No boundaries : perspectives of International Skype delivery of the Lidcombe Program.

146 JCPSLP Volume 14, Number 3 2012 Journal of Clinical Practice in Speech-Language Pathology www.speechpathologyaustralia.org.au JCPSLP Volume 14, Number 3 2012 147 Shane Erickson between and within countries due to economic, political and in particular, geographical factors. Lifestyle factors also present as a barrier for clients, with significant direct costs such as transportation and accommodation, and indirect costs including time off work for clients and family members or even childcare costs (Doolittle & Spaulding, 2006). While the Lidcombe Program has gained widespread acceptance among speech pathologists in Australia (Onslow et al., 2003), this isn’t necessarily the case around the world. The treatment has been introduced and accepted by clinicians in the United Kingdom, South Africa, Canada, New Zealand, and Germany. Additionally, there is some uptake by clinicians in other European countries like Denmark and the Netherlands. However, client access in some countries (including the United States) has likely been affected by a preoccupation with treatments influenced by the diagnosogenic theory of stuttering (that it is caused by parents inappropriately drawing attention to their child’s dysfluencies) which directly opposes the principles of the Lidcombe Program. To combat access issues, speech pathology services in other areas of the profession have been delivered via telehealth for more than three decades. However, published data regarding telehealth implementation in the field of stuttering is limited and only dates back to 1999. Harrison, Wilson, and Onslow’s (1999) single case study successfully adapted the Lidcombe Program to be delivered over the telephone for a family isolated from treatment services. The positive outcome has more recently been confirmed by phase I and phase II trials of telehealth delivery of the Lidcombe Program (Lewis, Packman, Onslow, Simpson, & Jones, 2008; Wilson, Onslow, & Lincoln, 2004). Presently, a randomised controlled trial is underway comparing in-clinic delivery of the Lidcombe Program with Internet delivery using Skype. In Melbourne, experienced speech pathologist Dr Brenda Carey has delivered the Lidcombe Program via Skype when families were unable to access in-clinic sessions. This has resulted in clients from places like China, United States, India, Singapore, Italy, and indeed rural Australia receiving this treatment. One such client is Jenny (pseudonym) and her son Tom (pseudonym) who live in South Africa. The following are the perspectives of Dr Carey and Jenny about their experiences of the Skype-delivered Lidcombe Program.