Lidcombe Program Basics: The Severity Rating Chart

Here is a new series of posts about key components the Lidcombe Program.

Critics tend to see the LP as a ‘cookbook approach’ to therapy. This is a long way from reality. The program maps out a range of essential components, but how this works with each child, each parent and each clinician, is very different. Speech Pathologists use their experience and judgement to tailor the program to each child in a unique way.

This week I will look at the Severity Rating (SR) chart. Using the chart is a non-negotiable. Parents need to rate their child’s stuttering each day. This means that they tune in to their child’s talking more actively. The ratings help the therapist to track progress and make adjustments to the therapy process. Parents can use their phone to track digitally, if that is more convenient. If parents forget the chart, I ask them to take a photo of it and text it through later that day.

The first part of all therapy sessions involves the parent and clinician chatting with the child and then agreeing a severity rating for that conversation. Initially, the SRs can seem a bit of a guess for the parent but within a few sessions, most parents get the hang of the scale and accurately rate their child in and outside of the clinic. After the talking sample is done, the chart is shared and I copy down the ratings from home. This data, combined with parent reports on home practice is key to how we move forward with therapy. When the ratings get lower, we know therapy is working. When the ratings stay put, we know we have to try different therapy strategies.

The photo above shows a sample chart. The ratings are: 0 = No stuttering; 1 = extremely mild stuttering; 9 = extremely severe stuttering.

Happy tracking!

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