1.SHAPING STUTTERFREE SPEECH
1.Innitial therapy targetting stutter-free speech
at one or two word level ,when stutterer is
successful the SLP increases the complexity of
2. Altering speaking pattern.
a.Silent / whispered speech/Articula-tory Pantomimming.
c. Slowed & Prolonged Speech.
d. Coral Speaking & Shadowing
e. Easy Onset Method
f. Light contact Method
g. Voluntary sttutering
h. Imitate Stuttering
i. Adronian Speech.
SLP modify the moments of stuttering by
introducing RELAXATION TECHNIQUES
And decreasing stress,effort & struggle.
INTEGRATING STUTTERFREE & MODIFICATION
The SLP benefit from both types of
Some of these devices resemble a
normal hearing aid.Best candidate for
such a therapy is one who has
a.stuttered for a significant period of
b.continue to struggle with stuttering
c. has found speech shaping & other
tra-ditional therapias ineffective.
DAF (DELAYED AUDITORY
Enhanced Vocal Feedback
Frequency Altered Feedback
Use of a Metronome(Rhythmic Speech)
Counseling does not mean ‘lecturing’ the
stutterer rather it refers to providing an
opportunity to explore, verbalize &
express feelings about himself,his
problems,about his therapy about the
process of changing ,about his
expectations & fears about the future.
Direct work with the child.
Parent-Child interaction therapy.
Fluency-Shaping Behavioral Therapy.
Parent & Family Counseling.
1.general excitement level in the home.
2.Fast paced activity
4.Competition for talking time.
5.Social & emotional deprivation.
7.Excessive speech interruptions.
8.Talking attempts aborted by family members.
9.Standards & expectations unrealistically
high or low.
11.Lack of availability of parents
12. Excessive pressure to talk & to perfo-orm.
13. Arguing & hostility among family mem-bers.
14. Negative verbal interaction between
child & family.
15. Use of the child as a scapegoat,or dis-placement of family problems onto the
16. Use of a faster than normal speaking
rate by one or both parents.
2.DIRECT WORK WITH
Directly working on the speech
symptoms in a caring and supportive
This therapy attempts to increase
gradually the child’s tolerance to
stress.The SLP starts with play activity
that reduces disfluency to its lowest
level,The SLP keeps as many stress
factors as possible out of the activity.A
typical desensitization session involves,
1.Eliminating talking altogether
2 Not asking direct questions
3. Silent parallel play
4 Maintaining a slow pace of interaction
5 Maintaining a low excitement level .
6 While not playing avoidind stressful
4.Parent –Child Verbal
The assumption is that childhood disfluencies
develop in respones to parent-child verbal
interaction.The SLP will observe such behavior
in a non-formal setting then can mirror image
the process doing just the opposite of what the
parent did following instances of disfluency.
When child’s disfluency reduced to 1% or
less,parents are introduced into the therapy to
learn more positive forms of
Of verbal interaction with their child and
to use them at home.
5.Parent & Family
Identifying and changing some family
behavior patterns,by making them
understand how their behavior & feelings
interact with the child.
Sometimes the SLP feel child’s speech
within boundries of normal disfluency,but
anxiety &concern of parents persists.
This is a very critical phase of therapy .In
this regard after reducing stuttering to a
minimal level the person practices these
new skills in a non-clinical
environment.This is called transfer and
maintaining these new skills is called
FOLLOW - UP
Follow up is very important to help
maintaining the new learned skill.
Innitialy on alternate days,then twice
aweek ,then once a week, then once
after every week,then once a month for