Managing fluency and disruptive behaviours in children who stutter: An integrated behavioural and stuttering treatment program

The study will comprise three groups of children who stutter. Group 1: Children who stutter with disruptive behaviours who receive stuttering therapy only. Group 2: Children who stutter without disruptive behaviour who receive stuttering therapy only. Group 3: Children who stutter with disruptive behaviours who receive stuttering therapy, in addition the Group Triple P Program. Stuttering therapy will be overseen by speech pathologists who have 10 years of specialised experience in the assessment and management of stuttering disorders. Stuttering therapy sessions will be delivered face-to-face, in individual sessions. The duration of stuttering therapy will be 12 weeks for all children, involving 1x hourly session per week delivered weekly. Sessions will take place at the Curtin University Treatment Clinic or in private metropolitan community clinics in Western Australia. The parent is encouraged to observe therapy sessions (between clinician and child) where the clinician implements stuttering therapy. The child is required to play and engage with the clinician during therapy using age appropriate fun activities such as: Play Doh, Go Fish, Shopping Game. Stuttering therapy principles will be implemented during these activities, mapping on to the Demands and Capacities Model as well as using Response Contingent Stimulation principles. The Triple P Program will be delivered by a registered Triple P Provider over an 8 week period. Parents will attend this training without their children. This will comprise of 3x 2-hour face-to-face group sessions weekly, then 3x individual 20-30 minute telephone calls delivered weekly, followed by a final 2-hour face-to-face session in the final week of the program. The Triple P training will be provided to parents at the Curtin University Stuttering Treatment clinics. It is a standardised and well recognised family behavioural intervention. Parents will learn strategies to encourage positive parenting, improve parent-child relationships and learn how to better manage their child's behaviour. Parents receiving the training will be provided with a work book to complete as part of their training, entitled "Every Parent's Group Workbook". To ensure treatment fidelity of fluency therapy, each therapist will complete standard checklists after each session (including session structure and stuttering treatment principles implemented). Sessions will be video recorded and 10% randomly analysed by an independent observer. Rater reliability will be assessed. A similar process will be followed for the Triple P Program. All group sessions will be video-recorded, the Triple P provider will complete a standardised Triple P fidelity checklist at the end of each group session, and 10% of sessions will be rated by an external reviewer.