Stuttering

Treatment Overview

Stuttering that develops between ages 2 and 7 years is not uncommon and usually resolves on its own. Regardless of whether stuttering is expected to be a temporary condition, treatment can be helpful. Success is more likely to occur if a child gets help during the preschool years.²

Treatment usually includes parent counseling and speech therapy. Specific treatment varies depending on when and whether a child's stuttering is specifically diagnosed as:

• Normal disfluency, which likely will resolve on its own.
• Developmental stuttering, which most often first appears around age 5 and generally requires treatment to improve.
• Acquired stuttering, which develops as the result of brain injury (usually from an accidental injury or a disease that affects the brain, such as Alzheimer's) or, less often, from severe emotional trauma.

Counseling

Parents of children with suspected normal disfluency may benefit from counseling. This therapy strives to educate parents about speech development and how to respond to their child's stuttering in positive ways. Appropriate responses to your child's stuttering can help the child avoid social and emotional problems that can develop. Being supportive of your child also helps prevent stuttering from becoming a more permanent condition.

Speech therapy

Speech therapy for stuttering has a number of different approaches depending on factors such as the person's age, whether stuttering is likely to resolve on its own, and the severity of the problem. Usually, a speech-language pathologist also combines and expands on elements of parent counseling techniques.

The two basic speech therapy methods used for treating stuttering are called indirect treatment and direct treatment.

• Indirect treatment focuses on creating a comfortable and relaxing environment in which the child's speech can improve naturally. A speech-language pathologist evaluates and monitors progress while observing the child and parents.
• Direct treatment is one-on-one personal interaction between a speech-language pathologist and a child who stutters. The speech-language pathologist teaches the child how to form words, speak slowly, and relax even while stuttering. The child can also practice these exercises outside of instruction time. The child also learns ways to eliminate the physical symptoms of stuttering, such as eye-blinking, and how to deal with the emotional difficulties that may result from speech problems.

Other treatments for stuttering are also sometimes used.

• Counseling is often recommended when stuttering is complicated by additional problems, such as anxiety. It is also sometimes used when speech therapy has failed. Counseling and speech therapy are often used together for teens and adults who have developmental stuttering. The longer stuttering is left untreated, the more difficult it is to manage because additional problems frequently develop, such as low self-esteem. Speech therapy alone is unlikely to resolve these problems. Treatment of teens and adults takes longer and is generally less successful than for children.
• Medicines are sometimes used as part of treatment for other conditions, such as depression or anxiety, that can make stuttering worse. Talk to your doctor if you have questions about when medicines may be appropriate.
• Specialized therapies are needed for acquired stuttering, which can happen as the result of brain injury (usually from an accidental injury or a disease that affects the brain, such as Alzheimer's) or, less often, from severe emotional trauma. After a thorough evaluation, a treatment program is specifically designed that often includes some combination of speech therapy, physical rehabilitation, and medicine.

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Author:	Debby Golonka, MPH	Last Updated: August 25, 2008
Medical Review:	Michael J. Sexton, MD - Pediatrics Robert M. Kroll, BSc, MSc, PhD - Speech Pathology
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