In this episode of The Speech and Language Kids Podcast, speech-language pathologist Carrie Clark explores different stuttering therapy activities that you can do in speech therapy to help your kiddos who stutter.
Preschooler Stuttering Therapy:
- Identify fast vs. slow speech from the therapist
- Practice using fast and slow speech for the child
- Practice slow, smooth, exaggerated speech
- Identify bumpy vs. smooth in the therapist’s speech
- Practice bumpy and smooth speech for the child
- Identify the child’s speech as bumpy or smooth during play
- Ask the child if his speech was bumpy or smooth
- Response Contingency: Praise/Reinforce smooth speech and provide immediate, direct corrective feedback for disfluent speech (“Oops, that was bumpy, let’s try it again) http://www.speechandlanguagekids.com/stop-stuttering-preschoolers-current-research-based-methods/
**Always watch students for signs that therapies are making it better or worse and adapt as needed.
Elementary-Aged Stuttering Therapy:
1. Learn About the Respiratory System
Start by doing a lesson all about the respiratory system. Use pictures, charts, models, or whatever you have available to you. Practice inhalation and exhalation, as well as deep and shallow breathing with the students. Talk about how we speak on exhalations and practice taking a deep breath in and then slowly exhaling while saying a single word. Gradually increase to speaking in longer phrases and sentences while using gentle exhalations. Talk about breathing timing during conversations (when to take a breath).
2. Practice Smooth, Prolonged Speech while Playing Games
Take whatever games you have available and practice using smooth, prolonged speech during those games. For example, you can have children play “Go Fish” and make sure they slow down and elongate their words when asking “Do you have a…”. Or, you can have them take a turn in a board game and use their slow, smooth speech to describe what happened (ex: “I rolled a four. I’m going to move four spaces”).
3. Learn About the Types of Stuttering
Help students learn about the different types of stuttering and which ones they do. Help them identify when they have stuttered and what type it was. Practice the different types of stutters to desensitize them to it.
4. Teach the Students Stuttering Modification Techniques
Help the students learn the different techniques they can use if they anticipate a stutter (preparatory set), are in the middle of a stutter (pull-out), or have stuttered and can’t move on (cancellations). Practice demonstrating these while playing games (pretend to stutter so you can use a technique).
Middle School/High School Stuttering Therapy:
Speech Modification (Fluency Shaping) Techniques:
Speech modification (including fluency shaping) strategies (Bothe, 2002; Guitar, 1982, 2013) include a variety of techniques that aim to make changes to the timing and tension of speech production or that alter the timing of pauses between syllables and words. These modifications are used regardless of whether a particular word is expected to be produced fluently. Strategies associated with speech modification include:
- rate control,
- continuous phonation,
- prolonged syllables,
- easy onset,
- light articulatory contact.
Other speech modification strategies, including appropriate use of pausing, are used not only to increase the likelihood of fluent speech production but also to improve overall communication skills (e.g., intelligibility, message clarity, etc.). In addition to being used for improving communication skills, pausing is also an effective method of rate control.
Keep in mind the child may be self-conscious about using these techniques.
Stuttering Modification Strategies (Reducing Physical Tension/Struggle)
- Identify where in the speech mechanism physical tension is and release it.
- Traditional stuttering modification strategies include preparatory set, pull-out, and cancellation and require a child to identify a moment of disfluency before, during, or after it occurs, making adjustments to reduce tension and struggle. The specific strategy that is selected will depend on when the client “catches” the disfluency, whether it be following a moment, in the moment, or in anticipation of the moment of disfluency (Van Riper, 1973).
- These strategies, like speech modification strategies, are introduced along a hierarchy of speaking situations that varies both with linguistic demands and with the stressors of the environment.
Strategies For Reducing Negative Reactions (Personal And Environmental Context)
- Cognitive Restructuring
- Support Group (grouping your kiddos who stutter)