Many preschoolers go through periods of dysfluency where they will stutter off and on for a while.  This happens as their mouths are struggling to keep up with all of the things that their developing minds want to say.  For many children, this stuttering goes away on its own.  For others, they will develop persistent stuttering that will require more therapy.

Here are the “red flags” or warning signs that may indicate that a child is more likely to have persistent stuttering that will require therapy:

• A parent, sibling, or other family member who still stutters
• Stuttering starts after age 3 ½
• Stuttering has been occurring for at least 6 months
• Preschooler is a male
• The child has other speech sound errors or trouble being understood
• The child’s language skills are advanced, delayed, or disordered

Source: http://www.stutteringhelp.org/risk-factors

Stuttering Therapy Activities for Preschoolers

For preschoolers, it’s usually a good idea to begin with indirect therapy as this will promote smoother speech without directly talking about the stutter (which can sometimes upset a child or cause more pressure).  If indirect therapy doesn’t work, or if the child is already upset by his/her stuttering, we can move to direct therapy activities.

Indirect Therapy:

• Identify fast vs. slow speech from the therapist
• Practice using fast and slow speech for the child
• Practice slow, smooth, exaggerated speech

Direct Therapy:

• Identify bumpy vs. smooth in the therapist’s speech
• Practice bumpy and smooth speech for the child
• Identify the child’s speech as bumpy or smooth during play
• Ask the child if his speech was bumpy or smooth
• Response Contingency: Praise/Reinforce smooth speech and provide immediate, direct corrective feedback for disfluent speech (“Oops, that was bumpy, let’s try it again)

Once children enter school, if they are still stuttering then we are ready to start addressing the stuttering directly.  The stuttering therapy techniques you use at this age will depend on what each child needs.  But here are some simple stuttering therapy activities you can use to help children who stutter communicate more easily:

Stuttering Therapy Activities for Elementary School Aged Children:

1. Learn About the Respiratory System

Start by doing a lesson all about the respiratory system.  Use pictures, charts, models, or whatever you have available to you.  Practice inhalation and exhalation, as well as deep and shallow breathing with the students.  Talk about how we speak on exhalations and practice taking a deep breath in and then slowly exhaling while saying a single word.  Gradually increase to speaking in longer phrases and sentences while using gentle exhalations.  Talk about breathing timing during conversations (when to take a breath).

2. Practice Smooth, Prolonged Speech while Playing Games

Take whatever games you have available and practice using smooth, prolonged speech during those games.  For example, you can have children play “Go Fish” and make sure they slow down and elongate their words when asking “Do you have a…”.  Or, you can have them take a turn in a board game and use their slow, smooth speech to describe what happened (ex: “I rolled a four.  I’m going to move four spaces”).

3. Learn About the Types of Stuttering

Help students learn about the different types of stuttering and which ones they do.  Help them identify when they have stuttered and what type it was. Practice the different types of stutters to desensitize them to it.

4. Practice Fluency Shaping Techniques

Practice different techniques that help a child speak fluently for a period of time.  These include slow/stretchy speech, easy onset, yawn-sigh, etc.

4. Teach the Students Stuttering Modification Techniques

Help the students learn the different techniques they can use if they anticipate a stutter (preparatory set), are in the middle of a stutter (pull-out), or have stuttered and can’t move on (cancellations).  Practice demonstrating these while playing games (pretend to stutter so you can use a technique).

Now we’re ready to dive deeper. Older clients who stutter can benefit from learning these stuttering therapy techniques and practicing with these stuttering therapy activities:

Speech Modification (Fluency Shaping) Techniques:

Speech modification (including fluency shaping) strategies (Bothe, 2002; Guitar, 1982, 2013) include a variety of techniques that aim to make changes to the timing and tension of speech production or that alter the timing of pauses between syllables and words. These modifications are used regardless of whether a particular word is expected to be produced fluently. Strategies associated with speech modification include:

• rate control,
• continuous phonation,
• prolonged syllables,
• easy onset,
• light articulatory contact.

Other speech modification strategies, including appropriate use of pausing, are used not only to increase the likelihood of fluent speech production but also to improve overall communication skills (e.g., intelligibility, message clarity, etc.). In addition to being used for improving communication skills, pausing is also an effective method of rate control.

Keep in mind the child may be self-conscious about using these techniques.

Stuttering Modification Strategies (Reducing Physical Tension/Struggle)

• Identify where in the speech mechanism physical tension is and release it.
• Traditional stuttering modification strategies include preparatory set, pull-out, and cancellation and require a child to identify a moment of disfluency before, during, or after it occurs, making adjustments to reduce tension and struggle. The specific strategy that is selected will depend on when the client “catches” the disfluency, whether it be following a moment, in the moment, or in anticipation of the moment of disfluency (Van Riper, 1973).
• These strategies, like speech modification strategies, are introduced along a hierarchy of speaking situations that varies both with linguistic demands and with the stressors of the environment.

Strategies For Reducing Negative Reactions (Personal And Environmental Context)

• Desensitization
• Cognitive Restructuring
• Self-Disclosure
• Support Group (grouping your kiddos who stutter)

Click here to access our guided program for addressing negative emotions for clients who stutter (Inside The Hub)