As speech pathologists who specialize in stuttering, it’s a question we get a LOT.
It sounds so straight-forward, right? As creatures of organization, we SLPs feel pressure to have a helpful answer. Shouldn’t we have a set of “homework assignments” on hand, ready to deploy? Some "speech tools” to practice? There’s got to be a worksheet or a sticker chart for this stuff, right?
The problem of Doing Too Much
The truth is, our clients often enter into therapy with too many mechanics going on. In fact, their voices have become buried in mechanics, paved over by physical processes programmed over time. Faced with the constant anticipation of stuttering, as well as a growing fear of certain speaking situations, children's bodies can adopt reflexive clenches of "self-preservation." It's a natural fight-or-flight response, intended to mitigate threat, but one that grows more unhelpful over time. We see this process in action when physical struggle behaviors emerge (the clamping of lips, the squeezing shut of eyes), as well as in the elaborate choreography of “tricks” used to postpone or dodge the stutter (word-switching, foot tapping, the silent rehearsal of certain phrases). Over the years, the constant vigilance of trying to keep the stutter at bay adds layers of avoidance behaviors and physical reactions. It becomes an exhausting, overwhelming load to bare.
So the last thing we want to do is to pile on yet more movement, more stress, more things to think about in the moment. In fact, one of the earliest phases of the AIS process is to try to unburden clients from this load, to peel the onion of struggle and get to their core stutter; to help them get to their authentic voice.
We absolutely can work on the physical aspects of the stuttering experience, but this style of therapy takes time. It requires finesse, a tolerance for nuance, and plenty of room to unfold. All things most school SLPs—and parents—don’t have the luxury of having. So it’s tempting to instead Google “speech exercises for kids who stutter,” grab two or three measurable targets, and "practice" your way out of the problem.
So in an effort to save all of us well-meaning adults from adding more layers to the stuttering onion, we’ve decided to put out a list of what NOT to do if you have a child in your life who stutters.
Top speech exercises to NOT do with children who stutter
1. Praise fluency/"correct" a stuttering moment
Let's start with the trickiest one!
We get TONS of questions from parents and SLPs about how they should respond to specific moments of speech, either particularly fluent OR disfluent. Should we call the child's attention to his stuttering? Praise the moments of fluency? Ask them, after a particularly tense block, to "try that again, the smooth way"?
Here's the thing: we could write volumes on the pros and cons of using Lidcombe-style verbal contingencies with kids who stutter. But let's keep it simple: The problem is the messaging. We in no way want to convey to a child, either explicitly or implicitly, that "we like you better when you are fluent." Why? Because we know that 20-25% of these children won't "grow out of it."
Some degree of disfluency will persist, possibly as a function of a genetic predisposition. So to suggest that fluency is unequivocally superior and should be maintained as consistently as possible...well, it can put a child's body in conflict with itself. Praising fluency means that even gentle moment of stuttering must be considered a "threat."
So we're revving up the nervous system to react, giving fuel to those avoidance and struggle behaviors. Worse still, we're planting the seeds of shame. Many of our adult clients tell us they spent entire childhoods trying desperately to "fix" their stutter at home and at school—and beating themselves up when it didn't work, doubling down on their resolve to fight or avoid at all costs.
2. Oral-motor exercises
Drinking from a straw? Bite tubes and jaw strengthening? Tongue push-ups?
There is no evidence to support the efficacy of oral-motor exercises for children who stutter.
3. Tapping, speaking with a metronome, and any other form of “robot talk"
Can. You. Im. Mag. In. Talk. Ing. Like. This. All. The. Time?
Speaking in a lockstep manner like this has long been known to reduce the frequency of stuttering. But who on earth would want to talk like that? It’s unnatural sounding, at the very least, but also wildly effortful, and only takes kids further away from their spontaneous, authentic voice—and the joy of talking in general. It also turns prosody, the musical rhythm of speech, into an enemy. And these days, scientists are busy demonstrating how utterly essential prosody is to the experience of human interaction.
Another danger: when a child is coached to tap a finger in time with his speech, these finger movements often become more pronounced over time, adding yet more unhelpful movements to the stuttering pattern.
4. Humming, singing, and other voice exercises
Similar to robot talk, these methods of “keeping your voice on,” stitching the breaks between words together with hums and vibrations, can be an unnatural, effortful way to talk. As with most “fluency-shaping” techniques, research tells us that these techniques are nearly impossible to perfect, often perceived as sounding "weird," and fall apart in real-life speaking scenarios, when people most want to be fluent. As a trick, it's tempting in certain situations. But it's not a sustainable solution. And when it fails to work—usually in that moment when you needed it most—it only amplifies the fear and anticipation of the next stuttering moment.
5. Breathing exercises
It is common for children who stutter to have a sensation of “running out of air” in the midst of a block. It’s also common for a slight gasping or gulping of air to be a feature of someone’s stuttering pattern. While it’s true that some children who stutter may be unknowingly clenching or pushing their diaphragm, as a panic response to the feeling of loss of control, it can be counter-productive to have them focus intently on their breath while speaking.
Telling a child who stutters to "just breath" feels a lot like telling them to "just use your tools"—and trying to scrutinize and manage breathing in the midst of a stuttering moment often amplifies the panicky thought that "I should be able to mitigate this!" and "Oh no, my tricks aren't working!" Which you puts you back in that heightened mode of stuttering anticipation.
Breathing can be used as a simple relaxation or meditation technique, or as a way to ground the child more solidly in their body. But as an exercise or practice, we tend to keep this separate from activities involving spontaneous speech.
If you're a parent or SLP confused over do's and don't's, by all means, please reach out to us. We can give you actionable, concrete steps to make your interactions more suitable for a stuttering child. Things like reducing time pressure, asking fewer questions, making turn-taking more explicit, and keeping language at the child's level are some supports that can be used to help children who stutter.
But for now, we'll leave you with this: Above all else, simply value what they say.
At every opportunity, turn off the fluency monitor. Emphasize that you're listening to what your child is saying, that what they have to say is important—and that they have all the time in the world to say it. Read a book together. Arrange for some special, one-on-one time. Practice full listening. Anything you can do to model that speaking and conversation is fun.
The term "speech exercises" implies that talking is always going to be a chore. And who wants more chores?
The American Institute for Stuttering is a leading non-profit organization whose primary mission is to provide universally affordable, state-of-the-art speech therapy to people of all ages who stutter, guidance to their families, and much-needed clinical training to speech professionals wishing to gain expertise in stuttering. Offices are located in New York, NY, Atlanta, GA, and Minneapolis, MN, and services are also available Online. Our mission extends to advancing public and scholarly understanding of this often misunderstood disorder.