I find that some parents and clinicians find it helpful to think in terms of dosage of treatment. I do not use it for all clients but as I would with other analogies, it may be used to explain expectations to some parents.
As for recommendations, I would usually start with daily structured treatment for 15 minutes as per the Lidcombe Program Guide and introduce verbal contingencies throughout the day when there is some fluent speech. I would monitor severity ratings from beyond the clinic and in the clinic to determine whether more or less treatment is required. Sometimes I change the timing of the verbal contingencies as well as the amount and the style of delivery.
However, the amount/dose of treatment really does vary for each child and will depend on the stage of treatment that they are in. The “dosage” is determined by the child’s response to treatment reflected in severity ratings and the child’s reactions to contingencies. For this reason, you should ask parents how many verbal contingencies they are providing, in what buy lipitor no prescription treatment situations, and whether they are delivering them in patches or intermittently throughout the day. That information forms the basis for any changes in the “dosage” of treatment that you recommend.
Times when you might deliver more frequent verbal contingencies include at the start of treatment, especially if the stutter is severe; when the child is starting to experience periods of stutter free speech throughout the day; if you suspect that the child needs more contingencies throughout the day to make further progress.
Times that verbal contingencies will be reduced include if the child is achieving mostly stutter free speech and appears to be stable, if the child does not like attention, if you suspect that verbal contingencies are too intensive and therefore invasive for the child (clues are if the child reacts, e.g. “stop saying that”, or if you can see the parent providing a contingency on every utterance).
It should be noted that verbal contingencies for stutter free speech should always be rewarding, unpredictable, and not constant or invasive.