In your opinion, How can operant methods (such as Lidcombe stutter program) be improved? My reply generally would be Lidcombe has excellent outcomes in young children but it becomes gradually less effective with age - so bad outcomes after age 12

In your opinion, How can operant methods (such as Lidcombe stutter program) be improved? My reply generally would be Lidcombe has excellent outcomes in young children but it becomes gradually less effective with age - so bad outcomes after age 12 I’m not trying to promote "operant methods" (or the Lidcombe program).. on the contrary, I disagree with their operant methods, as they don’t seem to be effective for adults who stutter. Although Lidcombe has been highly praised by some, it has also faced significant criticism (see these reddit posts: [1](https://www.reddit.com/r/Stutter/comments/xe1mrv/seeking_advice_for_my_5_year_old_in_lidcombe/), [2](https://www.reddit.com/r/Stutter/comments/qhcmis/experience_with_lidcomb_method/), [3](https://www.reddit.com/r/Stutter/comments/1gzav0k/help_please_seeking_advice_as_a_parent/), [4](https://www.reddit.com/r/Stutter/comments/159v4ep/tips_for_a_parent_who_has_a_child_that_stutters/)). So we could argue here that the "relapse component" needs re-work. Before I discuss further, I think it’s important to first acknowledge that stuttering primarily stems from genetic and neurological factors, which has been well-researched. On top of genetics and neurology, conditioning comes into play (such as stuttering anticipation, fear of judgment, or the confidence that a certain speech technique works (which might or might not trigger a stuttering episode). These conditioned factors are understood to develop on top of the root genetic and neurological causes. That said, I believe the role of conditioning in stuttering remission and relapse has been significantly under-researched. Take modern therapy approaches that use [operant methods](https://www.uts.edu.au/sites/default/files/2023-01/Lidcombe%20Program%20Treatment%20Guide%202022%20v1.4.%202023-01-26.pdf), for example. Why does it seem less effective as we age or the longer we suffer from stuttering? Why does [extinction ](https://drive.google.com/file/d/1L1Spz7wpRFPp9miv7T7AQWqNn0kulmqr/view?usp=sharing)of the conditioned stimulus often fail in adults who stutter? ([extinction failure](https://drive.google.com/file/d/1Rrij8kD5p8MkDic0cZdK6Pf4F1qpOWp9/view?usp=sharing)) **Question**: In your opinion, How can operant methods (such as Lidcombe stutter program) be improved? How can stuttering remission be explained from a behavioral or cognitive perspective? \-- I kindly ask that you provide thoughtful serious answers in your reply. We are all in this thing together https://preview.redd.it/4xydho7v7s4e1.png?width=592&format=png&auto=webp&s=d7d14a06a5cd2cb63ace48fbcceba0d583445032