From: Anne Bothe
Time: 4:45:30 PM
Remote Name: 184.108.40.206
Hi, Bryan Allow me to suggest two chapters that might explain a little bit more about how to do these "direct" approaches, if the ideas are new to you. One is by Janis Costello, called "Current behavioral treatments for children"; it's in a 1983 book called "Treatment of stuttering in early childhood," edited by David Prins and Roger Ingham. It's almost 20 years old now but that I still think it is among the very best discussions of, or introductions to, doing straightforward direct treatment with young children. The other is by Elizabeth Harrison and Mark Onslow, called "Early intervention for stuttering: The Lidcombe Program." It's in the new 1999 edition (the second edition) of "Stuttering and related disorders of fluency" edited by Richard Curlee, and it does a nice job of explaining the particular variations of these ideas that have become known as the "Lidcombe program." (And if you can't find the 1983 Costello chapter, then take a look at her chapter in the 1999 Curlee text; I just think that the 1983 version is a better place to start.)
Your other questions were about whether I have found this to be more effective than other treatments and about how long the maintenance phase is. I honestly have not done too much comparison between clinical applications of direct praise/correct approaches and clinical applications of too many other approaches with preschool children, other than the comparisons that my little paper was describing. I do know that we have seen children here who had been doing other types of treatments for up to a couple years and not responding, and then they responded to these sorts of approaches. In our study, we are using a 2-year maintenance/follow-up phase, but that is more for our purposes in data collection than because the children need to see us for two years. I don't think we know how long we really truly need to follow children who have recovered from their stuttering to be able to say with absolute assurance that they are completely recovered and will never relapse; I'd be willing to make a somewhat educated guess that a child who has not been stuttering at all, at home or at preschool or in the clinic, for 6 months, is probably going to be fine, but even as I'm typing that I'm wondering if I should have said a full year. It might be a difference between what I would expect of treatment outcome publications or experiments and what I would say is a nice benchmark for clinical work.
Hope I'm making some sense, and thanks for asking!