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 treating school-age children who stutter.
More information is available through the official Lidcombe Program website
The Westmead Program is an emerging treatment for early stuttering. Researchers were looking for improved treatments for school-age children and found that preschool-age children can respond well to this.
The Westmead Program involves speaking with syllable-timed speech to induce subsequent stutter-free speech. Syllable-timed speech is a simple rhythmic technique, and with lots of practice natural stutter-free speech can be established. Similar to the Lidcombe Program, stage 1 is for learning to be stutter free and stage 2 is for learning to maintain stutter-free speech.
The Lidcombe Program continues to have the strongest evidence base in early stuttering treatments. However, sometimes the Westmead Program is the most suitable treatment option.
Syllable-timed speech can be an effective treatment tool with older school-age children. Sometimes it is combined with verbal contingencies to improve effectiveness.
The Camperdown Program is suited to adolescents and adults who stutter, and involves learning to speak with a new speech pattern. Such a treatment strategy has been used since early reports of stuttering. Demosthenes is reported to have spoken with pebbles in his mouth to reduce the stuttering; the pebbles would have altered his usual articulation of sounds.
The Camperdown Program was developed at the Australian Stuttering Research Centre from research investigating the way people who stutter learn to restructure their speech pattern. Clients copy a video exemplar of the pattern to learn it. These skills are developed in the clinic before being transferred to everyday life. Clients also learn to measure their stuttering, and this becomes an invaluable tool as they adjust their speech pattern from situation to situation.
Although this technique masks stuttered speech such that the listener doesn’t perceive stuttering, the technique is effective only while being used. Video self modelling can be added to this treatment to help prevent relapse.