Lidcombe Program at Home: Feedback and Daily Ratings

In the Lidcombe Program the speech pathologist leads the treatment. She assesses the child, sets the goals, sees parent and child each week, measures progress and decides when to move on. Between sessions she gives the family a short part to play at home: a short, relaxed practice conversation, a few comments on smooth talking in the way she has shown, and one severity rating for the day. How the program is structured, what the trials show and what it costs are on the page about the Lidcombe Program. This guide covers only the time at home between sessions.

How the program works, as set out below, comes from its published treatment guide (August 2025 edition): what a speech pathologist shows the family and checks each week, not a plan to start on your own. The activity ideas and the common slips are suggestions built on the methods the guide describes, not part of the guide itself.

What happens at home each day in the Lidcombe Program?

In Stage 1 of the Lidcombe Program (the stage with weekly sessions), the speech pathologist shows a parent three short steps for each day, one at a time:

A practice session. Pick a book or a simple game your child likes and keep the talk easy for around 15 minutes, so most of what they say comes out smoothly.
Feedback. Short comments on the child’s smooth talking and, later and less often, on clear moments of stuttering. Feedback starts inside practice sessions and moves into everyday conversations over the following weeks.
A severity rating. One number at the end of the day for how the child’s talking went.

Each week the speech pathologist watches a practice session, checks the ratings and decides what changes next, showing you any change before you use it at home.

What do you say? The five kinds of feedback

The Lidcombe Program uses five kinds of feedback, which the research calls verbal contingencies. Three are for stutter-free speech and two are for unambiguous stuttering, meaning stuttering you are sure you heard. The wording below is an example only: your speech pathologist helps you find words that sound like you and suit your child.

Kind of feedback	When it is used	How a parent might say it	What to keep in mind
Praise	Smooth talking	“That whole story came out easily!” “Great talking, no bumps.”	Mean it, change the words often, and do not use it so much that it stops being fun
Acknowledge	Smooth talking	“No bumps.” “Easy talking.”	Low-key and quick. Suits a child who does not like a fuss
Ask the child	Smooth talking	“Any bumps then?” Then, when they say no: “None at all. Well spotted.”	Two steps: ask so the answer is easy to get right, then agree
Ask for a repeat	A clear stutter	“Can you say ‘my turn’ again?”	Used later and sparingly. Answer what your child said, and if the repeat is bumpy too, just carry on talking
Acknowledge	A clear stutter	“That one got a bit stuck.”	Brief and neutral, without stopping the conversation

Some rules hold for every kind. Feedback for smooth talking comes first, and most feedback stays that way. Not sure whether that was a stutter? Let it pass: feedback is only for the clear moments. Keep feedback about talking specific, so it is not confused with praise for a drawing. And feedback never replaces answering what your child said.

If your child shows any sign of not liking a kind of feedback, such as ignoring a request to repeat or asking you to stop, drop it and tell your speech pathologist. The treatment guide allows feedback to be paused for a while, or for the rest of the program.

How do you give the daily severity rating?

The severity rating is one number for your child’s typical talking across the whole day, usually noted at the end of the day. The current treatment guide uses a scale where 0 is no stuttering, 1 is extremely mild stuttering and 10 is extremely severe stuttering. Ten means the most severe stuttering you can imagine, not the worst you have heard from your child.

Earlier editions of the guide used a scale of 0 to 9, and many websites still show it. If what you have read does not match, check which scale your speech pathologist is using.

Some details make ratings more useful:

Rate what you hear. If your child goes to kindy or care, base the rating on the talking you hear yourself. Ratings at school are not needed.
Days that swing. If stuttering changes a lot across a day, your speech pathologist may ask for two numbers, such as the highest and lowest, rather than an average.
One situation. You may be asked for an extra rating for one daily moment, such as dinner or bath time.
More than one language. A bilingual child gets a rating in each language.

Ratings can go on a paper chart or on the Child Stuttering Severity Chart that the Australian Stuttering Research Centre publishes as a form for a phone or computer.

What does the speech pathologist do with the ratings?

The speech pathologist uses your ratings to follow progress from week to week, so they first make sure your numbers match theirs. Early in the program you both listen to your child talk for a few minutes and each give a rating. Within one point of each other is acceptable at first. After the first weeks the aim is for the numbers to match exactly, because the end of Stage 1 depends on accurate ratings at the low end of the scale. A recording of your child talking at home can be rated together in the session.

Accuracy matters both ways. Ratings that are too low can end Stage 1 too early, ratings that are too high can make it last longer than it needs to, and missing ratings leave nothing to judge progress by.

How do you run a practice session?

A practice session is a relaxed conversation of around 15 minutes, once a day, at a time that suits the family. Some children do better with two shorter sessions. Early on it helps to sit in the same quiet spot, at a table or on the floor, with a book or a simple game. Set it up as a game your child would choose anyway, so they enjoy it, talk a lot and talk mostly smoothly.

Shorter, simpler sentences are less likely to be stuttered, so the speech pathologist shows you how to keep the conversation easy. The guide names these ways:

taking turns
copying a word or phrase
finishing a sentence the parent starts
questions with a short answer, or a choice between two things
talking about what is in front of you rather than what happened yesterday.

Avoid turning practice into a quiz, and change the activities so they stay fresh. As stuttering eases, sentences get longer and the setup loosens. After a few weeks practice can happen while cooking, at bath time or during play, and feedback begins in natural conversations, starting with a few comments a day on smooth talking. Natural conversations are never steered the way practice is: you simply notice the smooth stretches when they come.

Lidcombe Program activities by age, with nothing to print

The practice ideas below are starting points to take to your speech pathologist, who adjusts them to your child’s stuttering that week.

Ages 2 to 3

Toy box turns. Take turns pulling a toy out of a bag and naming it: “My turn. A duck!”
This or that. “Do you want the red cup or the blue cup?” at snack time.
Finish the line. Pause in a favourite book and let your child fill in the word.

Ages 4 to 5

Building talk. Talk about blocks or a puzzle as you go: “What goes on top now?”
I spy with colours. Short guesses and short clues, taking turns.
Cooking steps. Name each step of making a sandwich or a smoothie together.
Picture walks. Talk about one page of a book at a time, from a word or two up to longer descriptions as stuttering settles.

Ages 6 to 12

Guessing games. Twenty questions, or guessing an animal from yes or no questions.
Show me how. Your child explains a drawing, a block build or a game’s rules.

Older children often prefer quiet acknowledgement to praise, so ask them. The program has been trialled by video for children aged 6 to 12, and the speech pathologist decides whether it fits a child of this age.

What if it is a bad week?

A week of higher ratings is common. Stuttering in young children goes up and down, and that is exactly what the daily ratings are there to show. Bring the week’s numbers to the next session rather than changing the program on your own.

The treatment guide names four situations that make it hard to keep stuttering low in practice:

the child’s stuttering is severe at the moment
the child loves long, imaginative stories
the child wants to do most of the talking and does not enjoy turns
the child gets bored or overexcited quickly.

The speech pathologist works out the answer to each and shows you what to change. Other common slips are missed ratings, feedback a child has grown tired of, and too many requests to repeat.

Raise it in your session when ratings are climbing or not falling, or practice is not fitting into the day. Raise it too when your child resists practice or feedback, or you are unsure whether you are hearing stuttering. In Stage 2, the stage for keeping the gains once weekly sessions end, if stuttering creeps back, the speech pathologist may direct more feedback in conversation or bring back practice sessions for a while.

Can you do the Lidcombe Program at home without a speech pathologist?

No. The treatment guide is written for speech pathologists, and it says feedback in everyday conversation should come only from a parent who has been shown directly by one. The program depends on weekly checks: your ratings measured against the speech pathologist’s, your practice watched and adjusted, and decisions about when each stage ends. Everyday ways to support a child who stutters, which are not treatment, are in how to help a child who stutters at home.

Doing it with Dr Lauren, by video

The treatment guide allows Stage 1 consultations in a clinic or by video, where the speech pathologist watches practice on camera at home with your child’s own books and toys. Dr Lauren Crumlish (PhD) is a Certified Practising Speech Pathologist who uses the Lidcombe Program with families by video, Australia wide. She runs every session, sets each week’s plan and checks the practice at home, so you are never left to work it out alone. What stuttering looks like before school is covered in stuttering in toddlers and preschoolers. Families can apply to work with Dr Lauren.