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Lidcombe

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62 views14 pages

Lidcombe

Uploaded by

AYAZ AHMAD KHAN
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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The Lidcombe Program

University of Wisconsin-Stevens Point

Lorrie Mittelstaedt Stacey Lamers


Lorrie.L.Mittelstaedt@uwsp.edu Stacey.L.Lamers@uwsp.edu

Presented on December 19, 2005


What is the Lidcombe Program?
Adapted from: Onslow, M., Packman, A., & Harrison, E. (2003). The Lidcombe program of early stuttering intervention.
Overview of the Lidcombe program (pp. 3-15). Austin, TX: PRO-ED.

◼ A fluency shaping program individualized for young


children who present with a stuttering problem
◼ Program focuses on behavioral feedback provided in
response to a child’s fluent speech
◼ Does not believe that the child’s home environment
caused stuttering
◼ Main goal is to reduce and eliminate stuttering with
pre-school children
◼ Requires participation from the direct caregiver of the
child
History

◼ Developed in the mid-1980’s for children


younger than 6-years-old
◼ University of Sydney at Lidcombe
◼ Collaboration between the University,
professionals at the Stuttering Unit, and
Bankstown Health Service
◼ Has been researched in
Australia, Canada, and the
United Kingdom
A Behavioral Treatment for
Children and Parents
◼ Focuses on developing behaviors related to
childhood stuttering
◼ The goal is to raise awareness
of the individual’s stuttering
characteristics and promote
“simply, no stuttering”
◼ Takes place in natural environments
◼ Clinicians demonstrate treatment techniques to
parents until they can conduct the treatment
independently
◼ Parents are encouraged to generalize techniques
outside of the clinical setting
Descriptive Terms

To Use:
◼ Stutter, stuttering or stuttered
◼ Bumpy
◼ Stutter-free (rather than fluent)
◼ Smooth (also describes ‘stutter free’)

Not to Use:
◼ Dysfluency
◼ Nonfluency
◼ Disfluent
◼ Nonfluent
◼ Fluent
The Treatment Agent

◼ Encourages verbal reactions for stutter-free


speech and selective stuttered speech during
everyday activities
◼ Acknowledge response (e.g., “That was smooth.”, “That was a bit bumpy.”)
◼ Praise response (e.g., “That was good talking.”)
◼ Ask child to self-correct (e.g., “Can you try that again?”, “Were there any
bumpy words?”)

◼ Rule of thumb: Praise for stutter-free speech


should be approximately 5 times the amount
for asking the child to self-correct
◼ Based on operant methodology
Implementation of Treatment

◼ Child and parent attend clinic once a week


◼ Parent rates child’s weekly performance on a 10-
point stuttering severity scale to obtain a percent of
stuttered syllables (%SS)
◼ SLP and parent compare severity ratings (SR) and
discuss discrepancies
◼ Parent provides treatment each day in the child’s
everyday environment
◼ As child’s awareness improves, parent’s role
becomes less invasive
◼ A stable and positive parent-child relationship is
imperative
Treatment
Adapted from: Onslow, M., Packman, A., & Harrison, E. (2003).

Stage 1 Stage 2
• Weekly clinic visits • “The Maintenance Stage”

• Clinician trains parent • Parent assumes responsibility


for treatment in the long-term
• Parent provides verbal and achieves independence
contingencies in structured from clinician
and unstructured
conversation • Time between clinic visits
increases
• Clinical measurement
procedures implemented in • Parents continue with
and beyond clinic treatment in unstructured
conversations
• Child is considered to be
making progress if his/her • If child show minimal
severity rating (SR) declines progress, SLP may slow
process or move to a
previous stage.
*Stage 1 concludes when child achieves near zero stuttering as documented within clinical measures
Maintenance & Generalization
Through Individualization
◼ Program is more likely to be maintained and generalized it is
tailored to the individual family
◼ Goal is to maintain the low level of stuttering achieved in
Stage 1 into and through Stage 2 by decreasing the level of
parent verbal contingencies
◼ Parents are made aware that in order for the treatment to be
successful the techniques must generalize beyond the clinic
setting
◼ Intervention is individualized base on:
1) Age of Child
2) Stuttering Severity
3) Child’s Behaviors
4) Personalities of Child and Parent
5) Familial Circumstances
Is There Evidence?
Obtained from: Lincoln, M. & Onslow, M (1997). Long-term outcome of an early intervention for stuttering. American
Journal of Speech Language Pathology 6, 51-58.

◼ YES! There is an abundance of positive data


◼ Currently, there is outcome data up to 7 years post-
treatment
◼ Lincoln & Onslow confirmed that %SS decreased from
approximately 5% to almost 0% following implementation
of the Lidcombe program (n=42)
How Long Before Results Are Evident?
Obtained from: Jones, M., Onslow, M., Harrison, E., & Packman, A. (2000). Treating stuttering in children: predicting
outcome in the Lidcombe program. Journal of Speech, Language and Hearing Research 43, 1440-1450.

◼ Stage 1 was completed with a median treatment time


of 11 visits (n=250)

◼ Data suggests that after approximately 20 visits,


almost all of the children had reached Stage 2,
indicating nearly zero stuttered syllables

◼ Results may vary based on


degree of parental
involvement
Are There Any Downfalls?

◼ Data does not account for natural recovery


(Jones, 2000 & Onslow, et al., 2003)
◼ Program has not been proven effective for children
between 7 and 12 years of age (Onslow, et al., 2003)
◼ Program has not been implemented cross culturally
(Onslow, et al., 2003)
◼ Results do not show significant differences in
outcome of the Lidcombe program versus other
treatment techniques (i.e., Demands-Capacity Model)
(Franken, et al., 2005)
Do We Recommend This Program?

◼ At this point, evidence shows a high rate of


“recovery” in children who stutter and have adhered
to the Lidcombe program
◼ Therefore, based on the data alone, it would be
considered best practice to recommend the
Lidcombe program to a family who has a child that
stutters
◼ Although there is no data suggesting a difference in
outcome, based on the treatment setting, it seems
beneficial that the parents provide intervention in a
natural setting
References

◼ Franken, M., Kielstre-Van der Schalk, C., & Boelens, H. (2005). Experimental treatment of
early stuttering: A preliminary study. Journal of Fluency Disorders 30, 189-199.

◼ Onslow, M. (2000, May). Stuttering treatment for preschoolers. Current Therapeutics, 52-56.

◼ Onslow, M., Packman, A., & Harrison, E. (2003). The Lidcombe program of early stuttering
intervention. Overview of the Lidcombe program (pp. 3-15). Austin, TX: PRO-ED.

◼ Jones, M., Onslow, M., Harrison, E., & Packman, A. (2000). Treating stuttering in children:
predicting outcome in the Lidcombe program. Journal of Speech, Language and
Hearing Research 43, 1440-1450.

◼ Lincoln, M. & Onslow, M (1997). Long-term outcome of an early intervention for stuttering.
American Journal of Speech Language Pathology 6, 51-58.

◼ Lincoln, M., Onslow, M & Reed, V. (1997). Social validity of the treatment outcomes of an
early intervention program for stuttering. American Journal of Speech Language
Pathology 6, 77-84.

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