• typical to go through phases of stuttering
• warning signs that stuttering may be persistent and not resolve on own
  • A parent, sibling, or other family member who still stutters
  • Stuttering starts after age 3 ½
  • Stuttering has been occurring for at least 6 months
  • Preschooler is a male
  • The child has other speech sound errors or trouble being understood
  • The child’s language skills are advanced, delayed, or disordered
• Source: http://www.stutteringhelp.org/risk-factors

So What Therapy is Most Effective?

• Younger children:  systematic review in 2006 by Bothe, et. al. found that the response-contingency approach
• Source: https://pubs.asha.org/doi/10.1044/1058-0360(2006/031)

What is Response-Contingency Therapy for Stuttering?

For a full article on this topic, visit the link below:

http://www.speechandlanguagekids.com/stop-stuttering-preschoolers-current-research-based-methods/

1. Reinforce fluent (non-stuttered) speech
   1. While playing with the child, comment on utterances that the child says that do not have any stutters.  You can say “oh I like how smooth that was” or “you say that without any bumps!”.
   2. If the child stutters frequently, try an activity that requires the child to use shorter utterances.  For example, you could play a game that requires the child to say a short sentence, like “Go Fish” (ex: “Do you have a ball?”).  If the child still stutters on these, back up to even shorter sentences, like having the child use one word to name an object in a picture.  Then, praise the fluent speech as above.
   3. If you need to shorten the utterance length down to have stutter-free speech, gradually build the utterance length back up by choosing slightly more demanding tasks.
2. Give direct corrective feedback for stuttering
   1. As soon as the child begins to stutter, corrective feedback should be given.  The research has shown that many different types of corrective feedback have worked so it doesn’t much matter what it is.  One study found that turning off the lights over a puppet that the child was talking to was effective.  Here are some ways that Bothe and Ingham suggest you can try:

i.      Say, “stop”

ii.      Say, “that was bumpy, try it again”

iii.      Say, “oops, hold on”

iv.      Say their name as a reminder

v.      Model the sentence without stutters

vi.      Hold up a hand and raise an eyebrow

**If the child is stuttering so much that you would be doing this kind of correcting constantly, try choosing just the most severe stutters or just some of them.  You can also try choosing activities that require a shorter utterance length as described above.

Source: http://www.asha.org/Events/convention/handouts/2010/1528-Bothe-Anne/

Great Example of Response-Contingency Therapy:

• Need to address psychological aspects
  • Reduce feelings of anxiety about stuttering
  • My activity for addressing emotional aspects.  Ask these questions, listen, and discuss
    • What are your strengths?
    • What are your interests?
    • What are your weaknesses?
    • How do you feel about talking?
    • What are your emotions when you stutter?
    • Describe how your stutters feel or sound.
    • Why do you think you stutter?
    • What changes do you make because of your stutter?
    • What situations do you stutter more or less?
    • How does your stuttering impact interactions with other people?
    • What’s the worst thing that could happen because you stutter?
    • How likely is that to happen and what is more likely to happen instead?
    • What strategies have you used and how have they worked?
    • What are your goals for yourself and will your stuttering prevent you from doing those things?

To Download the Emotional Aspects of Stuttering Worksheet (including what to say in response to the child’s answers), Click the Link Below

Click here to download the free PDF of the Emotional Impacts of Stuttering Worksheet.

Other Therapies for Older Children

• Response Contingencies once again tops the list
• Prolonged speech also has good outcomes (stretching out vowels and using extra pauses)
• Self-management for older kids : know when they are stuttering and provide the response contingencies themselves, such as stopping themselves

Thanks for Listening!

I hope that helped to clarify how to do therapy with children who stutter.  If you would like to download the free PDF of my emotional aspects worksheet, which includes what I recommend you say in response to the child’s answers, click on the link below.

Click here to download the free PDF of the Emotional Impacts of Stuttering Worksheet.

Thanks so much and don’t forget to leave a review on iTunes!