way people who stutter learn to restructure their speech.

Clients copy a video exemplar of the prolonged speech pattern to learn it. While these skills are developed in the clinic, clients also learn to measure their stuttering outside of the clinic. When clients start to speak using prolonged speech outside of the clinic, they learn to use their measurement and speech skills to make adjustments such that they sound fluent.
 

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