Our first meeting took place here in Perth, WA, on 14 October. It was a small and select group but there was plenty of passion and lots of sharing about using the Lidcombe Program with young children who stutter and ensuring evidence-based practice and great outcome for our clients.
We were fortunate to have Dr Michelle Donaghy from the Australian Catholic University in Sydney, join us via Skype for 1 1/2 hours and talk about current research trends in the use of the Lidcombe Program and how to ensure best practice.
One trend that is emerging – although ongoing research is required – is that verbal contingencies appear to not necessarily be the main treatment agent in the Lidcombe Program. Spending as much time as possible being smooth – possibly allowing the neural pathways involved in smooth talking to be used and established – could be more key. This stimulated loads of discussion about all the skills that Speech Pathologists have to teach and facilitate good quality talking from the initial session where single words or short utterances are needed for a child to be smooth onto everyday talking situations, where there is less structure and less scaffolding required in order to help the child to use smooth talking. So the Lidcombe Program treatment still looks very similar but the dose of verbal contingencies might have less focus in the future, compared to the focus placed on using stutter free talking from easy practice situations through to everyday natural conversations.
Feedback is an important consideration, in addition to motor practice, in establishing any motor skill. So for example, to develop a good forehand stroke in tennis, you need to practice a lot and you need feedback from someone who knows about tennis. This might prove to be a similar theme for talking without stuttering. Stuttering treatment will look like lots of smooth talking practice together with some feedback in the form of encouraging verbal contingencies.
For clients, it is important to choose a therapist who has training from the Lidcombe Program Consortium and who understands the importance of evidence-based practice (EBP). Knowing how to apply the principles of the Lidcombe program while tailoring the therapy to an individual child’s needs and preferences takes a lot of skill and experience on the part of the clinician.
For clinicians, Michelle advised that to ensure EBP in stuttering treatment, consider the following:
- measure progress scientifically e.g. Daily severity ratings for measuring stuttering are key to ensuring that therapy is on track.
- be knowledgeable of the science from peer reviewed evidence.
- observe and analyse client patterns like a ‘speech scientist’.
- individualise a client’s treatment with scientific clinical reasoning.
We will meet again next March, 2017. I plan to invite another clinical researcher to talk with the group via Skype. We will continue to focus on staying up to date with current research trends, and providing one another with clinical support and inspiration. Each meeting will also include building on our therapy “Bag of Tricks” and discussing both challenging and successful cases for all to learn from.