An investigation of the role of parental request for self-correction of stuttering in the Lidcombe Program

Abstract

This clinical experiment challenges the assumption that the verbal contingency request for self-correction contributes to treatment efficacy. Results suggest the need for further research to explore this issue.

Parent verbal contingencies during the Lidcombe Program: Observations and statistical modeling of the treatment process

“…The results from the present study suggest that verbal contingencies for stuttering might not be contributing to the treatment in the way in which it is assumed. This fits with recent findings by Donaghy et al (2015) who conducted a randomized controlled clinical experiment comparing Lidcombe Program treatment with and without the request for self-correction contingency for unambiguous stuttering. While inclusion of this contingency was predicted to be necessary for treatment progression, there was in fact no difference between the number of clinic visits or time required for the children to achieve a 50% reduction in stuttering severity.…”

“…Firstly, it is possible that the mechanism for stuttering control in the Lidcombe Program is more complex than previously thought. Donaghy et al (2015) also found that the request for self-correction contingency for stuttering did not have the expected impact on treatment progression, which supports this interpretation.…”

Management options for pediatric patients who stutter: current challenges and future directions

“…Stuttering treatment researchers are often divided about which components of stuttering treatment actively reduce stuttering in the pediatric population. 42 , 85 For example, as a treatment tested in numerous randomized controlled experiments, 14 , 20 , 24 , 86 the Lidcombe Program is regarded as highly efficacious, but it is not known which components of this treatment reduce stuttering. A recent RCT suggests parity in the treatment effect between divergent Lidcombe Program and DCM approaches, 24 but multifactorial treatments such as DCM carry multiple treatment components.…”

“…Recent Lidcombe Program studies have begun to reveal challenges to the long-held theoretical belief that operant mechanisms drive therapeutic success. 86 – 89 Such discoveries are important, as knowledge about which components of a treatment are useful will enable ease of clinical problem solving and increase treatment efficiency. Furthermore, such knowledge may assist in individualizing treatment to better serve individual client differences associated with concomitant disorders and treatment-resistant cases.…”

Direct versus Indirect Treatment for Preschool Children who Stutter: The RESTART Randomized Trial

“…Studies suggest that 30–70% of therapy outcome can be attributed to common factors, including good therapeutic relationships [ 47 ]. Unfortunately, little is known about the unique mechanisms that lead to change in stuttering behavior in both treatments [ 49 – 51 ]. Common components of the LP and RESTART-DCM treatment may include consideration of maintaining factors, an increase in one-on-one time that parents spend with their child, a boost of encouragement and a reduction of linguistic demands for the child [ 52 ], and emotional support for the parents.…”