Let’s Take the Struggle out of Stuttering!
Speech therapy for stuttering can be scary, but it doesn’t have to be! I remember being terrified of providing stuttering therapy during my master’s program. I may not have felt this way if I had had a child, adolescent, or teenager for my first fluency client however. As it was however, my first stuttering client was 82 years old! I knew I likely wasn’t going to teach him anything new at all, but figured maybe I could learn a thing or two from him. What I did learn was that he seemed to be looking for acceptance and positive social interaction despite his observed speech blocks and repetitions. Now, fast forward more than 30 years later, I have learned so much in the area of stuttering therapy, but still am learning!
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Fluency shaping strategies are taught to help a student/client to decrease the struggle when a disruption in speech fluency occurs. However, these strategies are not the only support that we as Speech-Language Pathologists should be providing. A summary of Nina Reeves in her short course Stuttering is Verbal Diversity, through SLP Summit and Bright Media, 2021, indicates that stuttering therapy is not necessarily to stop stuttering from happening, but to decrease the struggle when it occurs. By the way, Nina Reeves and Scott Yaruss of Stuttering Therapy Resources, are true experts on the topic of stuttering with tons of information to offer.
To decrease the struggle means to stutter more easily. Our role in therapy is to increase the student/client’s level of comfort and sense of control with how the stutter is handled (stuttering modification).. In doing so, physical tension is decreased which in turn may lessen the frequency/severity of dysfluencies as well.
Therefore, stuttering therapy should work to decrease and likewise, increase the following qualities:
Decrease–> sensitivity, negative feelings, fear, anxiety, tension
Increase–> awareness, knowledge, control, comfort, acceptance
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So, What Should I Teach in Stuttering Therapy?
- Teach anatomy and physiology and how the speech mechanism works, focusing on how muscles control the level of tension when speaking. I like to show students/clients how a spectrogram works by comparing muscle tension to visual changes in frequency (pitch) and intensity (volume). Additionally, finding videos on vocal fold function using stroboscopy is also a very visual teaching tool for discussing muscle tension and effects on vocal patterns.
- Teach locus of control, the brain, and how thinking affects muscle tension. Controlling thoughts, controls the level of tension! Joyce Meyer states, “We will never put the Word into practice physically, if we don’t first practice it mentally.” (Battlefield of the Mind, p.168, FaithWords.) I find this sentence applies to just about everything we do as humans!
- Discuss and listen to your student/client about their feelings of their speech. My free resource on the Boom Cards Platform- Stuttering Therapy Questionnaire for Adolescents & Teenagers: Inquiry & Discussion can help support this point. This resource can also be found as a Google Slides option in my Teachers Pay Teachers (TpT) store here. I also have developed Stuttering Therapy Questionnaire for Children: Inquiry & Discussion. For the Google Slides option in my TpT store here. The information and feelings you acquire from your student/client during this discussion may guide you into areas of stuttering modification that you haven’t considered. This can also help to develop a more supportive client/therapist relationship in the process. Reviews of this resource state:
*“My 7th grade stuttering group loved this activity and I learned so much about them! I thought one of them may be ready to dismiss, but after diving into this activity, there are some more situations we need to work through. I recommend this to anyone who has middle or high school fluency students.”
*”This was a great resource to guide therapeutic focus with my older students in speech therapy.”
Start with a fluency enhancing strategy that provides near instant success to build confidence and motivation. This is important since your student/client may already have a sense of lost hope for their speech patterns or may not even acknowledge any fluency concerns. Easy Onset for stuttering is generally my first go to as it seems a bit easier to grasp. Stretching is another option as a go to in the beginning of therapy. My most recent students/clients however, required my efforts to be focused toward easy breathing and breath support.
- Teach a variety of strategies to allow for your student/client to have a wide range of tools at hand for when communication becomes a struggle. Make sure you have visuals for each strategy to support learning. There are tons of visuals out there, but if you are looking for FREE, I have just what you need! Sign up for my email list to get Stuttering Therapy- Fluency Shaping Visuals & Activities. This is a 29 page pdf resource you can print or download onto a digital device. Your strategies may include the following:
*Easy Onset
*Stretching
*Light Contact
*Rate & Pacing
*Pausing & Phrasing (Chunking)
*Continuous Voicing
*Pull-Out
*Pseudo-Stuttering
6. Encourage your student/client to practice deliberate stuttering behaviors to
increase self-awareness and the ability to repair communication when needed.. I
believe an increase in self-awareness is important for self-acceptance and self-
advocacy.
7. Don’t forget your student/client’s support system….parents, siblings, classmates,
teachers! Stuttering Therapy Resources has some excellent FREE sharables that
address this very important area. Interpersonal communication cannot happen
without the presence of other human beings who bring with them feelings, biases,
prejudices, opinions, and various levels of understanding and empathy. Educating
them helps to foster acceptance and ultimately growth in our students/clients.
8. Finally, I love this one and only wish I had learned it years ago! Write stuttering
therapy goals or IEP (Individualized Education Plan) goals in a manner that focus on
increasing efforts to engage in interpersonal communication. By this, I mean participating in discussions, answering questions in a group, sharing ideas, giving opinions, presenting information, whispering to a friend, explaining the rules of a game, talking about hobbies or favorite topics, persuading, encouraging, or even arguing and complaining effectively! Interpersonal communication is the means to developing lasting social relationships.
*Of course this is not a complete list of all stuttering theories for modification and fluency, but it will get you started in the right direction!
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I don’t know about you, but I love to think we as Speech-Language Pathologists can have a huge impact on helping to develop a person’s self-esteem. That we might be able to support a person’s ability to communicate successfully in order to develop lasting and positive social relationships is amazing! Remember, speech therapy for stuttering, when broken down, is just “humanizing” dysfluent speech behaviors to increase acceptance of diversity.
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