Best time to begin stuttering modification

Hi everyone!

Based on your experience, how would you determine when would be the best time to start stuttering modification with a child and when would be not?

Thank you in advance for your input!



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Best time to begin stuttering modification — 3 Comments

  1. Christine,

    When working with a child who stutters, I generally model modifications in my own speech that are known to support fluency. So, talking with greater ease, using gentle beginnings of phrases, making smooth transitions between syllables, etc. Young children will often follow the model and when I hear them using their speech mechanism in an easier/less tense manner, I comment on this, verbally noticing that they are talking just like me, or saying that so easily, etc. The parents can learn how to modify their own speech in the same ways, and model for their child during short periods of each day when they have one-on-one conversation time with their child. I often also address issues around communication skills for the family so that all members of the family feel listened to and valued for what they have to say. So, for example, family members are given the space to say what they want to say without interruptions or having others talk over them.

    For older children, it is quite dependent on the particular child. In general, when a child is interested in learning how to speak more fluently, I think it is important that the clinician has first set the stage for this work by educating the child about how speech happens (the mechanics of speech), what the child does when they speak fluently and when they stutter, the skills that make someone a good or not-so-good communicator (and what skills they possess and other family members or friends possess/do not possess), how they feel and think about their stuttering, what talking situations are the easiest or trickiest for them, what the child sees as important changes they would like to make in their communication (e.g., I want to be able to talk to my friends when we are playing in a group, I want to be able to give a book report in class, I want to not be afraid to raise my hand in class).

    Beginning to learn about these aspects of communication and stuttering is important since it sets the stage for a comprehensive treatment program where the focus is broader than simply learning how to be fluent. Working only on therapy techniques to modify stuttering may often not be terribly durable if these other areas are not addressed.

    I’m afraid there is no single ‘best time’ for every child. When you spend time developing a relationship with each client so that he/she knows you value them as a person and that you will listen to them, your client will let you know what they need, and this is your best guide for how to proceed in therapy.

    All the best,

    Lynne Shields

  2. Hi Christine – I can’t add much to Lynne’s excellent response, but I do want to say that before I begin stuttering modification or any other type of strategy with the a child who stutters, I first spend time building a strong foundation for the child to be able to understand, and ultimately make, modifications in speech.

    Too often, I see clinicians dive into techniques before a child is ready. Sometimes, we feel a pressure to get right to making changes in the child’s speech. If a child does not understand stuttering, though, then his ability to use these modifications is going to be quite limited. (I think this is one of the reasons that we see so much difficulty with generalization in stuttering therapy.)

    Before beginning any technique work, then, I would encourage you to spend time helping the child learn about the speech mechanism, how we talk, what happens when we are fluent, and what happens when we stutter. (One of the analogies I use: if there’s something I want to change about how my car works, I first have to understand how my car works!) Also, help him understand the rationale for various strategies before you expect him to use those strategies. Without this background understanding, the child’s success outside of the therapy room is going to be limited.

    For an example: I have posted a free “Practical Tip” about how to teach children about the “speech machine” (the parts of the body involved in producing speech) at This gives an example of the types of background information that I think children need before they will be successfully able to learn and use techniques.

    Thanks again for your post,
    J Scott Yaruss