Stuttering and Fluency

Stuttering and fluency is a subject that I have always been interested in. My grandfather stuttered his whole life, though it never seemed to bother him. In my school system career, I have watched many students struggle with fluency and stuttering. Of course there is a spectrum... some children had more severe problems than others. Regardless, my goal has always been to improve their communication and self confidence in their speech skills.

The Stuttering Foundation of America is my go-to place for all things stuttering. They have many resources for speech therapists, parents, and teachers.  Here are 8 Tips for Teachers, here are 7 Tips for Parents, and here are free brochures on just about any topic regarding stuttering.

I have the book Treating the School-Age Child Who Stutters: A Guide for Clinicians by Carl W. Dell, Jr. and will be reviewing a few concepts in this blog post. The book is very comprehensive and is a great, inexpensive purchase for any clinician working with children who stutter.

The first thing is to determine whether the stuttering a child is producing is normal dysfluencies or true stuttering. Some of the speech behaviors indicating risk are:

• Facial tremors with tension
• Speaking very rapidly, almost compulsively
• Evidence of struggle and tension while speaking
• Blocks airflow
• Raises the pitch or volume during dysfluencies
• Uneven repetitions
• Many repetitions (5 or more) during a word
• Accompanying body movements during dysfluencies
• Other nervous habits (e.g. nail biting, bed wetting, hyperactivity)

In order to determine whether or not the dysfluencies are normal, a wide variety of speaking situations should be observed. Also, we need to determine if the child is fluent in certain speaking situations but not in others (e.g. reading is fluent but conversation is not). What level produces the first sign of dysfluency? Word level? Phrase? Sentence?  This is where we begin.  The child needs the opportunity to be fluent everyday.

The therapy techniques I use everyday with my students include:

• Pull-Outs - During a stuttering moment, the child pulls out the sounds with continuous voicing in order to smooth out the speech.
• Easy Onsets - This is almost saying a breathy "h" before each vocal onset. Muscles should be relaxed and breathing should also be gentle.
• Breathing - Relaxed breathing is very important. And specific patterns of breathing for smooth speech should be utilized.
• Cancellations - When a stuttering moment occurs, the student goes back and uses fluency shaping techniques to correct the dysfluency.
• Purposeful Stuttering - I do not use this technique often, but it is in my arsenol of strategies. Having the child stutter on purpose gives them a sense of control over their own speech and, emotionally, that is very important for self confidence.

I have created a Stuttering and Dysfluency therapy pack to use with these specific techniques. The activities are comprehensive and leveled for progression through more complex therapy activities.

The pack also includes homework sheets and activities, an informational letter for parents and teachers, and a letter to go home with the student.

You can pick up my Fluency Frogs Pack right here! If you download, please leave me some feedback.