Trusted Stuttering Treatments for Your Child
When it comes to stuttering, Australian Speech Pathologists use the Lidcombe Program as the most effective treatment for stuttering in young children. Whilst the Lidcombe program works for most children who stutter, what do we do when it doesn’t? New evidence-based treatments are beginning to make an appearance- the Westmead and Oakville programs.
The Westmead Program is designed to reduce stuttering by having parents use Syllable-Timed Speech (STS) in the child’s everyday environment and Severity Ratings (SR) to score the severity of the child’s stutter. This treatment involves parents to practicing STS with their child a few times during the day and completing a severity rating. But what are Syllable-Timed Speech and Severity Ratings?
Syllable-Timed Speech (STS) is when you say syllables in a rhythmic beat with similar stress on each syllable. For example, instead of saying “The kitten is licking it’s paw” you would say it as “The ki-tten is li-king it’s paws”. It might be helpful for young children to call STS “Syllable/Beat-Talking” or “Robot Speech”. Parents will be taught how to use STS with their children through demonstration, imitation, and practice. Initially STS is taught at a slowed down speech rate, but evidence has shown that it will eventually turn into a near-normal speech rate with normal volume, pitch, and intonation. STS should first be introduced to a child through imitating short sentences at a slow rate. Once the child masters that, they can move onto simple conversations. The child should be encouraged to use their normal pitch, volume, and intonation when using STS. It is suggested that parents have STS practice sessions at home 4-6 times a day for at least 5-10 minutes each time. It is important to note that parents should be talking in STS with their child during practice sessions. Finally, STS practice can happen anywhere as long as the child and parent are together, the child is focused, and it happens during naturally occurring situations. Here are some helpful examples of this:\
- Talking at the dinner table
- Reading a book
- Engaging in a play activity together
- Preparing meals
- Driving in the car
Severity Ratings (SR) are a way to track the child’s stuttering inside and outside of the clinic. It is a numerical scale that goes from 0-9: 0 = “no stuttering”, 1 = “extremely mild stuttering”, and 9 = “extremely severe stuttering”. Parents are expected to rate their child’s stuttering each day during every week to show their Speech Pathologist their child’s progress. These ratings also allow the parent’s and Speech Pathologists to modify the treatment plan accordingly. During the first consultation, Speech Pathologists and the parents will each rate the child and compare and discuss how to accurately rate the stuttering. It is important that the parents and Speech Pathologist ratings are similar to each other.
The Westmead Program has two stages for treatment. The goal of the first stage is for the child to speak with little to no stuttering in everyday conversation. The goal of the second stage is for the child to speak with little to no stuttering for a sustained period of time. Here is a brief overview of what each stage of treatment in the Westmead Program looks like:
- Parents consult with a certified Speech Pathologist to discuss the severity of the child’s stutter, develop a schedule, and to train them in how to do the Severity Ratings (SR) and Syllable-Timed Speech (STS).
- Parents are encouraged to use STS practice sessions at home with their child 4-6 times a day for about 5-10 minutes each time.
- Parents rate their child’s stuttering on the SR sheet every day during the week.
- Parents and children meet with their Speech Pathologist weekly to discuss progress of the child and to compare SR scores.
- The child can progress to Stage 2 of treatment when two criteria are met
- The Speech Pathologist gives the child a SR of 0 or 1 during a consultation
- The week before the consultation the daily parent SR ratings are 0 or 1 with 4 out of 7 ratings being 0.
- Once the child meets the criteria for stage 2 of the treatment program they can progress to this stage.
- The Speech Pathologist helps the parents slowly withdraw STS practice sessions.
- Weekly SRs are documented by the parent and shown to the Speech Pathologist during their meeting.
- If the child begins to increase their stuttering, parents are taught to reintroduce daily STS practice sessions to improve their child’s SR score.
- If child’s targets are met, parents and children meet less frequently with the Speech Pathologist
- Stage 2 continues until the child has sustained minimal stuttering for at least a year.
The Oakville Program is similar to the Westmead Program. They both use STS in everyday situations and treatment is directed towards young children. The key difference in these two programs is that the Oakville Program uses parent verbal contingencies, which is positive feedback when a child talks stutter-free or self-corrects their stutter. The Westmead Program doesn’t use this.
So, for those children for whom the Lidcombe program hasn’t been successful or for those who are school aged, ask your Speech Pathologist if these new stuttering treatments are might be suitable for them!
For more information about our Stuttering Therapy for Children get in touch with one of our Speech Pathologists today on 02 9313 8980.