Stuttering Treatment

Treatment for stuttering includes individualized goals that focus on increasing fluency, reducing secondary/avoidance behaviors (if applicable), improving self-confidence, and supporting the child and his/her family.

Treatment can begin after a child receives a stuttering diagnosis. The earlier treatment begins, the better the outcome.  

Individual VS Group Treatment

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Indirect Treatment (environment):

• Provide counseling to families
• Implement changes to the child’s environment such as reducing rate of speech at home, indirect prompts, and modeling of fluent speech 

Direct Treatment (altering a child’s speech):

• Practice speech modification strategies (see below)
• Practice fluency strategies (see below)

Indirect VS Direct Treatment

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Indirect Treatment (environment):

• Provide counseling to families
• Implement changes to the child’s environment such as reducing rate of speech at home, indirect prompts, and modeling of fluent speech 

Direct Treatment (altering child's speech):

• Practice speech modification strategies (see below)
• Practice fluency strategies (see below)

Speech Modification Strategies

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Speech modification strategies are designed to enhance/create fluent speech. The strategies below are used to alter a child's breath, articulation, and rate of speech.

They include:

• Slow rate of speech
• Continuous phonation
• Easy onset (start speaking with reduced tension and possibly phonation)
• Light contacts (lightly use articulators when talking)
• Stretchy speech (prolongate a "stuttering word/sound" and keep talking)
• Pausing/chunking 

Stuttering Modification Strategies

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Stuttering modification strategies help to bring awareness of stuttering to the child and reduce any physical tension or struggle. 

Some examples include:

• Pull-out (requires self-awareness): When a child has a dysfluency, the child uses a speech modification strategy and decreases/stops the stutter.
• Cancellation (requires self-awareness): When a child stutters on a word, the child stops and repeats the word using a speech modification strategy.
• Desensitization: Talk about fears of stuttering in a supportive environment.
• Self-disclosure: A child tells others that he/she stutters and gives information about it.
• Stuttering on purpose: A child purposely stutters to gain “control” over his/her stuttering

Counseling

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A large portion of stuttering treatment will be to counsel the child and his/her family on stuttering.

Many children and family members have a lot of fear wrapped up in stuttering and it is your job as an SLP to ease these fears, discuss and help reduce anxiety, and come up with strategies to support your client.

Generalization Ideas

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Once a child can use strategies within the therapy room, he/she has to use those strategies outside the therapy room.

This can be a hard transition since the world can be an unpredictable place. There are many environmental stressors that trigger stuttering.

When starting generalization activities, begin with a low-pressure situation. This varies depending on the child.

Once a child is successful in a low-pressure situation, move up to a SLIGHTLY higher pressure situation. Make sure the child can be successful. You want to build confidence!

Reference:  Childhood Fluency Disorders. Retrieved 4 October 2017, from http://www.asha.org/Practice-Portal/Clinical-Topics/Childhood-Fluency-Disorders/

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