How To Do The Camperdown Program For Stuttering

The Camperdown Program is an evidence-based stuttering treatment for adults (Brignell et al, 2020; Laiho, 2022).

It was developed by the Australian Stuttering Research Centre. And it’s free!

In this article, you’ll learn how The Camperdown Program works, with helpful links and tips to make your life easier.

What Is The Camperdown Program?

The Camperdown Program is a stuttering treatment program for adults and older teens.

It falls under the umbrella of speech restructuring treatment (also known as fluency shaping), an evidence-based stuttering approach that focuses on changing overall speech, not just the stutter. (Brignell et al, 2020; Laiho, 2022).

When combined with cognitive behavioral therapy, speech restructuring treatment decreases social anxiety and dysfluency (Laiho, 2022). Alone, it can reduce stuttering by an average of  50–57% (Brignell et al, 2020).

The Camperdown Program teaches what they call a “fluency technique” of slow and exaggerated speech.

The patient moves through 6 stages of treatment that gradually help them to control their stutter while sounding as natural as possible. 

The program also incorporates self-reflection, problem-solving, and using a hierarchy of tasks.

The Camperdown Program is free and available in full on the University of Technology Sydney’s website. 

Who Is The Camperdown Program For?

The Camperdown Program is for adults and older teens with mild, moderate, or severe stuttering.

The Australian Stuttering Research Centre also created a well-regarded stuttering treatment for children called the Lidcombe Program. It’s free and available online.

While the Camperdown Program teaches patients to better control their stuttering, it’s not a cure. Check that your patient’s goal is to manage—not to cure—their stutter before starting the program.

Don’t Forget Social Anxiety

For many adult patients, managing social anxiety is an important part of their stuttering treatment (Menzies et al., 2009). 

Address it as needed at any stage of the Camperdown Program.

Refer out for Cognitive Behavioral Therapy (CBT) or Acceptance and Commitment Therapy (ACT), which are evidence-based mental health approaches for stuttering. Or recommend online resources like the University of Technology Sydney’s free Cognitive Behavioral Therapy program for adults who stutter.

Mindfulness (when combined with CBT or ACT) also improves fluency while decreasing stress and anxiety (Beilby et al., 2012; Gupta et al, 2016). 

• Mindfulness Exercises for Speech Therapy Patients
• Mindfulness for People Who Stutter: 4 Guided Meditations

How To Do The Camperdown Program

The University of Technology Sydney generously offers the Camperdown Program for free. Download The Camperdown Program Treatment Guide and visit their website for everything you need to do the program.

That said, the guide is a bit wordy. 

Read the summary below to introduce yourself to the program. Or bookmark this page for a quick reference when working through the stages.

Stage 1: Overview of the Camperdown Program

The Goal. The goal of Stage 1 is to introduce the Camperdown Program.

Introduce the Camperdown Program to your patient:

• The Camperdown Program will teach a fluency technique to control—but not cure— their stuttering. By the end of the program, they’ll find a balance between stuttering control and natural speech
• They must practice the fluency technique outside of therapy and have a communication partner to practice with
• If needed, they’ll work on managing anxiety
• They’ll learn how to self-evaluate and self-manage their stutter

Set Patient Goals. Help your patient set meaningful goals for their stuttering treatment. 

Stage 2: Learn the Fluency Technique

The Goal. The goal of Stage 2 is for the patient to feel in complete control of their stuttering. They do this by learning an individualized “fluency technique.” 

The Fluency Technique. You’ll use audio recordings to teach patients to speak slowly (and, at this stage, very unnaturally) to gain control of their stuttering. Assure them that this is just the first step. In the following stages, they’ll learn to use it with more natural-sounding speech.

Practice. The patient will follow these steps to learn the fluency technique:

1. Listen. The patient listens to the recording of the fluency technique. Have them describe it and then use this wording throughout the program.
2. Speak. The patient reads in unison with the recording while imitating the sample as closely as possible. 
3. Record them using the fluency technique as they read the passage alone
4. Reflect. They’ll self-reflect by listening to the recording of themselves and then answering the 3 questions:
   • “Did my speech sound similar to the example?
   • Did I use my technique consistently during the task?
   • Did I feel completely in control of my stuttering?” (O’Brien et al, 2024)
5. Practice. From there, they’ll practice the fluency technique with a hierarchy of tasks.
   • Start from the easiest speaking task for them and progress to the hardest. For example, first read aloud, then describe pictures, then say a monologue, then have a conversation with you.
   • They’ll answer the same 3 questions for each task

Practice at home. Have the patient practice the fluency technique with their communication partner.

Moving on. To move on to the next stage, the patient must use the fluency strategy to speak with you for 15-20 minutes while feeling in complete control of their stutter.

Stage 3: Refine the Fluency Technique

The Goal. The goal of Stage 3 is for your patient’s stutter-free speech to sound more natural.

At this point, they won’t use this speech in everyday life. Just in treatment and when practicing at home.

Fluency Technique Scale. Introduce the Fluency Technique Scale:

The Fluency Technique Scale quantifies the amount of technique a patient uses during speech.

It goes from full technique (the slow, unnatural speech they learned in Stage 2) to no technique (not using any strategies). As they move down the scale, the patient uses the fluency technique less strongly and less often. 

Demonstrate all levels. Use the audio recordings to demonstrate each level to the patient.

Practice half technique. Have the patient learn and practice speaking using the half technique. Use Listen-Speak-Record-Reflect from Stage 2 to practice it with a hierarchy of tasks.

Moving on. Move on to the quarter technique when your patient can consistently answer “Yes” to the 3 reflection questions. 

Practice quarter technique. Move on to the quarter technique, again using Listen-Speak-Record-Reflect to practice.

Practice at home. Patients will practice the half/quarter techniques with their conversation partner. They’ll use a hierarchy of tasks:

• Reading aloud
• Describe pictures of photos
• Talk in a monologue
• Short question and answer session 
• Have a conversation 

Moving on. To progress to the next stage, patients should consistently answer “yes” to the following questions about their speech at home and in therapy:

• “Did my speech mostly sound similar to the quarter technique examples?
• Did I use quarter technique consistently during speaking tasks? 
• Did I feel completely in control of my stuttering when using quarter technique?” (O’Brien et al, 2024) 

Stage 4: Natural-Sounding Speech

The Goal. The goal of Stage 4 is for the patient to control their stutter at a comfortable level while speaking as naturally as possible.

Discuss the trade-off between natural-sounding speech and stuttering control. 

They still won’t use this speech in everyday life. Just in treatment and when practicing at home.

Demonstrate minimal technique. Demonstrate how the minimal technique of the Fluency Technique Scale sounds. 

Practice. Next, the patient practices using the 3 steps of Plan-Do-Reflect:

• Plan. The patient chooses a speaking task, how much fluency technique to use (full, half, quarter, or minimal), for how long, and why.
  • For example: “I will use the minimum technique for a 1-minute reading task because it’s my first time trying the minimal technique.” 
• Do. The patient does the planned speaking task.
• Reflect. The patient reflects on how they did by answering the 5 reflection questions: 
  • “Did I use my technique consistently during the task?
  • Was I mostly in control of my stuttering?
  • Would I be comfortable sounding like this in the real world?
  • What would I do differently next time? Why?” (O’Brien et al, 2024)

Practice at home. 

Moving on. A patient moves on to the next stage if they answer mainly “yes” to the following questions when speaking at home and in therapy: 

• “Have you practiced speaking using a variety of fluency technique levels? 
• Have you practiced speaking in a variety of tasks? 
• Did you typically use as much technique as you planned? 
• Did you typically use your fluency technique consistently? 
• Were you mostly in control of your stuttering when using a comfortable amount of technique?” (O’Brien et al, 2024)

Stage 5: Preparing for Real-World Speaking

The Goal. The goal of Stage 5 is to prepare your patient to use the fluency technique in their everyday life.

You’ll practice more complex conversations that fit their interests and needs (phone calls, longer conversations, multi-tasking, etc.) Try to use only the minimal and quarter techniques.

Practice. Use Plan-Do-Reflect with a hierarchy of speaking tasks. 

Practice at home. Practice with the communication partner outside the home in different locations and with different distractions.

Moving on. To progress to the next stage, the patient should consistently answer “yes” to the following questions:

• “Did you typically use as much technique as you planned? 
• Did you use your fluency technique consistently? 
• Were you mostly in control of your stuttering when using an acceptable amount of fluency technique? 
• Would you be comfortable talking like that in everyday situations?” (O’Brien et al, 2024)

Stage 6: Speaking In The Real World

The Goal. The goal of Stage 6 is for your patient to control their stuttering in everyday speaking.

Emphasize how to use self-reflection and problem-solving to meet their communication goals.

Practice. The speaking tasks will depend on patient factors, like stuttering severity and their goals. 

Continual Problem-Solving. During this stage, you’ll want to confirm that the patient can comfortably control their stutter in the day-to-day. If not, help them problem-solve how to get there. Continue to use strategies like Plan-Do-Reflect and a hierarchy of tasks to help them meet their communication goals. 

If the patient can’t comfortably use their fluency strategies, have them answer the reflection questions.

Stage 7: Managing Treatment Gains Long-Term

The Goal. The goal of Stage 7 is the long-term maintenance of the balance between controlling their stutter at a comfortable level while speaking as naturally as possible.

Continue to encourage your patient to use strategies for problem-solving, self-reflection, and managing social anxiety.

Practice. Help patients keep stuttering under control by:

• Keeping a consistent practice routine
• Being aware of what affects their ability to control stuttering (loud environment, multi-tasking, time pressure, etc.)
• Problem solve how to detect and react quickly and effectively to challenges

More Stuttering Resources

Visit our shop for evidence-based Fluency handouts and treatment guides.

For more guidance, check out The Adult Speech Therapy Roadmap Course.

References

• Beilby, J. M., Byrnes, M. L., & Yaruss, J. S. (2012). Acceptance and Commitment Therapy for adults who stutter: psychosocial adjustment and speech fluency. Journal of fluency disorders, 37(4), 289–299. https://doi.org/10.1016/j.jfludis.2012.05.003
• Brignell, A., Krahe, M., Downes, M., Kefalianos, E., Reilly, S., & Morgan, A. T. (2020). A systematic review of interventions for adults who stutter. Journal of Fluency Disorders, 64, 105766. https://doi.org/10.1016/j.jfludis.2020.105766
• Brewer, C., Aparo, M. (2021) The Adult Speech Therapy Starter Pack. Harmony Road Design Publishing.
• Gupta, S., Yashodharakumar, G. Y., & Vasudha, H. H. (2016). Cognitive behavior therapy and mindfulness training in the treatment
• Laiho, A., Elovaara, H., Kaisamatti, K., Luhtalampi, K., Talaskivi, L., Pohja, S., Routamo-Jaatela, K., & Vuorio, E. (2022). Stuttering interventions for children, adolescents, and adults: A systematic review as a part of clinical guidelines. Journal of Communication Disorders, 99, 106242. https://doi.org/10.1016/j.jcomdis.2022.106242
• Menzies, R. G., Onslow, M., Packman, A., & O’Brian, S. (2009). Cognitive behavior therapy for adults who stutter: A tutorial for speech-language pathologists. Journal of Fluency Disorders, 34(3), 187-200. https://doi.org/10.1016/j.jfludis.2009.09.002
• O’Brian, S., Carey, B., Hearne, A., Lowe, R., Onslow, M., Packman, A. (2024). The Camperdown Program Treatment Guide. [PDF]. University of Technology Syndey. https://www.uts.edu.au/sites/default/files/2024-07/Camperdown%20Program%20Treatment%20Guide%202024-07-09.pdf
• O’Brian, S., Onslow, M., Cream, A., & Packman, A. (2003). The Camperdown Program: Outcomes of a new prolonged-speech treatment model. Journal of Speech, Language, and Hearing Research, 46, 933–946.