Putting It All Together
All Evidence-Based Practice (EBP) stuttering therapies are compatible with all other EBP stuttering therapies. You don’t need to pick one or another. You can and should do all EBP stuttering therapies together.
In contrast, if an SLP tells you that they have the one effective therapy and you must not do any other stuttering therapies, the SLP is a charlatan.
In addition to combining several EBP stuttering therapies, developing fluent speech requires a few more strategies.
Stress Reduction
The first is to read the chapter about stress and dopamine. Therapies intended to reduce demands have not been proven effective (all EBP therapies increase resources available) but I believe that stress-reduction techniques can enhance EBP stuttering therapies. I.e., the combination of reducing demands while increasing resources is a good combination.
Speech Buddies
In eighth grade I had a teacher with a forceful personality. He tried to cure my stuttering. Whenever I stuttered he stopped me, then told me to say it without stuttering. I hadn’t had speech therapy and had no idea what to do. His method was as effective as teaching me Chinese by stopping me from speaking English and telling me to speak in Chinese. He gave up after three days and became my favorite teacher.
Twenty years later I’d completed several speech therapy programs. I’d used DAF devices for several years. I dated a woman who disliked my stuttering. Whenever I started to block, she’d give me a certain look. I’d stop, relax my breathing and vocal folds, and speak fluently.
After a few days with her I was talking fluently all the time. The relationship crashed and burned shortly after that.
For an individual who hasn’t completed a speech therapy program, a person pointing out his stuttering is the worst thing. Such an individual doesn’t have any control over his speech. Telling him to talk fluently increases his stress and his stuttering.
But for an individual who has mastered fluent speech skills, pointing out his disfluencies and reminding him to use fluent speech skills will help him. When you’re at that stage, find someone to do this for you.
A study of school-age stutterers compared speech therapy with an SLP in a speech clinic vs. the parents going to the speech clinic to learn the therapy and then the parents practiced therapy with their children at home every day, vs. using a biofeedback computer at the speech clinic. The children who used the biofeedback device had the best results. Parents were a close second. The SLPs were way back, in last place.
The parents were speech buddies. They corrected their children’s speech in conversations every day.
Adults need speech buddies too. You can’t learn to talk fluently on your own, without seeking help from a speech-language pathologist (SLP). You can’t maintain and improve your fluent speech without a speech buddy. Teach your family, friends, and co-workers to recognize when you begin to stutter. Ask them to remind you to use your fluency skills.
Support Groups
Adults and teenagers who stutter should join an in-person support group. Online support groups can be helpful but many are dominated by negativity.
Talk More!
Stuttering therapy doesn’t work if you don’t talk. Motor learning research suggests that talking three hours for six months is the minimum to change speech motor programs.
For teenagers, have an adolescent psychologist meet with you with your speech-language pathologist (SLP) to help you with dating. Nothing motivates a teenager to talk more than those mysterious creatures of the opposite persuasion.
Adults should ask their supervisor for more speaking tasks, take up a hobby that requires talking (e.g., Toastmasters), or just talk to strangers at every opportunity.
I would recommend Toastmasters. I LOVED Toastmasters!
I was a member of a great group in Worcester, Mass. for 8 years, and attended meetings almost every week during that time. I learned a side of myself that I never knew I had – that I really enjoyed doing public speaking! (within the limited venue of the club – typically 20-25 people attended the meetings).
Over the years I served in almost every office (including club President). I won numerous awards for my speeches, and also found success in speech contests, sometimes competing on a city-wide level. I reached the high rank of Advanced Toastmaster Gold. Sometimes I was fluent (especially in prepared speeches I had practiced a great deal), and sometimes I was quite disfluent – but the club learned that my speech would vary from week to week, and came to expect that.
Occasionally I gave speeches that related to the topic of stuttering, but they were a very small minority of the speeches I gave. I spoke on a great variety of topics.
There is no Toastmasters at all here in western Norway, and I miss it. When I’ve made visits to Massachusetts during the last few decades, I always stopped in at my old Toastmasters club whenever possible.
— Paul Goldstein
Self-Confidence
As learners become more skilled, their confidence in their ability to perform the skill will increase. With increased confidence comes increased motivation to improve further. Consequently, when designing learning experiences, practitioners should ensure that each learner experiences some degree of success during each practice period. (1)
With persons who stutter this increasing self-confidence manifests in their comfort in talking more, especially with strangers. A person who stutters who is shy and avoids talking, after some success with speech therapy, will start to talk a little, and will be more interested in speech therapy, and then will talk more, building a positive loop of self-confidence and fluency.
(1) Coker, Cheryl A.. Motor Learning and Control for Practitioners (p. 155). Taylor and Francis. Kindle Edition.
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