I read recently in the new Lidcombe Program Treatment Guide that the use of % Syllables Stuttered has changed. I see that while the within clinic Severity Ratings are still taken each week it is no longer considered necessary to measure %SS. I have been used to recording the within clinic %SS on the chart and I wondered whether you now record the within clinic Severity Rating instead?

Yes that is correct. It is still essential to have a severity rating from within the clinic, as this serves a number of purposes. It allows the clinician to observe changes in stuttering frequency and severity, and provides a way for the speech-language pathologist to confirm that the information that the parent has reported about their child’s stuttering severity at home is valid. Having an ongoing way of measuring stuttering severity and common communication with the parent on this is a key practice in the Lidcombe Program. Collecting severity rating also importantly allows the SLP to compare the progress of the child, their client, with clinical research benchmarks.

Measuring %SS is no longer considered compulsory because more recent research has shown the same clinical outcomes can be obtained when it is not used. Measurement of %SS is also fraught with reliability problems. However, if you like to measure using %SS it is an optional measure, and some SLPs report it is clinically useful. They find it may be helpful in ensuring that there is careful ‘tuning in’ to the stuttering, and that it permits the SLP to observe trends. Some parents also find it motivating to learn how their child’s %SS has reduced. In short, if you feel that the %SS measure is useful, then this can still be collected. However, if you choose not to, then you still need to observe and record a within-clinic conversation and rate it using the severity rating scale.