About treatment for stuttering

Researchers and speech pathologists at the Australian Stuttering Research Centre recommend starting treatment as soon as possible after a child begins to stutter. This is because research has shown that even very young children can receive negative reactions about their stuttering from other children, which can lead to the development of social anxiety. It is now known that children who stutter are at risk of feeling anxious about talking in social situations when they are as young as 3 years of age.

For children younger than 6 years of age who are stuttering, there are three therapy approaches that are supported with evidence from randomised clinical trials. These are the Lidcombe Program, RESTART-DCM, and syllable-timed speech approaches such as the Westmead and Oakville Programs. The strongest research evidence is for the Lidcombe Program.

The Lidcombe Program involves a speech pathologist instructing parents in how to give verbal feedback to their children about their speaking. It also involves daily, one-on-one talking activities between parent and child. Progress through the treatment is guided by parent measures of stuttering severity using a 10-point scale where 0 = no stuttering and 10 = extremely severe stuttering. The Lidcombe Program treatment goal is attaining severity ratings of 0 or 1. The treatment can be delivered in a clinic or by video telehealth.

The time taken to complete the Lidcombe Program varies from child to child. It is common for children to take several months to attain no stuttering or almost no stuttering. However, it is important that some improvement occurs shortly after treatment begins. More information about the Lidcombe Program can be found on the Lidcombe Program Trainers Consortium website.

RESTART-DCM is a different style of treatment from the Lidcombe Program. It is based on a method of understanding stuttering in young children, using the Demands and Capacities Model. This model states that stuttering is associated with aspects of the family environment that place demands on the child’s speech. RESTART-DCM treatment involves parents alleviating these demands. Some examples are not interrupting children when they speak, speaking to them with a calm voice, not imposing language demands on them, and having an unhurried lifestyle. If it is thought necessary, the treatment also involves directly working with the child’s speech, such as reducing speech rate or applying speech drills to train speech movements. As with the Lidcombe Program, the treatment can require several months for the child to attain no stuttering or almost no stuttering.

With syllable-timed speech treatments, which include the Westmead and Oakville Programs, the parent and child speak in a rhythmic way together using equal stress across all syllables. This is a well-known technique to stop or minimise stuttering temporarily. Research has shown that with children, the fluency achieved while practising syllable-timed speech transfers to natural speech. The aim is not for the child’s speech to sound rhythmic after treatment. In addition to practising syllable-timed speech, the Oakville Program includes positive feedback for stutter-free speech. 

Because of its simplicity, the Westmead program can be used with very young children, shortly after they begin to stutter. The Oakville Program is more often used with older children, including those of school age. In both programs, when no stuttering or almost no stuttering has been attained in natural conversation, regular practice with the technique is gradually withdrawn.

If you have concerns about your child's stuttering, please contact a speech pathologist.

For older children who stutter, the treatment approaches described above may be successfully adapted. In addition, speech pathologists may also adapt treatments that are used with teens and adults who stutter. A speech pathologist can determine which treatment approach is best for the individual child and family. The speech pathologist also typically works with the child’s school teacher, and other school staff, to support the child during time at school.

If you have concerns about your child's stuttering, please contact a speech pathologist.

Research shows that around half of adults and teenagers who seek clinical assistance for their stuttering wish to have some control over the condition. The treatment with the best evidence for that is commonly called speech restructuring. Speech restructuring involves learning to speak by changing the customary speech to minimise stuttering. Although the technique requires some effort, people who stutter find that it can make a big difference to their lives. It has been used for decades.

In speech-restructuring treatment, people are first trained to use the speech technique in a slow and exaggerated manner. They then increase speech rate and learn to sound as natural as possible while still controlling stuttering. The technique is learned from a qualified speech pathologist first, and then people continue to use the technique to control stuttering in everyday speaking situations.

Researchers at the Australian Stuttering Research Centre and colleagues around Australia have developed a speech-restructuring technique called the Camperdown Program. A randomised controlled trial showed that this method of treatment can be delivered effectively by a qualified speech pathologist via or telehealth. In other words, the client and speech pathologist can be in different locations, even in different countries, for the delivery of the program. Teenagers particularly like this because they are comfortable using digital devices in their everyday lives.

Adults and teenagers who stutter commonly experience anxiety about speaking, known as social anxiety. Anxiety of this type can impact on job performance and participation in social activities. Also, having social anxiety can make it difficult to control stuttering when using speech restructuring. For all these reasons, we recommend treatment for social anxiety if those who stutter experience it.

The therapy of choice for social anxiety is cognitive behaviour therapy or CBT, which is a well-established psychological approach. CBT is based upon the relationship between thoughts, feelings, and behaviours. The therapy focuses on thoughts and behaviours that are causing distress or interfering with life. Therapy teaches elimination of avoidance behaviours, confrontation of fears, and changing negative or unhelpful thinking patterns.

The Australian Stuttering Research Centre team has developed a standalone internet treatment, called iGlebe, specifically to treat the social anxiety of those who stutter. This digital platform provides treatment for social anxiety without the need for a clinical psychologist or a speech pathologist. The iGlebe treatment is available to the public free of charge.

If you have concerns about stuttering or stuttering related anxiety, please contact a speech pathologist or psychologist. 

Access iGlebe for free