Reducing Disfluency

Treatment for stuttering that emphasizes reducing disfluent speech is generally known as fluency shaping.[1] To use fluency shaping strategies, a person who stutters would work with a speech-language pathologist (SLP) to change the way they speak. The goal of fluency shaping is to eliminate all stuttering events and speak fluently at all times. Some therapies use assistive devices, such as delayed auditory feedback, to assist in this effort.

While delayed auditory feedback and fluency shaping programs may work for some people who stutter, not all find them helpful or easy to maintain over time. With a focus on eliminating stuttering, these methods may overlook underlying emotions and attitudes that contribute to communication difficulties.

Early Intervention is Key

While there is no universally accepted treatment for stuttering, most clinicians would agree that early intervention plays a crucial role. When potential stuttering is identified in a young child, they should be referred to an SLP for a comprehensive evaluation.

Research shows that the earlier treatment programs are implemented, the less likely it is that stuttering will persist into adulthood. Addressing disfluencies early on will also help a child cope with the negative emotional reactions, tension, and avoidance of speaking situations that can make stuttering more severe. Many early intervention programs also provide the parents/caretakers with support.

There is No Cure for Stuttering

It’s important to remember that there is no single technique, device, or medication that will cure stuttering. Many people who stutter are sometimes told to “slow down,” or to “just relax” when speaking. While delivered with the best of intentions, these tips imply that stuttering is caused by anxiety and that a person who stutters can control their stuttering if they try hard enough. Speaking fluently is not that simple, and people who stutter should work with an SLP to address their individual communication needs.

Selecting an SLP who is a board-certified specialist in fluency (BCS-F) is an important and highly individual decision. As a resource, the NSA® provides basic guidance and links to find a therapist.

Reducing the Effects of Stuttering

While fluency shaping methods center on eliminating stuttering all together, other treatment options focus on limiting its impact. One method, known as stuttering modification[1], involves identifying and adjusting disfluencies when they occur. An SLP using stuttering modification would help a person who stutters reduce their physical tension, overcome their fear of speaking, and utilize tools to monitor their own speech.

Stuttering modification includes education and counseling for the person who stutters, with the goal of decreasing anxiety when speaking. It can also include techniques for changing stuttering moments as they occur—making them shorter and less tense.

What Makes Treatment Successful?

Ultimately, the success of anyone treatment for a person who stutters depends on their individual goals, feelings, and attitudes toward their stuttering. Nowadays, most treatment programs utilize a combination of the methods described above.

Most importantly, successful treatment should help people who stutter overcome negative feelings, reduce stress surrounding speaking, participate in activities, and improve their overall quality of life. To that end, an SLP may encourage self-advocacy, incorporate counseling strategies, and promote family training in their treatment of stuttering.

Support Groups Help

Stuttering support groups can provide key information, a supportive environment, and community for people who stutter. The advantages of attending a support group include the ability to gain new perspectives on fluency, speak freely without judgement, and help others understand their stuttering[2]. Many people who attend support groups or the NSA’s Annual Conference report increased confidence when speaking and comfort in feeling they are not alone. To find a support group in your area, click here.

Alternative Treatments

Alternative treatments for stuttering (those other than speech therapy) are popular, and while some can be helpful, others are nothing more than digital snake oil. Ranging from motivational courses and vitamins to Botox injections, a 2002 survey conducted by the National Stuttering Association® showed that adults who stutter reported trying an extraordinary variety of treatments. To read more about alternative treatments for stuttering and their reported efficacy, click here.

[1] Tetnowski, J. A., & Scott, K. S. (2010). 19 Fluency and Fluency Disorders. The Handbook of Language and Speech Disorders, 431.

[2] Medina, A. M., Almeida, N., Amarante, K., Martinez, N., & Prezzemolo, M. (2020). Adults Who Stutter and Their Motivation for Attending Stuttering Support Groups: A Pilot Study. Perspectives of the ASHA Special Interest Groups, 5(1), 142-154.

Original material provided by: Leslee Dean, M.A. in Latin American Studies, MS-SLP student at Florida International University and Angela M. Medina, Ph.D., CCC-SLP.