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From: Rosemarie Hayhow
Date: 03 Oct 2010
Time: 12:43:47 -0500
Remote Name: 86.129.241.142
Hi Jennifer, thanks for your questions. There is a lot written about indirect methods with young children and I think referring to these sources would be a lot more useful than any summary I can give here. Your 2nd question is harder to answer without seeing a particular child but it is always worth bearing in mind that some young children with severe stuttering close to onset are getting frustrated and angry because they are really aware of their speaking and the severe stuttering behaviours may be part of their working out how to deal with the glitches in their speaking. Put another way these children sometimes have very good language skills and on some level a good understanding of how talking works- we refer to this as having good meta-linguistic skills. These children – the skillful talkers may be experiencing transient stuttering that will quite quickly resolve- within a few weeks. In this case I would support the parents in whatever ways they need and see what happens (i.e. monitor the stuttering) starting treatment if it gets worse. However, if there is a strong family history of stuttering and the child and parents are clearly suffering as a result of the stuttering then I might start the Lidcombe Program sooner rather than later. Your question is about clinical judgment which should always be based on as much information as possible, therapist knowledge (the evidence base) and skill, and jointly reached decisions.