From the Guidelines
Treatment for stutter speech should prioritize a multidisciplinary approach, incorporating education, symptomatic relief, modification of stuttering behaviors, and psychological support, as outlined in the 2021 consensus recommendations for speech and language therapy 1. The most effective treatment plans for stuttering typically involve a combination of strategies, including education and explanatory approaches, such as reassurance and explanation of the nature of symptoms and good prognosis for resolution, as well as symptomatic relief techniques to reduce excessive musculoskeletal tension associated with stuttering 1. Some key strategies for reducing muscle tension include:
- Reducing muscle tension using techniques similar to those used for functional voice disorders
- Selecting high-frequency abnormal behaviors associated with dysfluencies and addressing them
- Palpating or manipulating facial muscles or lowering the larynx to reduce muscle tension
- Reducing muscular tension in the head, neck, shoulders, and postural alignment
- Eliminating secondary or accessory movements that may involve asking the patient to do something differently or adding a distraction that is faded out as speech normalizes Additionally, modification of stuttering behaviors may involve introducing techniques used for the treatment of developmental stuttering, such as speech restructuring and fluency shaping techniques, including the Prolonged Speech Treatment Model, the Camperdown Programme, or the La Trobe Smooth Speech Clinic Programme 1. Psychological support is also crucial, and may involve communication counseling, addressing abnormal illness beliefs, and teaching the patient to respond to moments of stuttering in more adaptive ways, using less struggle and tension, which can be beneficial both psychologically and physically 1. Referral to mental health professionals for psychotherapy, acceptance and commitment therapy, or cognitive-behavioral therapy (CBT) may also be necessary for treatment of anxiety related to stuttering 1.
From the Research
Treatment Approaches for Stuttering
- Speech restructuring programs, such as the Camperdown Program, have been shown to reduce stuttering frequency by 50-57% in adults who stutter 2
- Cognitive behavior therapy (CBT) can be an effective adjunct to speech restructuring interventions, helping to decrease anxiety and social avoidance in individuals who stutter 3, 2
- The use of electronic devices, such as the SpeechEasy, which manipulate auditory feedback, can also alleviate stuttering in some individuals 4
- Transcranial direct current stimulation (tDCS) has been found to reduce stuttering frequency by 22-27% in adults who stutter, although more research is needed to fully understand its effects 2
Therapy Techniques and Strategies
- Individualized therapy based on each client's unique manifestation of stuttering is beneficial, as fluency-focused stuttering therapy may not be effective for all individuals, particularly those who covertly stutter 5
- Therapy techniques that include explicit goals and activities, personalized selection of techniques or strategies, and self-education can be impactful for individuals who stutter 5
- Educating those in the person's environment about stuttering and its effects can also be helpful in supporting individuals who stutter 5