Comparison of therapy approaches for young children who stutter.

Indirect Therapy	Direct Therapy	Lidcombe Program
Works on changes the environment to support fluency. .	Direct work with the child who learns to speak in a way that is incompatible with stuttering.	Spontaneous stutter free speech is “rewarded” and child is helped to change unambiguous stuttering
Ex. Fluency Generating Play Periods, planning a less hectic schedule, turn taking, parent speech models	Ex. “Easy Speech” “Turtle Talk” Language hierarchy is a key component.	Stutter Free Speech, moves from structured to unstructured including time of day, degree of adult direction of language difficulty.
Both clinician and parent conduct sessions.	Clinician does therapy, parent may do homework	Parent does therapy, clinician coaches parent and tracks progress
Evaluate from time to time.	Evaluate from time to time.	Daily documentation is essential to the program
Fun for parent and child.	Should be fun for child.	Fun for parent and child.
Time honored for preschool age child	Often done with preschool age child. Usually the treatment of choice for younger school age children.	Designed for children 6 and younger. May be done with older ages but may not be sufficient. Evidence based. Newer in US. Routine in Australia and Canada
Is it helpful? Absolutely yes. If it is not helpful in a reasonable period of time, move to another approach.	Is it helpful? Yes.	Is it helpful? The research says “yes” as does my experience.
Worries: Is it enough?	Worries: Some children dislike the artificial speech pattern. They may dislike the structure. Kids would rather be with their parents.	Worry: Will we convey to a child that stuttering is not okay. What if this is a child who will stutter for the lifetime?

Connie Dugan