Lidcombe News Edition 31st - Montreal Fluency

With this edition of the Lidcombe News we have reached our tenth
anniversary! And as it is also the tenth anniversary of the Lidcombe
Training coming to the UK we have dedicated this edition to looking
at how the workshops were introduced in three different parts of the
world over the last decade - the UK, Canada and Germany. We hope
to continue with this theme in future editions as it is something we
are often asked about on our training days. It is as relevant now as
ever since Rosemarie Hayhow and I have just returned from
Thessaloniki where we have run the very first workshop in Greece.
Later in the year we have been invited to give another training course
- another first - in Spain, while in Spring 2009 we have been asked to
go to Norway where it is hoped a workshop can be organised in
Oslo.
But amidst all this we have not forgotten the usual news and
features, and have our Dear Sue (about twins), and all the dates for
your diary: Link Days in the UK and the training courses. In addition
we have also repeated our Hot Tips with ideas for your clinics. So as
ever we start with the Link Days...
DATES FOR YOUR DIARY
Margate is holding a Link Day on Tuesday, September 2 nd 2008.
It will be held at The Speech Therapy Department, Mill Lane
House, Mill Lane, Margate, starting at 9.30am. For further details
contact Samantha David on tel.01843 282310 or email:
Sam.David@ekentmht.nhs.uk
Contents
Page 1
Dates for your diary
Page 2
News of training courses
Pages 3-5
Lidcombe training in the
UK by Mary Kingston
Pages 6-7
Lidcombe training in
North America by
Rosalee Shenker
Page 8-9
Dear Sue
Page 10
Hot Tips!
Pages 11-14
Lidcombe training in
Germany by Tina
Latterman
Norwich is holding a Link day on Tuesday, 7 th October 2008, 9.30-
3.30 at 40, Upton Road. Bring/buy your own lunch. Contact Mary Kingston
for details, directions etc. on tel. 01603 508946, or email:
kingstonamee@talk21.com
Contributions to Mary Kingston. Send your ideas and questions to:
Speech and Language Therapy Department, 40, Upton Road,
Norwich, Norfolk, England NR4 7PA Tel. 01603 508946
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E-mail address: kingstonamee@talk21.com
I can't promise to include everything and have to reserve the right to
edit contributions as necessary. But I'll do my best!

The Lidcombe Link Day for the North West is on Tuesday 7th October: 1.00
for a 1.30 start. It will be held at Handforth Clinic, Wilmslow Road, Handforth,
Wilmslow, Cheshire, SK9 3HL. We will be discussing tricky cases and a
journal article. For further information, please email:
Louise.Tweedie@echeshire-tr.nwest.nhs.uk or tel. 01625 661983
COURSES AND EVENTS
There are several courses being run in the UK this year but they are
not all open to people outside the departments running them, or else
they are already full. I am therefore only in a position to advertise those
departmentally based ones that still have places to sell, and the national ones.
The next course advertising places is in SE London. It is being held at
Catford on Monday and Tuesday, July 28 th and 29 th 2008, hosted by
Lewisham Children and Young People's SLT Service. For further information
contact Dorett Davis on email: dorett.davis@lewishampct.nhs.uk Tel. 020
7138 1385. The workshop is being presented by Rosemarie Hayhow and
Mary Kingston.
Norwich is holding its annual national workshop on Monday and Tuesday,
October 13 th and 14 th 2008, at the Assembly Rooms, in the centre of the city.
Contact Sally Wynne on email: robertsallywynne@boltblue.com for a flyer
or telephone 01603 425241 if you wish to speak to her personally. The course
is being presented by Mary Kingston and Sally Wynne.
Apart from this, and a workshop in Spain to be presented by Rosemarie
Hayhow and Mary Kingston in October 2008, there is nothing definite until
March 2009 when the annual national training course in London will once
again be held at the Royal College of Speech and Language Therapists. No
dates have as yet been fixed but do contact Sally Wynne on
robertsallywynne@boltblue.com if you would like the flyer when it comes
out.
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This is the first of three articles in this edition of Lidcombe News which will be
looking at the introduction of Lidcombe Training workshops over the last ten
years. We will start with the UK as we have the longest record of
these training courses and this year heralds our tenth
anniversary.
The Introduction of Lidcombe training in the United
Kingdom - some reflections
By Mary Kingston, Norfolk Community Healthcare
It hardly seems possible that it is twelve years (1996) since
Mark Onslow and Sue O’Brian made their whistle stop tour of
the United Kingdom to present the new and radical approach
to the treatment of young children who stutter known as the
Lidcombe Program (LP). I attended one of their sessions- in
Wolverhampton- and knew at once that I had found something for which I had
been looking for some time. I had long wanted a way of working directly with a
child’s speech but without teaching a novel speech pattern, had wanted to
involve and empower the parents and the children themselves, and had also
felt the need for some measures of outcome. Others however were not so
sure and a healthy debate ensued around what was the safest and most
correct way to treat pre-schoolers who stuttered. Some of these concerns
which were published the following year are discussed in the European
Journal of Disorders of Communication (1997) and give a flavour of the
thinking at that time. I for my part set about finding a way to get myself
trained and, following a business plan, which with the help of my department
head we presented to my health Trust in Norfolk, I was eventually granted
funds to go to Australia. The reason the health service was prepared to fund
me, I discovered, was that the research already carried out on the programme
was of such a high standard that the Trust was prepared to take the risk with
public funds and send me on my way.
I was not, I soon realised, the only one interested enough in this programme
to want to make the trip. Rosemarie Hayhow had attended a full day course
that Mark and Sue ran in Bristol. This gave her a good enough understanding
of the approach to use it with two five year old children who had previously
received indirect therapy but continued to stutter. It worked very well for these
children and so Rosemarie applied for a British Telecom bursary to visit
Australia and learn more about the LP. Rebecca Pitt (now Ledzion) from
London was also keen to receive the training. I found that Rosemarie and I
has similar reasons for wanting some additional methods of treating stuttering,
and that Rebecca, being Australian herself and having some previous
experience of the LP, was equally like-minded in this respect. The story of our
time there has been documented in the British Stammering Association’s
magazine “Speaking Out” (1997).
On our return we all implemented the LP in our clinics, with much success,
and as we found there was a demand for training from other UK clinicians we
invited Sue O’Brian over to London, Norwich and Bristol, to run three training
courses in January 1998.As the LP was still being fiercely (and emotionally)
debated over here, Sue must have felt she was entering the lion’s den...but
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the courses went down well with the majority (though not all and there are still
many who remain sceptical) of the thirty or so clinicians, and soon a demand
for more training was evident. Around this time the Lidcombe News was born
(May 1998, see Lidcombe News edition 12 for a brief history) and it was Sue
O’Brian who was our first agony aunt, though the ‘Dear Sue’ position in this
newsletter has now for many years been taken over by the Bankstown
Stuttering Unit with Lis Harrison, Vanessa Harris and now Margaret Webber
heading up the team.
As Sue could not keep coming over to the UK to deliver the workshops, this
role was handed over to Rosemarie, Rebecca and myself. Initially the courses
were spread over five or six days- this included a follow up day- and when
they were given at the clinic bases of the three trainers they also included
some ‘live’ observation of children being treated. During this time the
popularity of the courses increased and soon the demands on our time, as
well as the expense of the course to the health service, meant that we had to
reduce the number of training days to three with one follow up day. The
publication of the hardback book ‘the Clinician’s Guide’ in 2003, the formation
of the Lidcombe Program Trainers Consortium, and the development of
excellent videos and workbooks from Australia, have ensured a presentation
which is the same worldwide. The quality of these resources, the local
support networks and a greater acceptance that direct treatment can benefit
young children who stutter, has led to our reducing the workshops to two days
in English speaking countries and three days in countries where English is not
the first language.
Since those early workshops we have noticed a change in feeling about the
LP. They are no longer the challenge, or as exhausting, as they once were!
For the most part therapists have accepted that the LP is another way of
treating early stuttering, and new graduates who have learned about it at
university now view it as an appropriate intervention for children at risk of
persistent stuttering. Most of the health Trusts in the UK have someone who
has been Lidcombe trained and it is expected that clinical leads in stuttering in
Speech and Language Therapy departments should have the Lidcombe
training under their belts. Some may favour the indirect approach as their first
choice, others may prefer the LP, but both are now seen as mainstream
therapy in the UK, with the LP having the huge advantage of a strong
evidence base which makes it easier to access funding for training. I am
sometimes asked how many clinicians we have trained over the years in the
UK and I’m afraid I don’t have any figures for this, but a guestimate would be
around 2000.
The story of the training in this country does not stop with the UK. We have
been called upon to train therapists in other countries- most particularly in
Ireland, the Netherlands, Sweden and Denmark. The Netherlands has its own
Consortium member- Durdana Putker (email:durdana.putker@planet.nl)
and until recently so did Denmark. Lone Cordes Felby, unfortunately for us,
moved on to a new job so this position is now open to a new member. This
year we have had the privilege of travelling to Greece to train some twenty
five therapists and in the autumn we have been invited to Spain to run a
workshop there. Norway is currently advertising its own course which should
take place in April 2009, and we have also had enquiries from Italy.
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I mentioned earlier in this article that it was the research which had persuaded
my health Trust to fund my trip to Australia. During the eleven years since we
have implemented the LP in this country, Rosemarie and I who are now the
two UK Trainers for the Consortium, have added to that evidence base.
Initially I ran an audit in Norfolk, which is unpublished, but many of the results
appear in the Bulletin of the Royal College of Speech and Language
Therapists (1999). It was important in that, as Mark Onslow informed me at
the time, it was the first occasion that the Australian results had been
replicated in a different country, and in a different culture. Rosemarie too ran
an audit, which was national, and is summarised in Lidcombe News edition 15
(January 2003) and is available from the www.montrealfluency.com under the
Lidcombe Newsletters section. We will have a look at some further research
which has been conducted in this country, including Rosemarie’s Ph.D, and
some other studies which are not based in Australia, in a later edition of the
Lidcombe News.
So we continue with the Lidcombe Training as it proliferates throughout the
world, offering support where we can through Lidcombe Link days in the UK,
the Lidcombe News, and problem solving by email with individual therapists
who write to us. When I drove to Wolverhampton all those years ago I had
little idea of how that day would change my clinical practice, or indeed my life,
nor how it would help to spread the Lidcombe Program throughout the UK and
Europe. Rosemarie and I, and other colleagues who help us co-present the
training, Sally Wynne, Polly Mitchell, Corinne Moffatt and Samantha David,
will, we hope, to continue to work and learn together, offering workshops
where they are requested in the future.
My grateful thanks to Rosemarie Hayhow for her help with this article
References
Hayhow, R. & Enderby, P. (2001) An audit of Speech and Language
Therapists’ use of the Lidcombe Program. Unpublished manuscript, Speech
and Language Therapy Research Unit, Frenchay Hospital, Bristol, UK
Kingston, M. (1999, December). Is stuttering a motor speech problem?
Bulletin of the Royal College of Speech and Language Therapists, pp. 9-11
Kingston, M. (1997) The Lidcombe Programme comes to Britain. The British
Stammering Association: Speaking Out, Autumn edition
Onslow, M., Packman, A., & Harrison, E. (2003). The Lidcombe Program of
Early Stuttering Intervention. Austin, TX: Pro-Ed.
Onslow, M., O’Brian, S. & Harrison, E. (1997). The Lidcombe Program of
Early Stuttering Intervention: Methods and Issues. European Journal of
Disorders of Communication, 32, 231-250
Rustin, L. & Cook, F. (1997). Commentary on the Lidcombe Program of Early
Stuttering Intervention. . European Journal of Disorders of Communication,
32, 250-258
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A brief history of the Lidcombe Program
Clinician Training in North America:
Looking Back at 10 Years
Rosalee C. Shenker
I first heard Mark Onslow speak about the Lidcombe Program at an ASHA
Special Interest Division 4 meeting in Monterey, California, in 1997. Although
I had read a bit about the Lidcombe Program I was unprepared for the effect
that this presentation had on me. All of the components of the treatment and
rationale for the approach suddenly made perfect sense and I remember
thinking, “Why haven’t I thought of that!” After pursuing Mark as an email
‘pen pal’ for several months, we arranged that he and Ann Packman would
visit Montreal in November 1997. Their plane landed on the first snowy day of
the season and although it looked beautiful from inside the airport, it was not
so easily navigable for a couple from ‘Oz’ who had not had the experience of
walking in ‘slush’ without proper footwear. “Oh, oh”, I thought, “…bad start!”
However, from the first meeting, I was committed to the concept of the
Lidcombe program, and determined to try it out in Canada. The support and
mentoring that I and my colleagues have received from all the members of the
ASRC over the years has been exceptional. After several months of clinical
practice, and after convincing several staff clinicians and graduate students to
try out this ‘new approach’, Mark returned again in November 1998 to follow
up on our progress. We presented several cases with great trepidation, and
found Mark to be an excellent clinical teacher, providing supportive and useful
feedback that further encouraged us to shape our clinical skills in those early
days. Our initial fears of presenting in front of the ‘developer of the LP’ were
totally unfounded, we breathed a collective sigh of relief and became even
more determined to help other Speech Language Pathologists, (SLP) to learn
to use this effective program. At that meeting I agreed to initiate clinical
training in the Lidcombe Program in Canada.
The first Lidcombe Program Clinical Training workshop in Canada took place
in March 1999 when Elisabeth Harrison travelled to Montreal to train 30 SLPs.
Two of those clinicians were Melissa Bruce and Julie Reville, clinical
coordinators for student training at the University of Vermont. At the time of
initial training, North American clinicians were more familiar, and therefore
more comfortable, with more indirect models of early intervention. Although
many North American clinicians quickly embraced the Lidcombe Program, it
was still difficult for some to embrace a model that provided direct verbal
feedback for stuttering to the child. I shall ever be indebted to Barry Guitar
for his openness and willingness to try out this program. After seeing the
progress made by Melissa and Julie with the Lidcombe Program, Barry
registered for the first Lidcombe Program workshop given by myself and
JoAnne Wilding. Imagine our excitement…and anxiety… to have Barry as
one of our students. We need not have been concerned; he was a perfect
gentleman and enhanced the workshop through sharing his clinical expertise
and experience which included stories of his time spent in Australia working
with Dr. Gavin Andrews. By 2002 over 250 clinicians had been trained, mostly
6

in Canadian based workshops, and the Lidcombe Program was quickly
becoming best practice for the treatment of preschool age children. The early
model included a ‘problem solving day’ where clinicians returned to present
their own cases for group feedback and mentoring. This was replaced by
individual clinic initiatives as, more and more, we noted that whole clinics with
Lidcombe Program trained SLPs were getting together regularly for ‘pizza and
Lidcombe’.
After 2002, the workshop schedule began to include American cities. The first
American workshop took place at the University of Louisiana at Lafayette in
2003. This workshop included clinicians from Louisiana and surrounding
states. By 2004 there were 8 workshops scheduled, and for the first time
more of them took place in the USA in sites that included Maryland, Oregon,
Vermont, California, New York and Ohio. Soon after, the Lidcombe Program
Training Consortium was formed and I, JoAnne Wilding, Barry Guitar, Melissa
Bruce and Julie Reville became charter members in North America.
As I write, more than 2,000 Speech Language Pathologists have been
trained in North American workshops provided by the LPTC members. While
there continues to be a ‘mild resistance’ to the program in North America, it
appears to be the choice of clinicians, who have often been introduced to the
program by parents who have heard about the Lidcombe Program and are
searching for a ‘trained clinician’. The Montreal Fluency Centre maintains a
referral list for clinicians trained in LPTC workshops on its website at
www.montrealfluency.com
In 2006, Judy Kuster, who provides us with the wonderful Stuttering
Homepage, graciously offered to set up a chat room for the Lidcombe
Program. This was organized as a response to clinicians who requested online
mentoring and troubleshooting feedback following their training. This chat
line is reserved for those clinicians who have received training in the LP and
you can request an invitation by writing to Kristy at
lidcombe@montrealfluency.com
Since that first meeting in Monterey I have never looked back, and never once
regretted the decision to use the Lidcombe Program. In our follow up
assessments of children who have been discharged from the program we find
that the great majority of the children who we have contacted have maintained
their fluency after periods of up to 8 years following discharge from Stage 2.
As we enter the second decade of providing Lidcombe Program treatment,
workshops and support systems we are looking ahead to the future. We are
always supported by visits from Australian colleagues and with
helpful/encouraging feedback for our projects. The Montreal Fluency Centre
has become one of the models for evidence-based clinical practice in North
America. Look for the next chapter to this story in future editions of the
newsletter.
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Dear Sue,
I have a family who came to see me with twins who both
stutter. They are both boys, aged 4years 2m, and have
similar types and severity of stuttering. I know I will need to
see them both but am unsure how to proceed.
Should I see them simultaneously or consecutively?
If I see them simultaneously should the mother and I be working with
them individually or could I see them together, as a little group?
What in your experience have you found to be the better system and
why?
I am presuming that immediate treatment for both boys using the
Lidcombe Program (LP) is preferred. There might be a number of options
that the clinician could consider, along with the parent, but whatever is
decided it will be essential to determine quickly whether the approach is
working, and if not what changes to make. The obvious pitfall would be
that in trying to be time efficient neither boy receives appropriate
therapy.
Start as usual by discussing with the parent what is needed for the LP to
work. This would include:
• measurement for both children
• sufficient effective therapy at home to achieve the desired change
for both children
• sufficient clinic time to allow appropriate teaching and checking of
progress in relation to both the children etc.
With this knowledge and that of their home situation the parent may
well have an initial preferred, treatment delivery option.
The treatment options that the Stuttering Unit would consider for the
boys are:
Option 1
Trial starting the therapy for both boys at the same time. Extend the
clinic visit to one and a half hours to allow time to consider both boys
individually during the clinic visit. This would also ensure appropriate
problem solving in relation to each child. The parent could then provide
separate treatment times at home for each child. This approach is then
providing pretty much the standard LP to each child but during the same
time period.
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Option 2
Begin therapy with one child in order to train the parent. When the
clinician and parent feel confident that the parent could cope with
treating both children, begin treatment with the second child and
continue as for Option 1
Option 3
Treat one child first to Stage 2 and then commence treatment for the
other child as the first one continues through Stage 2.
In considering your question about delivering the LP in a “group” context,
the clinician and parent would need to reflect that this approach would
then be purely experimental. The treatment outcomes clinicians expect
from the LP are from research where the children received individual
therapy. We cannot presume that the LP delivered in a “group” context to
children will work. The ASRC (Australian Stuttering Research Centre) are
considering a group format for clinic visits, but this entails a group of
mothers each with their own child not a group of children.
Some of the likely problems that would arise with treating the twins as a
”group” are as follows:
1. Can the parent learn and implement appropriate structured
conversation?
2. Can the parent attend to both children effectively and deliver
verbal contingencies appropriately to both boys?
3. Are the verbal contingencies effective for the boys in this
context?
In the experience of our unit it is essential to allow sufficient clinic time
to provide appropriate parent training and to consider each child’s
progress separately. The clinician and parent are then in a position to
consider “Is this working?”
Our thanks as ever go to the staff of the Bankstown Stuttering Unit in
Sydney, Australia. This particular Dear Sue was compiled by Margaret
Webber, Wendy Lloyd and Kylie Farnsworth.
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Hot Tips
The following ideas are essentially for rewards (on the star chart theme)
during the unstructured part of treatment and are given out occasionally and
unpredictably during the day in conjunction with all the verbal contingencies.
They help to make the parental feedback more meaningful to the child, and
also prompt the parent to remember to give it! Some of you will have seen a
few of these before but newcomers may like to try them out. They are ideas
compiled by Mary Kingston, Rosemarie Hayhow and Lizzie Hunt from their
own clinics but most of them were thought up by the parents themselves.
If you are looking for a new idea for a star chart, how about this one from
Lizzie Hunt in Cambridge? Instead of a chart use a parcel, and instead of
sticking on a star, take off a layer of paper! In other words ‘pass the parcel’,
with the prize inside to make praise for good talking extra special.
A parent of a child I have been seeing came up with another good idea, for
the same process. Instead of stars her son won cardboard arrows, and when
he had won the requisite number she laid them down as a Treasure Hunt trail
which he then followed around until he found his prize.
More hot tips from Lizzie in Cambridge! One of her parents came up with this
idea for a reward. Instead of using a star chart the child drew a picture of the
prize they were going to win, cut it up like a jigsaw, and then won the pieces
one by one. The child could then see the reward growing in front of his eyes!
One of Rosemarie’s parents drew a page of stick people without faces and
the reward was to put a smiley face sticker onto each one.
Another idea on the star chart theme is to draw some sheep in a field and
stick a piece of cotton wool onto each one as the reward. A similar idea would
be to draw a snail with a spiral shell which is divided into segments, and then
put a sticker, or colour in each section.
Again on the same theme, a parent of mine had the idea of making a train
track (her son was mad on trains) and putting stickers into the sections. The
final reward was at the station where her son had drawn a picture of what he
was going to win when he got there.
One parent of Rosemarie’s had the idea of drawing each letter of their child’s
name onto a page in a scrap book. They made each letter quite wide so that
there was space to fill it up with stars.
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This is the third article about the introduction of the Lidcombe Program
training outside of Australia, this time to Germany. Tina Latterman and her
colleague Anna Hearne, are members of the Lidcombe Program Trainers
Consortium, and Tina has also conducted a Randomised Controlled Trial of
the programme (to be discussed in the next edition of the Lidcombe News).
Introducing the Lidcombe Program to Germany –
Laying foundations for something new
Christina Lattermann
The idea of introducing the Lidcombe Program to
Germany was born in 2001 and has kept us busy ever
since. At the time, Anna Hearne (nee Huber) and I were both were “Germans
living in exile”. Anna was completing her PhD at the ASRC in Sydney with
Mark Onslow and Ann Packman, investigating treatment for adolescents who
stutter and working as a clinician. I was completing my Masters at McGill
University in Montreal, where I was introduced to the Lidcombe Program by
Dr. Rosalee Shenker. I had worked as a clinician for seven years in Germany
before and treatments of choice for preschool children who stuttered were
mainly indirect approaches or stuttering modification techniques. The
Lidcombe Program definitely fascinated me as an alternative approach, in
particular as it was tailored for the very young children and involved the
cooperation of their parents. I was thrilled when Rosalee Shenker offered me
the opportunity to learn in depth about the program and mentor me at her
clinic during the course of my studies at McGill. In addition, Barry Guitar took
me on for a three month internship at the University of Vermont in 2002,
where I had the great fortune to work with him, Melissa Bruce and Julie
Reville.
After completing my Masters in March 2003, I returned to Germany and was
invited by Dr. Katrin Neumann at the University of Frankfurt, Hessen, to
initiate a PhD project involving the Lidcombe Program. We decided to
investigate whether, in the short term, the Lidcombe Program results in
reduction of stuttered speech beyond what would be expected due to natural
recovery. In addition to this project, I worked in private practice exclusively
treating children with the Lidcombe Program in Bavaria.
After two years of intensive emailing, Anna and I met for the first time in the
fall of 2003 in Germany to give our first presentation about the Lidcombe
Program. At this time the approach was met with overwhelming scepticism
and rejection by many colleagues. This was to be expected as behavioural
techniques have been considered controversial in the European “therapeutic
landscape” for the last few decades. Nevertheless, we kept on presenting
about the program and treating children in Germany. Towards the end of 2003
the first children I treated in Hessen and in Bavaria had entered Stage II. (My
sincere thanks to Anna Hearne and Rosalee Shenker for great mentoring and
patient trouble-shooting all the way through!) So we were now able to present
data, video clips and parental comments regarding the treatment at following
conferences.
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In the fall of 2004, we felt confident enough to launch the first German
Lidcombe Program workshop in Frankfurt, which was attended by a group of
enthusiastic but also somewhat sceptical colleagues. However, most of the
workshop participants left being much less sceptical and motivated to give this
new approach a try. Anna and I became members of the Lidcombe Program
Trainers Consortium, and since 2004 we have presented between one and
three workshops a year, thereby training around 270 German colleagues to
date. All attending colleagues are offered supervision via email and skype. In
addition, we conduct Follow-Up Days enabling colleagues to present and
discuss cases. We have continued the email-supervision-offer ever since our
first workshop and many colleagues make use of it.
Supervision and Follow-Up-Days on a regular basis appear to be crucial in
supporting our colleagues to implement this method safely and correctly. Our
experience with the Lidcombe Program in Germany has also indicated that it
is important to know about the culture, attitudes and health care system
issues of the country you establish the treatment in. Unfortunately, due to
private reasons Anna now lives in Auckland, while I am back in Montreal. We
have not yet managed to live in the same place at the same time! Although
we both continue to work with the Lidcombe Program - we now do so in a
mainly English and French speaking environment. Yet we agree that it is
paramount to keep in touch with the German “stuttering therapy-scene”.
Therefore, in 2006 we decided to look for a third colleague to join us, who still
lived in Germany, and was primarily involved in childhood stuttering treatment.
This decision was easy and we were both more than happy, when Bettina
Freerk agreed to come aboard and join Anna and/or me in presenting
workshops and presentations at conferences and SLP-schools. Bettina lived
in Sydney from 2001-2002 and was able to observe treatment with the
Lidcombe Program at the ASRC. She also spent some time with Anna at the
Stuttering Treatment and Research Trust in Auckland in 2007. Since her
return from Australia she has successfully treated many German preschool
children with the LP.
The latest workshop Bettina Freerk and I presented in April 2008 indicated
that there is a shift of attitude regarding the Lidcombe Program in Germany.
We realized that for the first time the general scepticism and prejudices
against the LP were not present. It seems word has finally gotten around that
we are actually not trying to sell “the one-and-only-miracle-treatment which
will cure all stuttering children”- which of course we never were, but that was a
rumour that had spread since we first started to introduce the program.
Discussions and personal comments indicated that the Lidcombe Program
has become more and more accepted as an alternative therapy-program in
Germany. The program has been mentioned in some of the recent stuttering
textbooks and an increasing number of schools for Speech-Language
Pathologists have started to introduce the method to their students. So, word
is spreading that this actually might be an approach worth considering, who
would’ve thought!
As there has been an increasing demand for German stuttering literature,
Anna and I are currently writing a German book about the Lidcombe Program
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for clinicians. Unfortunately, to date many German colleagues feel
overwhelmed by English written textbooks and articles, and consequently
reject reading these. Therefore, most of the Speech-Language Pathologists
attending the workshops in Germany do not acquire the Lidcombe Program
textbook by Onslow, Harrison and Packman (2003), thereby lacking a great
resource for treatment. We hope a German textbook covering the Lidcombe
Program for clinicians will close this gap. We maintain information about the
Lidcombe Program, a schedule of upcoming workshops and a referral list for
clinicians trained in LPTC workshops on our website at www.lattermann.net.
One of the great advantages of the Lidcombe Program is the broad evidence
base supporting its efficacy and efficiency. In Germany there is a lack of
studies analysing the efficacy of early stuttering intervention. During the last
five decades, to the best of my knowledge, only two studies were published in
this area (Pape-Neumann, Bosshardt, Natke, & Oertle 2004; Randoll, 1988).
The offer to set up a randomised controlled trial to investigate the impact of
the Lidcombe Program on early stuttering in German-speaking preschoolers
therefore was a great opportunity to collect data and start building an
evidence-based support system to establish the method in Germany. In the
next edition of the Lidcombe News I shall provide a short overview of the
study outcome with German preschoolers, which has been published in the
Journal of Fluency Disorders (Lattermann, Euler, & Neumann, 2008).
Looking back on the last seven years, starting with our first email exchange in
2001 and a vague idea about introducing the Lidcombe Program to German
colleagues Anna, Bettina and I have come a long way. We have certainly
learned a lot during this journey and are still learning. The Lidcombe Program
Trainers Consortium is a great resource and stimulates ongoing discussions
about further development of the Lidcombe Program based on all of our
experiences and the feedback provided by trained colleagues. In the context
of our plans, Follow-Up Days in Germany will certainly become a focus of
attention for the years to come. We seem to have managed to lay foundations
and get the Lidcombe Program going in Germany, nevertheless, there is still
more work to do: We are looking forward to it!
References
Harris, V., Onlsow, M., Packman, A., Harrison, E., & Menzies, R. (2002). An
experimental investigation of the impact of the Lidcombe Program on
early stuttering. Journal of Fluency Disorders, 27, 203 - 214.
Lattermann, C., Euler, H.A., & Neumann, K. (2008). A randomized control trial
to investigate the impact of the Lidcombe Program on early stuttering in
German-speaking preschoolers. Journal of Fluency Disorders, 33, 52 –
65
Onslow, M., Packman, A., & Harrison, E. (2003). The Lidcombe Program of
Early Stuttering Intervention. Austin, TX: Pro-Ed.
Pape-Neumann, J., Bosshardt, H. G., Natke, U., & Oertle, H. (2004). Testphase
of the German program for the evaluation of stuttering therapies
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(PEVOS). In A. Packman, A. Meltzer, & H. F. M. Peters (Eds.), Theory,
research and therapy in fluency disorders. Proceedings of the 4th
World Congress on Fluency Disorders in Montreal, Canada (pp. 210-
217). Nijmegen: Nijmegen University Press.
Randoll, D. (1988). Erfahrungen und Ergebnisse bei der Anwendung des
Systematic Fluency Training for Young Children (SFTYC) von R. E. Shine
[Experiences and results after application of the Systematic Fluency Training
for Young Children (SFTYC)]. Die Sprachheilarbeit, 33, 227-240.
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