Saturday, September 10, 2005

Against everything we believed in

Lidcombe has first been heavily critised by many, but nowadays the therapy is The Answer to childhood dysfluency for many. I tend to believe that both are wrong (but Lidcombe is less wrong that the others) and that I have no answer either!!! :-)

It is intriguing that the Lidcombe approach is a 100% contradiction to the old ways of doing things: let me call them psycho theories (for simplicity - and I dont deny psycho influence in PDS). Johnson, Sheehan, and Bloodstein have said in the past that
Stuttering is a disorder of the social presentation of the self. Basically, stuttering is not a speech disorder but a conflict resolving around self and role, an identity problem. (Sheehan)
Extrapolating, one conclusion is that parents' intervention and attitude towards a child's dysfluencies causes stuttering. Many children go through a normal period of dysfluecnies. Parents make them aware of these dysfluencies. The children (and parents) get more anxious and therefore stutter even more and keep on stuttering. Thus, many therapists and doctors in the past urged parents to avoid whenever possible to make their children aware of their dysfluencies.

You can imagine that the "establishment" (I love conspiracy theories... :-) was not very pleased to hear about the Lidcombe therapy that instructs parents to do what supposedly causes adult stuttering! I do admit that the parent psycho theory is quite elegant and makes a lot of sense and explains why some children do not recover from dysfluencies, namely their parents, so it is a shame that the theory is dead wrong! For several reasons:

1) Lidcombe therapy does at the very least not produce more stuttering teenagers than natural recovery. If the parent psycho theory were true, many more kids should keep on stuttering!!! So even if Lidcombe does not have a treatment impact, at the very least it convincingly refutes the parent psycho theory. How can anyone anymore take the warnings seriously that parents should whenever possible avoid telling the child about their disfluency or else their kids face life-long stuttering?

2) Recent research has shown that girls and those without family history seem to recover in greater numbers. So the parent psycho theory need to explain why girls and those without family history are LESS receptive to interactions with their parents?

3) There are many kids who recover who had much greater pressure from their parents.

4) It is a myth that parents have very much impact of their kids.

In my next post, some comments on Lidcombe.

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