We need to know why preschool stuttering treatments work

The big picture:

The Lidcombe Program, Westmead Program, RESTART Demands and Capacities Model Method, Mini-KIDS, and Palin Parent-Child Interaction Therapy are all evidence-based treatments for preschoolers who stutter.

So why do they work?

Why it matters:

On the surface, each program looks different. But do they share elements? Could one or more of these be “active ingredients” to improve therapy outcomes? 

Zoom in:

Across multiple programs, therapy includes:

  1. the speech-language pathologist (SLP) providing information to parents about the child’s stuttering;
  2. the SLP educating families about stuttering and how speech works;
  3. continuous assessment of the child’s fluency throughout treatment; 
  4. clear treatment goals related to speech; 
  5. a high-level of parent involvement in the treatment;
  6. increased one-to-one child-parent interactions, with a focus on speech;
  7. a positive working relationship between parents, the treating SLP and/or the child;
  8. the SLP teaching problem-solving skills to parents and individualising the program for each child; 
  9. the SLP, parents and others responding to stuttering in an open and normalising (neutral to positive) manner; and
  10. parents slowing down their conversational speech rates, including pausing more between sentences when talking with their child.

Front-line tips:

Clinical SLPs know we also need to:

  • listen more to what families and children want/expect from therapy;
  • review services to respond to families’ cost and time constraints;
  • provide practical supports for managing everyday life (daily routines, sleep habits, emotions, and life changes);
  • connect children and families with peer support and research networks;
  • tackle social and environmental barriers to acceptance; and
  • work harder to de-stigmatise stuttering by adopting affirming practices. 

Bottom line:

To improve our care and outcomes, SLPs and researchers need to shift focus from individual programs to identify the key active components of effective and affirming therapy for preschoolers.

Go deeper:

Sjøstrand, Å., Næss, K-A. B., Melle, A. H., Hoff, K., Hansen, E. H., & Guttormsen, L. S. (2024). Treatment for Stuttering in Preschool-Age Children: A Qualitative Document Analysis of Treatment Programs. Journal of Speech, Language, and Hearing Research, 67(4), 1020–1041. (Open Access)

Related reads:

Stuttering: will my child recover? Factors that predict recovery and why you shouldn’t wait

My child stutters. Is it because he’s shy? sensitive? hyper?

Stuttering: what do we mean by “recovery”? 

The Lidcombe Program for children who stutter

The Lidcombe Program for stuttering: my 10 favourite therapy activities

The Westmead Program for children who stutter

My preschooler stutters: should we do the Lidcombe Program or the Westmead Program (or something else)?

School-age stuttering research update: mixing and matching treatments to get results

Stuttering therapy: going beyond medical models

Man with glasses standing in front of a bookcase

Hi there, I’m David Kinnane.

Principal Speech Pathologist, Banter Speech & Language

Our talented team of certified practising speech pathologists provide unhurried, personalised and evidence-based speech pathology care to children and adults in the Inner West of Sydney and beyond, both in our clinic and via telehealth.

David Kinnane
Speech-Language Pathologist. Lawyer. Father. Reader. Writer. Speaker.

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