The terms stammering, stuttering and dysfluency are interchangeably used to mean the same thing, disruption in fluent speech. While there are many theories about stammering the cause and nature is not well understood. Therapist are instead more focused on the therapy approaches that can support a child who stammers. The Lidcombe Program is an effective therapy program for children under the age of 6 years. The Lidcombe Program it is a direct treatment program, meaning that therapy involves direct remediation of the stammer. Indirect therapy approaches may involve making changes to the child’s environment e.g. reducing talking demand etc.
The Lidcome program is named after the Australian suburb in which it was developed. Since its conception at the Australian Stuttering Research Centre University of Sydney, Lidcombe, use of the program has grown with countries such as the United Kingdom, the United States, Denmark, Canada, Germany, New Zealand and the Netherlands boasting members that are part of the International Lidcombe Program Trainers Consortium.
Treatment involves parent training, meaning that the parent would attend the therapy session to learn how to deliver the Lidcome Therapy Program at home/outside of the therapy environment. The therapist supports the parent in providing a therapy experience that is as positive for the child as possible. Sessions may commence with inclusion of structured games or language activities and later in the program be more informal in nature e.g. Language produced in ‘Guess what game’ versus language produced in child sharing about his recent school trip.
Progress related to the child’s increasing fluency is measured by rating the ‘severity’ of the stammer. A severity rating of 10 would signal a severe stammer, a rating of 2 a very mild stammer and a rating of 0 would reflect fluent speech. Consequently over a period of time following the Lidcombe program the severity rating would reduce, indicating improvement in fluent speech. At each clinic visit the speech and language therapist and the parent look at these severity ratings for the previous week to keep track of changes and progress over time.
There are two phases to the Program, with stage 1 focusing on a lowering of the severity rating and phase 2 focusing on maintaining the improved fluency. Commitment to the full Lidcombe Program, including part 2, is essential to avoid regression of skills (potential return of the stammer). While no child is the same a rough time frame of one year is often quoted at commence of therapy.
There has been a lot of interest and research into the programe in line with its strong treatment outcomes. Results have shown that despite its behavioural approach the Lidcome therapy is a safe and positive program and parents have reported positive effects on the child’s communicative confidence as well as of course fluency.
A case study
Jonny (not his real name) was referred to the therapy centre following parental concerns about his increasing stammer. His stammer was present across environments and heightened when he was tired or excited. Jonny the youngest of 3 children, presented with strong language skills for his age. He was reported to be aware of ‘when he gets stuck’ and was starting to share about his frustrations at ‘not being able to talk properly’ at times. Jonny responded well to meeting the speech and language therapist and appeared to enjoy the opportunity to play various games. Jonny responded well to the Lidcombe program both within the therapy environment and outside of the sessions when the work was implemented by his mother. Towards the end of the program Jonny was asked to share about how he felt about his talking now. He was aware that his talking is better, that his sentences were “more smooth”. The therapist and his mother were in agreement that Jonny was generally happier, displayed increased confidence in communicating and interestingly actively sought out activities that involved public speaking such as ‘drama class. Since the family committed to the full completion of the Lidcome program Jonny has now been discharged from therapy services.
For further information about the Lidcombe program please check out the link below:
Also check out the Lidcombe video from ASRC on Vimeo: https://vimeo.com/211800077