From 1980 – 2000 , various American speech language pathologists eanna and Glyndon D. Riley, Edward G. Conture, Charles W. Starkweather and Hugo H. Gregory gave workshops in the Netherlands on their treatment methods for children who stutter. While these experts τeach had their own distinct treatment focus, their overall approaches could be characterized as a ‘Demands and Capacities Model’ treatment approach, in which stuttering is viewed as the expression of an imbalance between the ‘Demands’; i.e., the expectations with regard to fluent speech, and the ‘Capacities’: the abilities or skills for fluent speech (Starkweather & Franken, 1991). The philosophy of the experts differs strongly from an operant based method, such as that of the Lidcombe Programme (LP, Onslow et al, 2003).
By the late eighties, the Demands and Capacities Model (DCM) approach had emerged as the standard treatment in the Netherlands for young children who stutter. It is this approach that has been taught to Dutch students of speech therapy for the past 25 years. After giving his first workshop in the Netherlands, Starkweather returned a number of times to teach courses. He also spent a year working and living in this country. In 1990 Starkweather and his colleagues Gottwald and Halfond described their method in a book entitled Stuttering Prevention; a clinical method. A Dutch translation of this book appeared in 1991. An information booklet that was written by Starkweather especially for the parents of young children who are beginning to stutter, was also translated and adapted for the Dutch situation (Beerthuizen van Giesen, Franken & Nijhuis-Louwerens, 1991). In Dutch practice, however, the exact procedure followed according to the DCM treatment model varied extensively. In some cases, parents were only given advice (e.g. to speak to their child more slowly, to use short sentences and not to ask many questions), while in other cases, speech therapists (fluency experts) gave, instead of advice, training to parents to achieve actual behavioural change. Some focused solely on reducing ‘demands’, i.e., the expectations, while other also worked on promoting the capacities of the child. Moreover, the DCM continued to be further developed over the course of time both by Starkweather and his immediate colleagues, as well as by other practitioners. Within the scope of the research project Cost-effectiveness of the Demands and Capacities Model based treatment compared to the Lidcombe programme, known as the RESTART study a treatment protocol has been developed based on the DCM treatment model. The aim was for all the speech therapists (fluency experts) participating in the project to follow a similar treatment approach based on the DCM. Durdana Putker de Bruijn and Marie Christine Franken prepared a preliminary, rough version of the RESTART - DCM Method. Then, during the initial stage of the project, all the participating speech therapists (fluency experts) gave their feedback on the manual, which resulted in the treatment protocol that was used during the study. In the final stage of the project, it was decided to make the protocol generally accessible. To this end, the treatment protocol once again underwent textual revision, this time by a smaller group, in order to ensure its readability by speech therapists (fluency experts) from outside the project. Crucially, the description of this method is no substitute for a course in which the methods and skills described are taught and trained. We have just a few remaining remarks about the protocol as a whole. In the first place, there are authors other than those we mentioned whose work may also be considered to come under the heading of the DCM approach. However, the method we describe draws primarily on the work of the said authors. Secondly, if specific expertise should be required for certain parts of the diagnostic evaluation performed prior to the treatment e.g. a differential diagnosis of phonological and/or dyspractic disorders, an evaluation of RESTART DCM Method 3 cognitive, socioemotional and/or behavioural social abilities a referral for evaluation by a specialist should be seriously considered. In addition, a speech therapist/fluency expert may be consulted if there is a need for supervision or coaching during ongoing therapy. Consultation with or referral to a fellow speech therapist/ fluency expert should also be seriously considered if no progress is noted after three months of treatment.