Expert Preschool Stuttering Therapy Techniques that Get Results

You’re back in grad school.  Classes are intense.  Clinicals are overwhelming.  The amount of coursework expected of you is not doable by any human, and you’re wondering if the stress of it all will ultimately be your demise.

Sound familiar?  Here’s what I want to know.  How is it that with all of that work, we were still not well-prepared for certain aspects of our jobs?  Preschool stuttering therapy is an area I wish I’d gotten more experience in.  Though I had several fluency clients, none of them were preschool-aged.  When I got my first preschool fluency client, I pulled out the books to research on my own.

Since that first client, I’ve seemingly had a preschool fluency case every year of my career.  So, all that researching paid off!  Today, I’m here to share some of my favorite preschool stuttering therapy techniques I’ve learned along the way.  

1. Preschool Stuttering: Indirect Therapy

Indirect therapy involves modifying the child’s environment rather than working directly with the child.  In these cases, you are educating parents. And you’re facilitating fluency through modifications to the home environment and parents’ speaking patterns.

You want to provide parents with information, tips, and strategies to reduce stressors and place less pressure on the child.

When to use: We often implement indirect therapy when the preschooler is not aware of and not frustrated by their stuttering.  Usually, we try this approach first when there are very few risk factors in a child’s situation.

Resources I recommend: Since most indirect therapy involves educating the parent, we want to be sure and provide them with easy-to-implement ideas and handouts.  Here are a few resources that I use.  And bonus!  These are all free!

• Articles/brochures from The Stuttering Foundation – I like “If You Think Your Child is Stuttering” as well as “7 Tips for Talking with Your Child.” Both provide parents with a great starting point for dealing with stuttering.
• Handy Handouts from Super Duper
• Free Parent Handouts for fluency 
• Fluency through Play Handouts

It’s also important to have face-to-face (or virtual) conversations with parents.  You want to be able to create a plan to provide individualized strategies for their specific family situation. 

2. Preschool Stuttering: Direct Therapy

Direct therapy targets the child’s individual speech behaviors in the moment.  This treatment can be SLP-directed or parent-directed.  So, either or both the SLP and parents can target the speech disfluencies.

Some examples of direct therapy might be modeling reduced rate, pausing, relaxed breathing techniques, etc.

When to use: We often use direct therapy when a child is aware and/or frustrated by their stuttering.  It could also be recommended if there are significant risk factors for long-term stuttering.

Resources I recommend: The Lidcombe program is a direct therapy program. It’s based on operant conditioning through giving verbal feedback.  It’s research-based and proven to be effective.

• The Lidcombe resource guide is free to download!
• Color Me Fluent by Super Duper – This program is mostly direct therapy and promotes the learning of correct and exaggerated speech patterns.  I like that this comes with manipulatives for hands-on learning and visual feedback. 

3. Comprehensive Approach

The comprehensive program involves parent education, reducing stressors, and directly working on speech fluency, decreasing tension, and developing healthy attitudes.  It’s kind of a combination of direct aspects and indirect aspects of therapy.

When to use: Because this includes using both aspects of therapy, portions of this approach can be incorporated at any point. 

Resources I recommend: The work and research done by J. Scott Yaruss and Nina Reeves are my favorites for the comprehensive approach.  I love that they promote treating the whole child- attitudes/emotions, family counseling, and fluency.  Here are my favorite preschool stuttering resources based on this model:

• Early Childhood Stuttering Therapy: A Practical Guide
• Preschool Interactive Stuttering Binder – This binder was based on the research behind the comprehensive approach.  It includes components for parent education, feelings/attitudes, speech mechanism education, strategy practice, and feedback.

4. Pro Tips!

A few more tips I recommend when working with preschoolers who stutter:

• Make sure you get a thorough case history!  It’s important for identifying risk factors and environmental changes that need to be made.  
• Observe the child in multiple environments if possible. 
• Take advantage of the free fluency cheat sheets!  These at-a-glance cheat sheets contain lots of fluency information, strategies, and ideas for therapy. Now you don’t have to try and keep all that information in your head.

I hope these preschool stuttering therapy techniques will start you off strong with your preschoolers!  Don’t forget to grab you some freebies!

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