Treatment for stuttering includes individualized goals that focus on increasing fluency, reducing secondary/avoidance behaviors (if applicable), and improving self-confidence.
Treatment can begin after a child receives a stuttering diagnosis. The earlier treatment begins, the better the outcome.
Individual VS Group Treatment
Individual Treatment Sessions:
- Allows for focused teaching of new skills
- Ensures privacy when discussing private issues such as stress, anxiety, avoidance behaviors
Group Treatment Sessions:
- Children will discover that some of their peers also stutter
- Children are able to learn from each (peer modeling)
Indirect VS Direct Treatment
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
Speech modification strategies are designed to enhance/create fluency speech. The strategies below are used to alter a child's breath, articulation, rate of speech, etc... They include:
- Slow(er) 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)
Stuttering Modification Strategies
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 their stuttering
A large portion of stuttering treatment will be to counsel the child and their 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.
Once a child is able to use strategies within the therapy room, he/she has to be able 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 can cause anxiety, trigger stuttering, etc...
When starting to do generalization activities, make sure to start with a low-pressure situation. This varies greatly 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 is able to be successful. You want to build confidence!
Bridget is an ASHA certified, practicing speech language pathologist. She is passionate about providing parents with information on child speech and language development as well as provide functional, easy activities to do at home! Parents have the power to make a real difference. Follow Bridget at Facebook and Pinterest for more fun!
Author of child language development eBook series
Reference: Childhood Fluency Disorders. Retrieved 4 October 2017, from http://www.asha.org/Practice-Portal/Clinical-Topics/Childhood-Fluency-Disorders/