The Lidcombe Program for Speech Therapy
The Lidcombe Program is a parent-delivered behavioral treatment for developmental stuttering in young children (typically preschool age) where parents provide verbal feedback during daily conversations to reinforce fluent speech and gently correct stuttering moments. 1
Core Components and Mechanism
The program operates through two essential elements:
- Parental verbal contingencies: Parents deliver immediate positive reinforcement for fluent speech (e.g., "That was smooth talking") and gentle acknowledgment of stuttering moments during natural conversations throughout the day 2
- Parent as co-therapist model: The speech-language pathologist trains and supervises parents to capitalize on teachable moments during daily routines and natural speaking situations, which increases intervention time and facilitates generalization of learned skills across different environments 1
Evidence for Effectiveness
The Lidcombe Program has the strongest evidence base for treating preschool stuttering, with a landmark randomized controlled trial demonstrating highly significant reduction in stuttering frequency (P = 0.003) at 9 months. 3
- Children receiving the Lidcombe Program achieved 1.5% syllables stuttered compared to 3.9% in controls, representing an effect size of 2.3% that was more than double the minimum clinically worthwhile difference 3
- The program is effective across different delivery formats, with research showing reduction in stuttering severity in preschool children whether delivered as a standalone direct intervention or as part of an integrated approach 4
- For school-age children (6-12 years), telehealth delivery showed that approximately one-third (32.4%) achieved near-zero stuttering levels by 12 months, with two-thirds showing partial response 5
Optimal Timing and Target Population
Treatment should begin as early as possible once stuttering is identified, ideally before age 3 years, as interventions initiated before this age have greater positive impact than those begun after age 5 years. 1
- The program is primarily designed for preschool children (ages 3-6 years) with developmental stuttering 3
- Inclusion criteria typically require stuttering frequency of at least 2% syllables stuttered 3
- The program is not appropriate for functional/psychogenic stuttering in adults, which requires different treatment approaches targeting psychological factors and muscle tension reduction 6, 7
Clinical Implementation Structure
The program follows a structured two-stage approach:
- Stage 1: Parents conduct daily 10-15 minute structured practice sessions plus unstructured verbal contingencies throughout the day, with weekly clinic visits for training and monitoring
- Stage 2: Maintenance phase entered when stuttering reaches near-zero levels, with gradual reduction in clinic visits 5
Important Caveats
- The program focuses on developmental stuttering originating in childhood, not functional stuttering acquired in adulthood which requires addressing psychological stressors and muscle tension 6, 8
- While highly effective for preschoolers, response rates decrease with age—only about one-third of school-age children (6-12 years) achieve complete fluency compared to higher rates in younger children 5
- The program requires committed parent participation and consistent implementation across daily routines to be effective 1