JCPSLP Vol 19 No 2 2017

that it is perceived as “doable” by those clinicians who have engaged in this vanguard practice change. Acknowledgements Funding for this research was provided by the NSW Health Education and Training Institute as part of the Rural Research Capacity Building Program. While this funding provided education and support for the researcher, the funding agency had no influence on the conduct or reporting of the study. References Arnott, S., Onslow, M., O’Brian, S., Packman, A., Jones, M., & Block, S. (2014). Group Lidcombe Program treatment for early stuttering: A randomized controlled trial. Journal of Speech, Language, and Hearing Research , 57 (5), 1606– 1618. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology , 3 (2), 77–101. de Sonneville-Koedoot, C., Adams, S. A., Stolk, E. A., & Franken, M.-C. (2015). Perspectives of clinicians involved in the RESTART-study: Outcomes of a focus group. American Journal of Speech-Language Pathology , 24 (November), 708–716. de Sonneville-Koedoot, C., Stolk, E., Rietveld, T., & Franken, M.-C. (2015). Direct versus indirect treatment for preschool children who stutter: The RESTART randomised trial. PLoS ONE , 10 (7), 1–17. Finch, E., Cornwell, P., Nalder, E., & Ward, E. (2015). Uncovering motivators and stumbling blocks:Exploring the clinical research experiences of speech-language pathologists. International Journal of Speech-Language Pathology , 17 (2), 138–147. Franken, M.-C. J., Kielstra-Van der Schalk, C. J., & Boelens, H. (2005). Experimental treatment of early stuttering: A preliminary study. Journal of Fluency Disorders , 30 (3), 189–199. Guitar, B., Kazenski, D., Howardd, A., Cousins, S. F., Fader, E., & Haskell, P. (2015). Predicting treatment time and long-term outcome of the Lidcombe Program: A replication and reanalysis. American Journal of Speech- Language Pathology , 24 (August), 533–544. Johnson, M., Baxter, S., Blank, L., Cantrell, A., Brumfitt, S., Enderby, P., & Goyer, E. (2016). The state of the art in non-pharmacological interventions for developmental stuttering. Part 2: Qualitative evidence synthesis of view and experiences. International Journal of Language & Communication Disorders , 51 (1), 3–17. Jones, M., Onslow, M., Packman, A., Williams, S., Ormond, T., Schwarz, I., & Gebski, V. (2005). Randomised controlled trial of the Lidcombe Programme of early stuttering intervention. British Medical Journal , 331 (7518), 659–663. McCulloch, J., Swift, M. C., & Wagnitz, B. (2017). Case file audit of Lidcombe Program outcomes in a student-led stuttering clinic. International Journal of Speech-Language Pathology , 1–9. Miller, B., & Guitar, B. (2009). Long-term outcome of the Lidcombe Program for early stuttering intervention. American Journal of Speech-Language Pathology , 18 (1), 42–49. O’Brian, S., Iverach, L., Jones, M., Onslow, M., Packman, A., & Menzies, R. (2013). Effectiveness of the Lidcombe Program for early stuttering in Australian community clinics. International Journal of Speech- Language Pathology , 15 (6), 593–603.

there is usually a child to treat, even when others have failed to attend without notice. Interestingly, one route towards embedding practice change appears to be SLP involvement in clinic-based, practitioner-led research. The authors of a Dutch study (de Sonneville-Koedoot, Adams, et al., 2015) reported that by participating in the trial, the SLPs have not only been able to alter their preconceived attitudes and beliefs regarding therapies but have been more inclined to incorporate the study outcomes into their current practice. Similarly in this study, several SLPs reflected that engagement in the research process had resulted in capacity building for the rolling-group methodology, which has been further borne out by sustained practice and policy change within the community health centres. Participants’ perceptions point to clear avenues for future support. Provision of bricks and mortar, or in this case rooms and toys, can offer only a limited starting point if LP rolling-groups are to be widely established. Service managers may need to proactively free up a portion of face-to-face clinical time for training, ongoing mentoring and supervision, based on an understanding that there is evidence for the cost-efficiency of the LP rolling-group model through the reduction in clinical hours per child (Arnott et al., 2014; Rappell et al., 2017). Such “coaching” support may help bridge the evidence–practice gap and foster consistency in clinical practice (de Sonneville- Koedoot, Adams, et al., 2015). Lastly but by no means least, participants endorsed the rolling-groups for advantages that were not directly measured. Participating SLPs described more real-world or functional communication between children and a sense that each child was less in the spotlight or under less focus during stuttering severity rating discussions or when parents were demonstrating treatment due to the group format. Responses from the participating clinicians concurred with Arnott et al. (2014) in acknowledging that the rolling-groups created an environment where roles were shared between the SLP and parents whereby problem- solving or sharing ideas was multidirectional, not solely from SLP to parent. Finally, participating SLPs reflected on the likelihood of intrinsic social support benefits within the LP rolling-groups as children and parents alike were often meeting another person who stuttered and a family also embarking on their treatment journey for the first time and sharing their experiences. Conclusion This study aimed to advance the speech-language pathology profession’s understanding of the views of practitioners delivering interventions for stuttering and the acceptability of the treatment process. Most specifically it reports on the perceptions of community-based SLPs pertaining to the value and sustainability of a new rolling- group delivery model for the Lidcombe Program for young children who stutter. Qualitative analysis determined that while the LP rolling-group model may be complex and offer challenges, it is perceived by the participating SLPs to be viable in real-world clinical practice. Furthermore, clinicians were optimistic about LP rolling-group establishment within their standard service delivery, making recommendations for operational support such as ongoing coaching or supervision to embed practice change. These results move the speech-language pathology profession beyond the proposition that a LP rolling-group model may work within real-world settings, to evidence that it does and, crucially,

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JCPSLP Volume 19, Number 2 2017

Journal of Clinical Practice in Speech-Language Pathology