Published by Unseen Progress, an independent publisher of caregiver research. Last reviewed 2026-05-10. Part of the childhood stuttering research overview.
Short answer. RESTART-DCM is an indirect, parent-mediated treatment for preschool stuttering developed in the Netherlands and grounded in the Demands and Capacities Model (DCM). The DCM frames stuttering as the child's speech-language capacities being temporarily exceeded by the demands placed on them — by the environment, by the listener, and by the child's own internal pressure. RESTART-DCM treats stuttering by adjusting the demands rather than by directly targeting the disfluency. It is one of the three preschool stuttering treatments with a meaningful evidence base, alongside the Lidcombe Program and Palin PCI.
The Demands and Capacities Model, developed by Starkweather and Gottwald in the 1980s and elaborated since, proposes that fluent speech requires the child's capacities (motor speech skills, language formulation, cognitive resources, emotional regulation) to keep pace with the demands placed on them in the moment (Starkweather, 1987). When demands exceed capacities, the speech system produces disfluencies — repetitions, prolongations, and blocks. When capacities catch up, or when demands drop, fluency returns.
The DCM is a frame, not a single treatment. It explains why stuttering fluctuates moment-to-moment: a tired child at a noisy birthday party with multiple adults firing questions has high demand and reduced capacity. The same child the next morning, rested and in a quiet one-on-one conversation, has lower demand and full capacity. Disfluency rises and falls accordingly.
Two clinical implications follow. First, changing the demand side can produce immediate fluency improvements even before any change in the child's underlying capacities. Second, a child whose capacities are still developing will benefit most from environmental adjustments that reduce demand during that window.
RESTART-DCM is the structured Dutch protocol that operationalises the DCM into a parent-mediated indirect treatment for preschool stuttering. The treatment is delivered by the parent, supervised by an SLP, and works through systematic adjustments to the communicative environment (Franken et al., 2005; Franken & Putker-de Bruijn, 2007).
The core moves include:
A parent does not implement all of these at once. The SLP works through them systematically, adjusting one or two demand variables at a time and observing the child's response.
Marie-Christine Franken and colleagues' randomised comparison trial of RESTART-DCM versus the Lidcombe Program in Dutch preschoolers found that both treatments produced significant and comparable reductions in stuttering at follow-up, with no clear superiority for either approach (Franken et al., 2005; de Sonneville-Koedoot et al., 2015). This is one of the most-cited findings in contemporary preschool stuttering research, because it suggests that indirect demand-reduction approaches can be as effective as direct contingency-based approaches in the right hands and the right child.
The evidence base for RESTART-DCM is smaller than for Lidcombe but is methodologically strong and has been replicated. Clinical guidelines in the Netherlands and parts of Europe favour indirect approaches as a first-line treatment for younger preschoolers; clinical guidelines in Australia and parts of the English-speaking world favour Lidcombe. Both choices are evidence-supportable.
The choice between RESTART-DCM (indirect) and Lidcombe (direct) is made by the SLP based on the child's profile. Indirect approaches are often preferred when:
Lidcombe is often preferred when the child is robust to direct contingencies, when the family is well-suited to the structured daily session format, and when the SLP has Lidcombe expertise.
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