Speech Pathology Australia (SPA), Australia's professional organization for speech-language pathologists (SLPs), recently submitted a proposal that suggests that SLPs working in clinics run by the Australian government must be trained in the Lidcombe Program in order to treat pre-school aged children who stutter.  SPA is also supporting legislation that would extend this mandate to private practitioners and require them to provide the Lidcombe Program in order to be reimbursed by Medicare.  Although the SPA’s intentions may be to increase access to treatment for young children who stutter, we must not overlook the ramifications of having the government and private insurance companies intervene with clinical decision-making.  

The first thing to consider is that there are multiple factors that are known to contribute to the onset of stuttering.  Each child has a unique set of abilities and vulnerabilities that determine if and how stuttering is going to persist. Those different circumstances demand different approaches to treatment.  A speech pathologist cannot be expected to develop a treatment plan that is specifically tailored to the client when the SPA is using Medicare reimbursement to limit them to one approach. Speech pathologists could be faced with the unfortunate dilemma of deciding whether to use an approach that best fits the child and families’ needs or to use the approach that will get reimbursed. 

Question: Do you have a sequence in which you like to introduce techniques to students who stutter?  

I do not believe there is a "right" sequence. Each child and family experiences stuttering in a different way due to their temperament, home environment, communities, etc. and their treatment plan has to reflect that.  However for new clinicians or clinicians who have little experience with treating a child who stutters, it is understandable that you may want a blueprint of what therapy should look like.