ACQ Vol 12 No 3 2010

Stuttering therapy

Clinical insights Implementing effective stuttering therapy

within a school setting Malathi Ferdinando and Luana Stone

Speech pathology service delivery at the Catholic Education Office Melbourne (CEOM) incorporates an agent training philosophy, involving the explicit training of parents (or an alternative agent) to complete follow-up practice tasks. Agent training occurs in a number of different ways across all areas of speech therapy. In the area of stuttering, the Lidcombe and Intensive Fluency Programs were considered to be agent training programs. This article examines service delivery at the CEOM for students who stutter and provides a discussion of the challenges faced with implementing time-intensive stuttering therapy in a busy school-aged model. Philosophy of service delivery at CEOM The speech pathology service at the Catholic Education Office Melbourne (CEOM) was developed in 1995 with an agent training philosophy. Its aim was to provide an evidenced based best-practice speech pathology service resulting in positive student outcomes and a time- and cost-efficient service. The philosophy was to involve parents (or an appropriate agent) to work with children to complete the practice required between treatment sessions as described in Roberts, Ferdinando, and McCusker (2000). Speech language pathology intervention provided with family involvement has been found to be as effective, if not more effective than intervention provided with no family input. For example, Eiserman, Weber, and McCoun (1992) investigated the outcomes of children with speech disorders using a home parent training program and a clinic-based, low parent involvement program. In all areas of speech and language functioning, the home parent group performed at least as well as the clinic-based group one year post intervention. In another study, Dodd and Barker (1990) indicated that in the area of communication skills, significant improvement was evident when students were trained in their own communication environments compared to training in a clinical setting. As part of implementing this service delivery, it was important that support be provided to parents regarding how to create a good learning environment for the child

and how to implement and better understand the activities in the program (Tetreault, Parrot, & Trahan, 2003). These features were incorporated into the CEOM agent training process, where therapy sessions might include individual therapy sessions or group training courses along with home and school based programs. All forms of service delivery however, had the underlying philosophy of agent training.

Keywords INTENSIVE PROGRAM LIDCOMBE PROGRAM SCHOOL-AGE STUTTERING

Language consultation with the school

Programs via agent training course with an agent

Programs via individual consultation with an agent

Agent training

Programs via individual sessions with student and agent (includes

Voice intervention via individual sessions with student and agent and class

Fluency intervention via intensive program with student and agent

Malathi Ferdinando (top) and Luana Stone

Lidcombe Program)

Figure 1. Agent training service delivery model

In the area of fluency, the Intensive Fluency Program and the Lidcombe Program are both considered to be agent training programs. Parents are trained to do home practice (or activities) with their child and progress is reviewed by the speech pathologist at regular intervals. The first fluency support program which the CEOM implemented was the Intensive Fluency Program. The implementation of this program and the outcomes achieved are described below. In more recent years the Lidcombe Program has been incorporated into CEOM’s service delivery. The process through which this was implemented and the outcomes achieved are described in the subsequent sections of the article.

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ACQ Volume 12, Number 3 2010

ACQ uiring knowledge in speech, language and hearing