Treatment
Doing the Lidcombe Program at home: practice sessions, feedback and severity ratings
The short daily practice the speech pathologist shows a parent in the Lidcombe Program: the five kinds of feedback in...
The Lidcombe Program
In the Lidcombe Program the speech pathologist leads: weekly video sessions at first, then visits spaced out to 16 weeks apart over a year or more, with a short daily practice at home that she shows you and checks each week. It is for children younger than 6. Dr Lauren Crumlish (PhD) uses the Lidcombe Program with families by video, Australia wide. This page follows it in that order, from the right age to the last Stage 2 visit.
In plain terms
The Lidcombe Program is a behavioural treatment for early stuttering, developed in Australia. A speech pathologist sees the child each week, measures the stuttering, sets the week's goals and adjusts the treatment. Between sessions, a parent praises smooth, stutter-free talk during a short daily practice, in the way the speech pathologist has shown them.
The speech pathologist shows the parent three things, step by step: how to listen for stutter-free talk, how to note a 0 to 10 severity rating at the end of each day, and how to give brief, warm praise that suits the child. The child simply plays and talks; there are no drills or techniques to learn.
The Family's Part
Dr Lauren leads the program. For most families the deciding question is time, not age. Over the program, a family takes on these things, each one shown and checked by her.
A video session with Dr Lauren every week while Stage 1 runs, with a parent and child on screen together
Around a quarter of an hour of play and talk with your child each day, as Dr Lauren shows you
One number at the end of each day that sums up how your child talked
Sticking with it after stuttering settles, because Stage 2 usually runs for 12 months or more
| Age | Where the Lidcombe Program sits | What the published sources say |
|---|---|---|
| Under 6 | The usual first choice | The program was developed for this age. The Australian Stuttering Research Centre lists three approaches backed by randomised trials for children under 6 and says the strongest evidence is for the Lidcombe Program. |
| 6 to 12 | Sometimes used, with adjusted goals | The treatment guide says the program suits some children older than 6 and that its goals may need adjusting. In a 2024 trial run by video with 37 children aged 6 to 12, 12 reached the Stage 2 criteria within 12 months. |
| Teenagers | Another approach is used | The program was not designed for teenagers. The Australian Stuttering Research Centre describes speech restructuring as the treatment with the best evidence for teenagers who want more control over stuttering. |
The treatment guide sets no minimum age for the Lidcombe Program. The children in the published trials were aged 2 to 6. For a child of 6 to 12, whether this program or another approach fits is decided after the assessment: see stuttering in school-aged children and stuttering in teenagers.
The Lidcombe Program starts with a decision, not with treatment. The treatment guide asks the speech pathologist to take a history, watch and listen to the child, and ask how the child reacts to stuttering: signs of struggle, frustration or avoiding talking. The speech pathologist then recommends whether the program suits the child, and agrees with the family when to begin.
The guide also tells speech pathologists to say one thing plainly at this point: the goal is for stuttering to resolve, and there is no guarantee that it will. With Dr Lauren this step is the stuttering assessment, held by video.
In the first sessions of the Lidcombe Program the speech pathologist sets the starting point and shows you, step by step, the small part you play at home. She listens to your child and shows you how to tell smooth talk from clear stuttering on the program's severity scale. Then she demonstrates the feedback with your child in a short, playful conversation.
You try it with your child while she watches and guides you. The guide notes that this may not happen in the very first session, and that the speech pathologist may keep demonstrating for several weeks before practice moves home. Feedback for stutter-free speech always comes first.
A week in Stage 1 of the Lidcombe Program has three parts.
Practice comes first. Once it is part of the family routine and you feel at ease with it, often a few weeks in, the speech pathologist will suggest praising smooth talking at other times too: in the car, at meals, at bath time. What a parent says, how to give the rating and what to do when a week goes badly are set out in doing the Lidcombe Program at home.
The speech pathologist decides when Stage 1 of the Lidcombe Program is finished. The guide's mark is when the ratings sit at the bottom of the scale for three sessions running. In each of those weeks, every rating from home is a 0 or a 1, four or more of the seven are 0, and the rating the speech pathologist gives in the session is also 0 or 1.
Those numbers are a starting point, not a fixed rule. The speech pathologist may set different targets for a child who is older, or who has other speech, language or health needs.
Stage 2 of the Lidcombe Program keeps stuttering absent or extremely mild while the treatment is withdrawn slowly. Sessions move further apart for as long as the ratings hold.
| Stage 2 sessions | Gap between sessions |
|---|---|
| First and second | 2 weeks apart |
| Third and fourth | 4 weeks apart |
| Fifth and sixth | 8 weeks apart |
| One or two more | 16 weeks apart |
At each Stage 2 session the speech pathologist talks with the child to agree a rating, reviews the ratings since last time and decides how much feedback should still be given. If stuttering has risen above the Stage 2 criteria, she does not take the next step: she books a session sooner, goes back a step in the schedule or, rarely, returns to Stage 1.
At home during Stage 2, the feedback becomes less and less frequent, as she directs, and you note ratings for the week before each session. If stuttering rises a little, she will have shown you how to bring the feedback back for a while.
The guide says Stage 2 usually takes around 12 months or more. Stuttering can come back after the program, sometimes years later, and ending Stage 2 early because a child sounds fine makes that more likely. That is why the speech pathologist keeps watching the ratings through Stage 2, and shows the family what to look for and when to contact her between visits.
For a family starting now, the Lidcombe Program is a commitment of a year or more. The 2021 Cochrane review describes it as designed to last one to two years in total, and the Stage 2 schedule above accounts for most of that time.
| Question | What research found |
|---|---|
| How long is Stage 1? | In treatment records from Australia, the United Kingdom and North America (450 children), the midpoint was 11 visits. Children whose stuttering was more severe at the start took longer. |
| When does change show? | The Australian Stuttering Research Centre says some improvement should be noticeable soon after treatment starts. |
| Does it work? | Randomised trials favour it. A 2021 Cochrane review rates the certainty of that evidence as very low, so it is the best-supported option at this age rather than a proven one. |
None of these figures is a forecast for one child, and no number of sessions is promised. How the evidence compares with other treatments is set out in stuttering treatment compared.
The Lidcombe Program does not suit every child who stutters, or every family, at every time.
Every Lidcombe Program session described on this page would be with Dr Lauren Crumlish, a Certified Practising Speech Pathologist whose PhD is from The University of Queensland. She assesses your child, sets the goals, runs the sessions, measures progress and decides when to move on. She works with stuttering from the preschool years through to 18, and the Lidcombe Program is the approach she uses with young children. She is a speech pathologist, not a medical doctor.
Dr Lauren works with a small number of families and has limited availability. Read more about Dr Lauren Crumlish, or Apply Now.
The Weekly Session
The Lidcombe Program treatment guide sets out the same sequence for every Stage 1 consultation and lists video as a standard way to hold it. The speech pathologist runs the session; you and your child sit together at home in view of the camera.
The speech pathologist, you or both of you talk with your child for about 10 minutes, until there is enough talking to rate. A recording of your child talking at home can be used instead.
The speech pathologist rates the talking she just heard and checks your rating against hers. The aim is to agree within one point on the scale.
She goes through the week's daily ratings with you: when practice happened, what you talked about, and whether your child enjoyed it.
The speech pathologist watches a short practice with your child, or a recording of one from home, so she can check it is going the way she intends.
She talks through what went well, what was hard and how your child responded.
The speech pathologist decides any change, demonstrates it, and watches you try it before it is used at home.
She ends the session with the plan for the week ahead. The guide suggests writing it down.
Fees
Sessions are $193. The first step is an initial assessment, from $590. Medicare rebates are available with a doctor's referral. The practice is not NDIS registered: self-managed and plan-managed participants are welcome; NDIA-managed funding cannot be used.
Therapy
One hour of service: 45 minutes of therapy and 15 minutes of preparation and notes
$193
Initial assessments
$590
The shortest of the three initial assessments
$890
A longer initial assessment
$1,290
The most comprehensive initial assessment
The program's treatment guide sets weekly sessions in Stage 1. In Stage 2 sessions move to 2, then 4, 8 and 16 weeks apart, so there are fewer session fees as the program goes on. No number of sessions is promised. Private health rebates may apply. See full pricing
Questions Parents Ask
Under 6 is the age it was built for. Some children aged 6 to 12 do it with adjusted goals, and teenagers are usually offered another approach. The age table on this page sets out each band and its source.
Two. Stage 1 brings stuttering down to none or extremely mild, with a session every week. Stage 2 holds it there while sessions space out from 2 weeks to 16 weeks apart.
No number is promised. In published treatment records, half of the children finished Stage 1 in 11 visits or fewer and half took more. If the ratings hold, Stage 2 adds seven or eight spaced sessions over about a year.
Because the visits space out: from weekly in Stage 1 to 16 weeks apart late in Stage 2, while each session stays the same price. Sessions are $193. The first step is an initial assessment, from $590. Medicare rebates are available with a doctor's referral. The practice is not NDIS registered: self-managed and plan-managed participants are welcome; NDIA-managed funding cannot be used.
The steps are the same. The speech pathologist's weekly session moves to a screen, and the short daily practice was always done at home, and the treatment guide lists video as a standard way to run it. The research on video sessions is on the page about online stuttering therapy.
No. Your child's part is to play and talk. Dr Lauren shows the parent the small part they play at home.
The schedule pauses. Instead of the next, longer gap, the speech pathologist books a session sooner or goes back a step, and only rarely returns to Stage 1. A rise later on, even after the program ends, is handled the same way: the feedback comes back at home first, as she has shown you.
No. The Australian Stuttering Research Centre lists three approaches for children under 6 that are supported by randomised trials: the Lidcombe Program, RESTART-DCM and syllable-timed speech. It says the strongest research evidence is for the Lidcombe Program, which is the one Dr Lauren uses.
Work With Dr Lauren
Dr Lauren works with a small number of families and has limited availability. A parent or guardian applies.
Apply Now