Supporting a Child Who Has Mild to Moderate Stuttering
Hello, my name is Kela a second year graduate student at SFASU.
As someone who is learning more about fluency disorders, I’m curious about how professionals balance building fluency skills with supporting a child’s confidence and comfort with their stutter.
For children who present with mild to moderate stuttering, what strategies or approaches do you find most effective in helping them transfer fluency techniques into natural conversation, without increasing pressure or reinforcing the idea that “fluent speech is the goal”?
I’d also love to hear how you encourage self-advocacy and emotional resilience at this stage of development.
Thank you for taking the time to share your expertise and experiences.
Dear Kela,
Thank you so much for your thoughtful question. I truly appreciate your interest in supporting not only fluency development but also crucial components such as self-advocacy and emotional resilience. It is very encouraging to see a graduate student who values these aspects of working with children who stutter.
I would warmly recommend the following resource as a starting point: Byrd, C. T. (2024). Blank Center CARE Model: Application for School-Age Children Who Stutter. Dream. Speak. Live Publications.
Additionally, I strongly encourage exploring the literature on stutter-affirming therapy. It is important to consider whether fluency techniques are truly what a child wants and needs, or whether it may be more beneficial to focus on communication competence, advocacy skills, acceptance, and open stuttering. Some key publications in this area include:
• Constantino, C. D. (2023). Fostering positive stuttering identities using stutter-affirming therapy. Language, Speech, and Hearing Services in Schools, 54(1), 42–62. DOI: 10.1044/2022_LSHSS-22-00038
• DeThorne, L. S., & Gerlach-Houck, H. (2023). Resisting Ableism in School-Based Speech-Language Therapy: An Invitation to Change. Language, Speech, and Hearing Services in Schools, 54(1), 1–7. https://doi.org/10.1044/2022_LSHSS-22-00139
• Gerlach-Houck, H., & Constantino, C. D. (2022). Interrupting ableism in stuttering therapy and research: Practical suggestions. Perspectives of the ASHA Special Interest Groups, 7(2), 357–374. https://doi.org/10.1044/2021_PERSP-21-00109
• Gerlach-Houck, H., Kubart, K., & Cage, E. (2023). Concealing Stuttering at School: “When You Can’t Fix It… the Only Alternative Is to Hide It”. Language, Speech, and Hearing Services in Schools, 54(1), 96–113. https://doi.org/10.1044/2022_LSHSS-22-00029
• Reeves, N. A., Flynn, T. W., & Schuff, R. Z. (2023). Ableism to empowerment: Navigating school structures when working with students who stutter. Language, Speech, and Hearing Services in Schools, 54(1), 8–26. https://doi.org/10.1044/2022_LSHSS-22-00026
• Reeves, N. A., & Yaruss, J. S. (2025, January). Toward Stutter-Affirming Therapy. The ASHA Leader Live.
• Sisskin, W. (2022). Disfluency-affirming therapy for young people who stutter: Unpacking ableism in the therapy room. Language, Speech, and Hearing Services in Schools, 54(1), 114–119. https://doi.org/10.1044/2022_LSHSS-22-00015
These resources provide excellent guidance for supporting children in developing confidence, advocacy, and positive communication identities, instead of focusing on fluency. Thank you again for your thoughtful inquiry, and I wish you the very best as you continue exploring these important areas of practice.
Warm regards, Kasia
Hi Kela!
Thank you so much for your question!
As a speech-language therapist working with persons who stutter, balancing speech- and communication skills with confidence and self-acceptance is very important. I will share some strategies which I find useful myself.
Emphasize the importance of effective and authentic communication rather than perfect speech. Reinforce that stuttering is just one part of who they are and not something to be ashamed of.
If the person wants to focus on speech, then integrate awareness towards speech gradually. Increase the curiousity and awareness towards ways the person may use the voice and body language more effortlessly. Explore voice- and speech adjustments in supportive and safe environments, then gradually increasing the complexity. Provide a safe space for practice where the persons feel comfortable experimenting with his or her speech. Encourage spontaneous speech to help the person to transfer the skills to natural conversation, and model patience and acceptance in conversations, demonstrating that it’s okay to stutter and take your time while speaking. Teach the persons to self-advocate, such as for example by expressing that the person needs extra time or explaining what helps the person to communicate more effectively. This may empowers the persons in various social and academic settings. Offer emotional support by acknowledging any feelings of for example frustration and anger. Use stories or activities that foster resilience and a positive self-image.
Another important aspect is to work closely with parents, other family members and/or teachers to create a consistent and supportive environment. This ensures that everyone in the persons’s life is on board with the approach and knows how to support the persons’s communication. Encourage and praise efforts in different and authentic ways (which may include both dysfluent and fluent moments) to build confidence. Reinforce that the person is valued as an important communicator no matter what!
By focusing on these areas, it is a hope that the persons may develop effective communication skills rather than striving for fluency.
Best wishes from
Hilda
Hi Kela,
Great to see you here!
I think you’ve already got some amazingly helpful responses from my fellow panellists and their recommendations.
I really like that you’re keen to encourage self-advocacy and emotional resilience. For me, this is one of the key things to be fostering at all ages and stages of therapy. A couple of ways to do this, could be:
– Being open about stuttering and talking about it with young people using neutral, affirming or positive language
– Helping people know more about stuttering, such as what it is, the causes, it’s variability – I think this can be empowering
– Having a network of people around the child who also does and knows these things
– Connecting young people with others who stutter
– Enabling young people to be independent – to do things for themselves, say things for themselves, helping caregivers let go and not feel the need to save and protect their child
– Valuing and praising their communication regardless of the amount of stuttering
I also admire your curiosity about balancing building fluency skills with supporting a child’s confidence and comfort with their stutter. For me, the two can’t ever go hand in hand. How can we tell a child that they need to stutter less/not at all whilst helping them feel confident and comfortable with their stuttering at the same time? It’s a conflicting message! I’m a therapist who values and appreciates stuttering, so in my therapy, I’m keen to honour stuttering. I’d never want to suggest to a person that their voice isn’t okay the way it is and needs to change. I really like the work of referenced by Kasia, above, for helping us understand why this is detrimental to well being and can have an adverse impact on quality of life.
This doesn’t mean however, that I believe that speech change, building comfort and confidence can’t go hand in hand. This may sound confusing. I think it helps if we separate the stuttering from the struggle. We can support our clients to let go of the struggle associated with stuttering, including the physical struggle that may manifest in their speech. They can move towards stuttering, letting go of the effort, tension, and things they may have leant to try and minimise their stutter. (All natural reactions/responses, given the overt and more subtle responses they may have received from others). Again, the references, above can help!
Enjoy the rest of your studies,
Nic