SLPCohortInternational journal of language & communication disorders2023

Lidcombe Program translation to community clinics in Australia and England.

Sue O'Brian, Rosemarie Hayhow, Mark Jones and 4 others

PMID 36114801

WHAT IT FOUND

Community speech therapists in Australia and England achieved stuttering reduction outcomes similar to those in randomized trials.

Interestingly, clinicians who deviated from the treatment manual due to workplace pressures still achieved these results at 9 months. This suggests the Lidcombe Program is robust to therapist drift in the short term.

Key findings

01Community clinicians achieved mean stuttering outcomes (1.4%SS) that fell within the range reported in randomized controlled trials.

02Unlike previous research, formal training from the Lidcombe Program Trainers Consortium did not significantly predict better stuttering outcomes for clinicians in Australia.

03Clinicians from England showed significantly less deviation from the treatment manual (therapist drift) than those from Australia, but this better adherence did not result in superior stuttering outcomes.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

A high proportion of children in the Australian cohort withdrew from treatment before completing Stage 1 (36%) compared to the English cohort (19%), and the reasons for these withdrawals were not documented. The method for collecting audio recordings differed between countries: Australian parents recorded at home, while English clinicians supervised recordings, which may have introduced bias in the %SS scores. The study could not determine if the reduced number of clinic visits in the community setting was due to faster progress or premature movement to the next stage of treatment. The study only measured outcomes at 9 months, so it is unknown if the observed therapist drift affects long-term recovery.

Declared interests

The authors declared no conflicts of interest. The study was funded by the National Health and Medical Research Council (Non-U.S. Gov't).

The easy way to misread this

Do not assume that because therapist drift did not harm outcomes at 9 months, it is safe to ignore the treatment manual. The study notes that the long-term effects of this drift are unknown, and the mechanisms of the Lidcombe Program are not fully understood.

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