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Parents’ experiences of the Lidcombe Program of early stuttering intervention
Easy Access Summary
An Exploration of Parents’ Experiences of the Lidcombe Program of Early Stuttering Intervention.
The Lidcombe Program (LP) is a treatment for early stuttering where parents are shown how to encourage smooth talking and also gently help their child smooth their stutters or ‘bumpy’ words. Quantitative studies, involving larger numbers of children, have shown that the LP can lead to normally fluent talking in many children when therapy is started before the age of seven. These studies have not investigated what it is like to receive the LP.
We explored the experiences of 14 parents (and one nanny) using the LP with their children to understand more about the day to day processes. Twenty-one in-depth qualitative interviews with parents revealed a range of responses to treatment. Six parents were interviewed twice so that changes over time could provide further insights. When the LP was first introduced into the UK from Australia there was concern that drawing attention to the child’s speaking could either make the stuttering more severe or encourage the child to avoid talking. There was no evidence of this from any of the parents interviewed.
The majority of parents were able to understand the principles and procedures of the program and fit these with their understanding of stuttering, parenting and their children who stutter. These parents experienced the LP as satisfying and relatively simple to use and therapy proceeded straightforwardly.
Parents who were finding the LP more difficult were also sought and this smaller group divided further. There were three who started well and both the frequency and severity of stuttering reduced but then progress slowed down. These children had other speech, language and /or learning needs and it is possible that reduction rather than resolution of stuttering was the right treatment outcome. The parents needed to use the skills they had learnt for longer than the main straight-forward group.
The other two mothers found the LP difficult from the start and, with hindsight, some problems they had with parenting and their beliefs about stuttering and child behaviour could have been addressed first, this might have led to a better outcome.
The study suggests that the LP can be experienced as a straight-forward treatment by many but that if problems arise they need to be tackled by parent and SLT together. Parents should not feel guilty or that they have failed if treatment progresses slowly but time should be spent trying to sort out the problems so that maximum progress can be achieved.
stuttering and stammering mean the same
Practical implications for SLTs:
When parents grasp the principles of the LP and can use these in a child friendly way then it can be a straight forward treatment leading to rapid change. They also quickly learn how to use the inter-related LP skills of parental verbal contingencies and structuring of conversations to ensure both continued progress and maintenance of therapy gains. When there is no change within the four session benchmark then SLT and parent need to work together to explore whether or not there are problems and to address these as needed. SLTs need to ensure that parents can talk openly about their problems in using the LP without fear of negative judgement. Slow progress can lead parents to feel guilty and inadequate and in these cases they may need more support to keep using the LP constructively.
Practical implications for parents:
The LP can be a relatively quick and straight-forward treatment which both parents and children can enjoy. If parents are finding it hard work and their child is not enjoying home therapy then they must talk openly about this with their SLT. Problem solving is an important part of the LP and slow progress is not the parents fault but may indicate that either their child just needs longer or that
the parents need alter the way they are working with their child. The SLT’s role is to work with the parents to find the best way of using the LP.
The Lidcombe Program is a parent-based behavioural treatment for early stuttering. Quantitative studies have shown it is an efficacious treatment for eliminating stuttering in children of 6 years and younger. This study explores parents’ experiences in order to understand more about the process of implementing the Lidcombe Program. Twenty-one in-depth qualitative interviews took place with parents of 14 children who showed a range of responses to treatment. Six parents were interviewed twice so that changes over time could provide further insights. The data was analysed using an inductive approach supported
by NVivo qualitative software. This interview data suggests that parents’ experiences of the Lidcombe Program are influenced by their ways of making sense of the principles and procedures of the programme and how these fit with their understanding of stuttering, parenting and their children who stutter. Parents experience the Lidcombe Program as satisfying and relatively simple when therapy proceeds straightforwardly. When progress is slower or erratic parents perceive the treatment as more complex and confusing. Failure to adequately address difficulties with the Lidcombe Program can reduce its therapeutic impact and lead to parental distress. These parents’ perspectives provide knowledge about the Lidcombe Program that is not recorded in the published quantitative studies.