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For those who stutter, the journey to confident communication can be challenging, but with the right support, significant progress is possible. One of the most crucial elements in this support system is the collaboration between Speech-Language Pathologists (SLPs) and the  National Stuttering Association (NSA) . This partnership plays a pivotal role in providing comprehensive care and fostering a supportive community for people who stutter.   Holistic Support and Expertise The expertise of SLPs is greatly enhanced when they collaborate with the NSA, an organization dedicated to supporting people who stutter and educating the public about stuttering. The NSA offers a wealth of resources, including support groups, educational materials, and events that provide invaluable opportunities for learning and connection. By working together, SLPs and the NSA can ensure that people who stutter receive clinical, emotional, and social support. Collaborative goal setting between the individuals and the SLP can lead to a successful outcome.   Access to Resources and Continuing Education The field of speech-language pathology is a dynamic landscape that is continuously emerging. The National Stuttering Association (NSA) plays a crucial role in spreading this evolving knowledge by organizing conferences and workshops that feature leading experts in stuttering research and therapy. In addition to events, the NSA offers a wide range of resources, including webinars, publications, and support networks, which SLPs can leverage to stay informed and enhance their practice. These resources provide SLPs with an environment to continually refine their skills, ensuring they can best serve their clients.   Community and Peer Support One of the most significant benefits of the NSA is the sense of community it fosters among people who stutter. This supportive network can be a powerful complement to speech therapy. Individuals who stutter often find solace and encouragement in connecting with others who share similar experiences. Support groups and events organized by the NSA provide a safe space for people to share their stories, challenges, and successes. SLPs who encourage their clients to engage with the NSA community can help them build a strong support system, which is an asset while navigating the emotional and psychological aspects of stuttering. This peer support can enhance the therapeutic process, providing motivation and reducing feelings of isolation.   Advocacy and Public Awareness The NSA plays a vital role in advocating for the rights and needs of people who stutter. Through public awareness campaigns, educational programs, and advocacy efforts, the NSA works to dispel myths and reduce the stigma associated with stuttering. SLPs can amplify these efforts by collaborating with the NSA, participating in advocacy initiatives, and educating their communities about stuttering. By joining forces, SLPs and the NSA can create a more inclusive society where individuals who stutter are understood and supported. This collaborative effort not only benefits those who stutter but also promotes a greater understanding of verbal differences among the public.   Conclusion The collaboration between Speech-Language Pathologists and the  National Stuttering Association  is a powerful alliance that enhances the support available to people who stutter. By working together, SLPs and the NSA can provide comprehensive care that addresses the emotional and social aspects of stuttering. This partnership ensures that people who stutter receive the best possible support, empowering them to communicate confidently and live fulfilling lives. Through continued collaboration, ongoing education, and a shared commitment to advocacy, SLPs and the NSA can make a lasting impact on the lives of individuals who stutter and contribute to a more understanding and inclusive society. Nicole Kulmaczewski, MS, CCC-SLP

While there is currently no cure for stuttering that works consistently, across time, for all people, there are various options that may help people who stutter. Some methods focus on promoting confident and effective communication, facilitating desensitization to stuttering, practicing mindfulness, modifying speech, and/or exploring stuttering acceptance. Like any good treatment, help for people who stutter should be tailored to the individual. In other words, what works for one person who stutters may not work for everyone! There is No Cure for Stuttering There is no single technique, device, or medication that will cure stuttering. People who continue to stutter through early childhood will likely stutter in some way for the rest of their lives. It is commonly assumed that stuttering is controllable, but this is unlikely without a significant, and likely unwanted, amount of physical and mental effort.. Research indicates that stuttering is caused by neurophysiological differences in the brain. Although people who stutter may speak differently than people who do not stutter, they are just as capable of being effective communicators without needing to impose uncomfortable effort on their speaking pattern. What Speech Therapy Can Look Like for Young Children Most clinicians would agree that early intervention is best for supporting young children who stutter and their families. When potential stuttering is identified in a young child, they should be referred to an SLP for a comprehensive evaluation that focuses not only on behavioral examples of stuttering, but also potential impact and frustration experienced by the child. Research suggests that while early intervention programs may not influence whether stuttering persists into adulthood, it may help to facilitate a healthy perspective and reaction to stuttering. Working with an SLP can help children and caregivers self-advocate as well as cope with any negative reactions and/or avoidance of speaking situations that children may experience. Early intervention can also help young children who stutter develop a positive communication attitude and effective communication skills. Fluency Shaping Treatment for stuttering that emphasizes reducing disfluent speech is generally known as fluency shaping. To use fluency shaping strategies, a person who stutters would work with a speech-language pathologist (SLP) to change the way they speak. The goal of fluency shaping is to eliminate stuttering events and speak fluently. Some therapies use assistive devices, such as delayed auditory feedback (DAF), to assist in this effort. While delayed auditory feedback and fluency shaping programs may work for some people who stutter, not all find them helpful or easy to maintain over time. With a focus on eliminating stuttering, these methods may overlook underlying emotions and attitudes that contribute to communication difficulties and make communication more effortful and less comfortable or spontaneous. Stuttering Modification Stuttering modification is a therapy approach developed primarily by Charles Van Riper in the mid-20th century. Unlike fluency-shaping techniques (which aim to reduce or eliminate stuttering by teaching new speech patterns), stuttering modification focuses on changing how  a person stutters , making moments of stuttering easier and less tense. While fluency shaping methods center on eliminating stuttering, other treatment options focus on limiting its impact . One method, known as stuttering modification[1], involves identifying and adjusting disfluencies when they occur. An SLP using stuttering modification aims to help a person who stutters reduce their physical tension, overcome their fear of speaking, and utilize tools to produce speech in a way that feels more comfortable and natural to them. Stuttering modification includes education and counseling for the person who stutters, with the goal of decreasing anxiety when speaking. It can also include techniques for changing stuttering moments as they occur—making them shorter and less tense. Stutter-Affirming Treatment Approaches These treatment approaches encourage autonomy, acceptance, advocacy, and pride by conceptualizing stuttering as part of one’s identity rather than a deficit. Stutter-affirming treatment approaches encourage choice of treatment, peer-to-peer relationships among children or adults who stutter, and may utilize strategies such as self-disclosure, voluntary stuttering, and communication competencies unrelated to speech fluency. Goals may focus on stuttering openly and sharing about stuttering with others, rather than attempting to change one’s speech patterns. Alternative Stuttering Treatments Alternative treatments for stuttering (those other than speech therapy) are popular, and while some can be helpful, others are nothing more than “digital snake oil.” Ranging from motivational courses and vitamins to Botox injections, a 2002 survey conducted by the National Stuttering Association  showed that adults who stutter reported trying an extraordinary variety of treatments. To read more about alternative treatments for stuttering and their reported efficacy, visit the   Alternative Treatments for Stuttering page on our website. It is recommended to review these alternative treatments with a critical eye given to a ranging evidence base; and remember, there is no evidence-based cure for stuttering. What Makes Treatment Successful? Most importantly, successful treatment should help people who stutter overcome negative feelings, reduce stress surrounding speaking, participate in activities, and improve their overall quality of life. While many treatment programs utilize a combination of the methods described above, an SLP may encourage self-advocacy, incorporate counseling strategies, and should promote family training in their treatment of stuttering. Choosing to participate in speech therapy is an important and highly individual decision. As a resource, the NSA  provides basic guidance and links to find a therapist . Support Groups Help Stuttering support groups such as our Local NSA Chapters can provide key information, a supportive environment, and community for people who stutter. The advantages of attending a support group include the ability to gain new perspectives on the stuttering journey, speak freely without judgment, and help others understand their stuttering. Many people who attend support groups or the NSA’s Annual Conference report increased confidence when speaking and comfort in feeling they are not alone. To find a support group in your area, check out our Local NSA Chapter Directory . To Sum It Up Ultimately, the success of any one treatment for a person who stutters can depend on their individual goals, feelings, and attitudes toward their stuttering at the outset, and to be considered successful, should improve the overall quality of life for the person who stutters. Regardless of if or when or if you choose to seek treatment for your stuttering, remember: If You Stutter, You’re Not Alone ! [1] Medina, A. M., Almeida, N., Amarante, K., Martinez, N., & Prezzemolo, M. (2020). Adults Who Stutter and Their Motivation for Attending Stuttering Support Groups: A Pilot Study. Perspectives of the ASHA Special Interest Groups, 5(1), 142-154. [2] Constantino, C. D. (2023). Fostering positive stuttering identities using stutter-affirming therapy. Language, Speech, and Hearing Services in Schools, 54(1), 42–62. https://doi.org/10.1044/2022_LSHSS-22-00038 [3] Byrd, C. T., Winters, K. L., Young, M., Werle, D., Croft, R. L., Hampton, E., Coalson, G., White, A., & Gkalitsiou, Z. (2021). The communication benefits of participation in Camp Dream. Speak. Live.: An extension and replication. Seminars in Speech and Language, 42(2), 117–135. https://doi.org/10.1055/s-0041-1723843 Original material provided by: Leslee Dean, M.A. in Latin American Studies, MS-SLP student at Florida International University and Angela M. Medina, Ph.D., CCC-SLP. Revisions provided (01.2024) by Caitlin Franchini, MS, CCC-SLP and Megan M. Young, ABD, CCC-SLP.

What is Stuttering? Stuttering  is a natural variation in speech  in which the timing and flow of spoken language include moments of repetition, prolongation, or blocking  of sounds and words ( ASHA, n.d. ; Tichenor & Yaruss, 2019 ). These moments are simply examples of the many ways humans produce speech. Commonly Observed Features Repetitions  – repeating sounds, syllables, or words (e.g., “I-I-I want to go”). Prolongations  – stretching out a sound (e.g., “ssssun”). Blocks  – pauses where speech momentarily stops, usually with a build up of internal and/or external muscle tension, even when the speaker knows what they want to say. These variations may occur more often when someone is excited, tired, feeling pressure to speak quickly, or navigating certain environments ( ASHA, n.d. ). Stuttering is not only about what can be heard—it can also involve: Physical movements  like eye blinks, facial tension, or shifts in posture that may accompany moments of stuttering ( Yaruss & Quesal, 2004 ). Feelings and thoughts  about speaking, shaped by personal experiences and societal attitudes. Some people who stutter feel comfortable and confident speaking; others may experience anxiety or frustration in unsupportive contexts ( Boyle, 2013 ). Communication choices  such as word substitutions or avoiding certain situations—often not because of stuttering itself, but because of how others may respond to it ( Tichenor & Yaruss, 2019 ). Varieties of Stuttering While every person’s speech is unique, stuttering may be described in terms of how and when it begins: Childhood-Onset Stuttering  – often begins between ages 2–5 during speech and language development ( Yairi & Ambrose, 2013 ). Neurogenic Stuttering  – may appear after neurological changes such as brain injury or stroke ( Theys et al., 2024 ). Functional Stuttering  – rare, and often linked to psychological or emotional events ( NIH, n.d. ). Causes of Stuttering Stuttering is a complex condition with multiple possible causes and cannot be attributed to talking too fast nor feeling nervous. Developmental stuttering is neurological, not psychological in origin; affecting areas of the brain responsible for speech and language. Stuttering may present in isolation or with speech and language disorders. ADVISING CAREGIVERS Misconceptions about stuttering are prevalent, and as a result, parents and caregivers frequently feel responsible for their child’s stuttering. It is crucial for physicians to convey to caregivers that they are not to blame and to emphasize the available options to support children who stutter and their families. SPEECH THERAPY FOR CHILDREN For young children, speech therapy includes supporting the child and their family in preventing negative emotional responses to communication and social connection because of stuttering. For older children and adolescents, treatment addresses the continuation of reducing negative reactions to stuttering as well as tailoring therapy to the specific needs of the child to empower them and create positive experiences with social communication. EARLY IDENTIFICATION Guidance regarding when to refer to a Speech-Language Pathologist (SLP) can be found in an evidence-based screener such as the Childhood Stuttering Screening for Physicians ( CSS-P ), which helps to identify early stuttering impact. Relying on observation of a child stuttering is not indicative of stuttering severity or whether therapeutic intervention is warranted. Factors such as caregiver concern, physical tension, and awareness or frustration can help families decide if they want to pursue therapy.  EARLY INTERVENTION Up to 75% of preschool children who stutter recover naturally, leading some physicians to adopt a wait-and-see approach before recommending therapy. Identifying children at risk of persistent stuttering and having them be seen by an SLP can reduce the challenges associated with stuttering. Identifying and implementing a treatment plan early can reduce the risk of negative emotional reactions. SLPs certified by the American Speech, Language, and Hearing Association (ASHA) diagnose and treat stuttering. To find an SLP in your area, including those specialized in treating youth, contact the NSA.

Please review our brochure for detailed information. An Individualized Education Program (IEP) is a legally binding plan under the Individuals with Disabilities Education Act (IDEA) that outlines the specialized instruction, supports, and services a student with a disability needs in order to access a free appropriate public education (FAPE). For a child who stutters, an IEP ensures that their communication needs are recognized and that they have equal opportunities to participate in the classroom and school environment. Preschool Parents or preschool teachers usually refer preschool children for assessment due to concerns about stuttering negatively impacting a child’s day to day life. In general, the parent contacts the services coordinator at the school district to schedule screening. The child is screened by a team that includes preschool teachers and speech-language pathologists or assistants. They conduct screening in all developmental domains (cognitive, motor, social/emotional, self-help/adaptive behavior, and communication). Vision and hearing screening are also conducted. Based on the child’s performance and/or the parents concerns, the child may be referred for further evaluation. Parents are advised of their rights to due process, including the fact that they must give signed consent for the evaluation. In some districts, individual evaluations for preschool children are scheduled with the parents present. The evaluation team collects a detailed case history and conducts a developmental assessment. If the child’s speech is the only concern, the speech-language pathologist (SLP) conducts a speech and language evaluation that includes an oral mechanism examination, and assessments of voice quality, receptive and expressive language development, social-pragmatics, speech sound production, and fluency. Depending on the needs of the child, standardized tests may or may not be administered. The SLP analyzes a speech sample obtained during the evaluation.. Ideally, speech is sampled under several contexts, such as conversation, storytelling, “reading,” etc. Sometimes, the parents are asked to submit a recorded sample of the child’s speech if the child will not talk to examiners. The SLP determines what types of dysfluencies the child exhibits and whether they are typical, linguistic nonfluencies typical of young children who are acquiring language, or whether the child presents with stuttering (or sometimes called Childhood Onset Fluency Disorder).  Based on the results of the speech analysis, the child’s history, and any other relevant factors, the evaluation team determines whether the child meets the district criteria as Speech-Language Impaired. They may also determine eligibility for services at that time. In some situations, the SLP may believe it is better to consult with the parents and allow the child more time before determining the need for services. If intervention is recommended, an SLP and the parents develop an Individualized Education Plan (IEP) that describes the child’s needs and how those needs will be met. This may be done several weeks after the actual evaluation. If the child has been found eligible for services, the district has 60 calendar days from the time parents gave signed consent for the evaluation to conduct the IEP meeting and provide services for the child. School-Age The process for school-aged children is similar. The IEP process usually begins when a parent, teacher, or school staff member raises a concern about a student’s communication or academic progress (negatively impacted by communication). A written referral for a special education evaluation is submitted to the school district. For a child who stutters, this may happen if stuttering is impacting classroom participation, oral presentations, social interactions, or testing performance. The school then seeks parental consent to evaluate the student. Parents are advised of their rights to due process, including the fact that they must give signed consent for the evaluation. A multidisciplinary team, which includes a speech-language pathologist (SLP), conducts a comprehensive evaluation. This may involve observations, interviews, standardized tests, speech samples, and input from teachers and parents. The evaluation looks at whether the student’s stuttering significantly affects their educational performance—not just academics, but also participation, social/emotional well-being, and communication across settings. The evaluation assesses communication in all areas, including the oral mechanism examination, and assessments of voice quality, receptive and expressive language development, social-pragmatics, speech sound production, and fluency.  Once the evaluation is complete, the IEP team (parents, general education teacher, special education teacher, SLP, administrator, and others as needed) meets to review results. If the student qualifies under the category of "Speech or Language Impairment," they become eligible for an IEP. Importantly, the decision isn’t based on the severity of stuttering alone, but rather on how it impacts the child’s educational access and performance. If eligible, the team writes the IEP, which includes measurable goals, accommodations, services (such as direct speech therapy), and how progress will be tracked. Parents are equal members of the team and must consent before the plan is put into place. The IEP is then implemented by teachers, SLPs, and other staff, with progress reviewed at least once a year and a reevaluation required every three years. An Individualized Education Program (IEP) for a student who stutters should focus on access, participation, and self-advocacy . Support can be both accommodations  (how learning is accessed and demonstrated) and goals/services  (skills the student works on with the SLP or school counselor). Here are some examples: Accommodations & Supports Flexible Response Options Extra time for oral presentations, reading aloud, or classroom discussions. Option to respond in writing, video, or small group instead of always in front of the whole class. Reduced Communication Pressure Teachers avoid interrupting or finishing sentences. No forced participation in timed/random reading. Option to volunteer instead of being called on unexpectedly. Supportive Classroom Environment The teacher provides wait time and models patience for peers. Education for peers about stuttering to reduce teasing and stigma. Preferential seating if helpful (closer to supportive peers/teacher). Testing Accommodations Extended time on oral parts of standardized tests. Alternative formats for oral testing when appropriate. Assistive Technology Access to devices/software that support communication if desired (e.g., recording answers). IEP Goals Examples (Stutter-Affirming, Functional) Self-Advocacy The student will identify at least 2 strategies for explaining their stutter to peers/teachers and practice using them in role-play with 80% accuracy. Communication Confidence The student will increase participation in classroom discussions by initiating contributions at least 2 times per week, with self-rating of comfort/confidence (not fluency) after each. Education & Awareness The student will explain what stuttering is and 2 things that help them communicate best, to a teacher or peer, in structured practice. Strategy Use (if part of student’s goals) The student will choose and use preferred speech strategies (e.g., voluntary stuttering, easy onset) during structured activities with 70% independence. Emotional Support The student will use self-rating scales (confidence, comfort, tension) to reflect on speaking experiences weekly and share with the SLP. Related Services Speech Therapy  focused on: Understanding stuttering (psychoeducation). Building self-acceptance and resilience. Exploring communication strategies (only if the student chooses).Goal co-construction with student input. Counseling/Collaboration Coordination between SLP, teachers, and the school counselor to address anxiety, bullying, or self-esteem related to stuttering. Written by Lynne Remson, CCC-SLP & Edited by Nicole Kulmaczewski, MS CCC-SLP As kids transition from elementary school to middle school and then to high school, how can parents ensure their child’s speech therapy model transitions with them? Parents should take time to get to know their school SLP and begin early to advocate for their elementary school child in an effective and supportive manner. I also recommend that parents learn all they can about stuttering. When parents are well-educated consumers, they are better equipped to effectively advocate for their children. Approach the SLP with the information you have and ask what s/he thinks. Explain that you want to know what treatments are available for your child. Offer to help get information if s/he needs it and make it known that you want to work as a team. Parents also need to learn about their child’s stuttering. Children’s level of awareness and concerns about speaking and stuttering can change over time. This occurs due to maturity, experiences and perceptions. It’s okay to talk about stuttering, fears and concerns. It’s important to know what concerns a child may have about going to middle school, especially in regards to communicating. Usually, there is an annual IEP review at the end of the school year to review the child’s progress and to make recommendations for the next year. It would be helpful to have the elementary SLP and classroom teacher and the middle school SLP and teachers at the meeting. Sometimes this is a challenge, but it is ideal. Navigating the transition can be tricky since there will be six to eight weeks of break in the summer during which time the motor speech aspects of a child’s stuttering may change along with possible changes in attitudes and emotions. Therefore, a second transition meeting is recommended prior to or just after the start of middle school. Ideally, the elementary and middle school SLPs should be there along with the parent. Perhaps an informal meeting could be scheduled as a parent-teacher conference, rather than a formal IEP meeting if this is easier. The student might attend, depending on their developmental maturity. A discussion of the child’s summer in regards to stuttering, attitudes about communicating, and significant experiences could be addressed. In addition, goals would be addressed as well as the child’s concerns about communication in the coming year. The transition from middle school to high school is going to be very different than the previous one. Students are more mature and have a desire for more independence. Some teens continue to receive speech therapy services in school, others opt for private services and still others opt to discontinue therapy. Teens should be actively involved in decisions about therapy and goals. Parents can encourage and advise at this stage but the teen’s choices should be respected. For the transition to high school, parents can request a meeting with their teen and the SLP to make the initial introduction as the school year begins. This does not have to be a formal IEP meeting but could be more like a student-teacher conference. During this meeting, the previous years’ speech therapy goals will probably be reviewed, but the meeting should also involve discussion about the student’s interests and activities as well as his or her concerns about stuttering and/or communicating in general. The meeting might also include a review of IEP goals and discussion about how well they match the student’s goals. Submitted by Karen Kumar, CCC-SLP How often is an IEP reviewed?  By law (IDEA), every IEP must be reviewed at least once every 12 months (an “annual review”). In addition, every three years, a student must also have a reevaluation to determine continued eligibility and needs (sometimes called a “triennial”). However, an IEP can be reviewed at any time  if the parent/guardian, teacher, or service provider requests a meeting. For example, if a student’s needs change (new communication challenges, bullying incidents, or shifts in academic demands), the team can reconvene to update goals or accommodations. Progress monitoring is the system schools use to track how well a student is meeting the goals written in their IEP. The IEP serves as documentation for speech-language therapy. It involves collecting ongoing data  that is specific, measurable, and aligned with the student’s individualized goals. This data helps the IEP team decide whether: The student is making adequate progress. The current supports and services are effective. The IEP goals need to be adjusted. By law, parents must receive regular progress reports  (often quarterly or at the same frequency as report cards). When reviewing an IEP for a student who stutters, the team should consider more than just the frequency and severity of stuttering. Key areas include: Participation & Access Is the student able to participate in classroom discussions, group work, oral presentations, and social interactions without unnecessary barriers? Are accommodations (extra time, alternative response options, reduced pressure) being implemented consistently? Self-Advocacy Skills Can the student explain their needs to teachers or peers? Do they have strategies to handle speaking situations (e.g., asking for wait time, choosing when/how to participate)? Confidence & Well-Being Does the student feel safe, supported, and respected in their communication?Are there signs of increased avoidance, anxiety, or teasing that need to be addressed? Progress Toward Goals Are IEP goals (such as advocating for themselves, increasing participation, or using self-rating scales) being met? Do goals need to be updated to reflect new challenges (e.g., transitioning to middle/high school, larger presentations, standardized testing)? Collaboration & Education Are teachers and peers aware of how to best support the student? Has the SLP provided education to staff or classmates to foster understanding? Submitted by Lynne Remson, CCC-SLP & Edited by Nicole Kulmaczewski, MS CCC-SLP How much emphasis should be placed on carry-over of speech strategies and techniques at home? This depends on a lot of several key factors. Perhaps the two most important are the child’s age and the specific goals the child is working toward in therapy. For example, for a very young child who is not yet working on speech fluency, then it may not be appropriate to place any emphasis on speech at all. For a school-age child who is learning to use speech techniques, then it would generally be appropriate for there to be some type of home practice routine to support generalization and to help the parents understand what is going on in therapy. For an adolescent, it is quite unlikely that there will be benefit to the parent reminding the teen to use speech techniques, so an emphasis on “speech” would not be helpful. Indeed, I’m not sure that any emphasis on “speech” would ever be helpful – if what is meant by that is emphasis on “fluency.” An emphasis on communication is always helpful, and this is what the parent should provide. Indeed, for all ages, it is critically important for the parents to provide a supportive, accepting atmosphere where the child knows that it is okay to stutter even as s/he is working toward enhancing fluency, minimizing the burden of stuttering, or whatever other goals may be selected in therapy. Submitted by Dr. Scott Yaruss, CCC-SLP What might a parent look for that would indicate a therapy model is outdated or ineffective? This is a tough question to answer. In general, treatment that focuses on fluency to the exclusion of more balanced goals for improving communication and reducing the burden of stuttering on the child’s life are, put simply, inappropriate for children who stutter. There are different times in therapy where treatment might address speech production goals to a greater or lesser extent, but any time treatment is out-of-balance, then this can cause problems for the child. Clinicians and parents should be very aware of what the child’s overall goals are for treatment, and if those goals are too narrowly focused in any one area, then it would be sensible to take a step back and ensure that the goals are sufficiently broad-based that they address the child’s entire experience of stuttering, particularly including the adverse impact of the speech disruption on the child’s life. Submitted by Dr. Scott Yaruss, CCC-SLP IEP Ideas for Parents Whose Children May Be Resisting Speech Therapy IEP vs 504 Plans: Differences & What Parents Should Know As a special education teacher and the mother of a teen who stutters, and as a person who is familiar with the IEP process, a question that is often posed to me is, “My child/teen does not seem to be getting anything out of speech services in school anymore. She hates it and doesn’t want to attend. Should we discontinue the IEP and stop services?” I realize that there is not one correct answer to a question like this. Knowing that, my response often begins with a question of my own. I ask, “Have you considered changing her IEP by asking the team to add what is called a Monitor and discontinuing only the direct or pull-out speech therapy services?” When written in an IEP, a “Monitor” generally covers weekly or monthly “check ins” by the speech clinician. This allows your child to continue receiving precious and often “hard-won” special education services like Specially Designed Instruction (the list of helpful supports to help your child who stutters find success in the classroom, which are usually contained at the end of the IEP document) without having to participate in weekly speech therapy that is currently not meeting their needs. When “checking in” the Speech and Language Professional may speak to your child, his teacher and even to you about how your child is doing. Periodic progress monitoring should be included, which may only need to occur one time per marking period. Using a Monitor model allows you to keep the IEP current. Keeping your child’s IEP current is crucial and often misunderstood by parents. It is important to remember that if you dismiss all IEP services this year and decide at a later date that your child is in need of services again, you must start from the beginning with the entire district evaluation process. The evaluation process by law can and often does take up to a year to complete. In that time, your child will not be receiving any of the supports and services they need. I understand the need for many children and teens to take a break from active school speech therapy. Keeping the IEP open by changing the level of services to Monitor only allows the IEP to remain active so your child won’t lose those important additional services like Specially Designed Instruction. If, in the future (and this often happens), your child is open to active speech therapy again, it is MUCH easier and quicker to call for a meeting and modify the IEP to reinstate these services. Written by Joan Duffield   allthreeduffs@hotmail.com

Therapy for school-age children and teens who stutter is quite different from therapy for preschoolers who stutter. With preschoolers, goals often focus primarily on preventing negative reactions to stuttering and counseling caregivers through their concerns. Certainly, these are still relevant goals for many older children who stutter, but other goals become increasingly important as children grow. For example, therapy for school-age children and teens who stutter may also address their feelings about stuttering, the physical tension or struggle that they may experience during moments of stuttering, and, especially, the reactions of people in their environment. These factors cannot adequately be addressed if therapy focuses primarily or solely on fluency, so a broad-based approach to stuttering therapy  is absolutely necessary. It is impossible to provide a concise overview of everything that might occur in therapy for school-age children and teens who stutter. Every speaker has their own individual needs and concerns, so therapy must  be individualized. Caregivers should be wary of any clinician or other professional who suggests that all children who stutter need the same treatment. Clinicians should identify the specific needs that each individual speaker has, and then develop a customized therapy plan that addresses those needs. The aim of therapy for school-age children and teens who stutter is to ensure they can communicate freely and effectively, without stuttering preventing them from expressing what they want to say. This does not mean they must be fluent—most children who stutter will continue to stutter throughout their lives—but it does mean that stuttering should not stand in the way of their goals. Therapy focuses on helping children manage stuttering in ways that reduce struggle and allow for more comfortable communication. For some, this may involve skills for speaking with greater ease, such as “easy onsets,” “easy starts,” or slower speech. For others, it may involve learning to stutter with less tension by easing through moments of disfluency rather than forcing their way out. Since each child’s needs differ, SLPs work collaboratively to identify which strategies are most helpful. Because stuttering is often linked to fear and embarrassment, therapy also addresses the attitudes of both the child and their environment. Children who feel pressure to hide their stuttering often tense their muscles, avoid speaking situations, or miss out on opportunities to participate in class. By fostering acceptance of stuttering—both within the child and among peers, teachers, and family members—therapy helps reduce tension, minimize avoidance, and create a supportive environment focused on communication rather than fluency. Acceptance also extends to identity. When children view stuttering as part of who they are, they are less likely to avoid speaking and more likely to engage fully in daily activities. Embracing stuttering in this way not only reduces its overall impact but also empowers children to use their voices in more situations. Finally, therapy must include education and advocacy in the child’s broader environment. Children who stutter are at risk of bullying and misunderstanding, so it is crucial that peers, caregivers, and educators learn how to respond with patience, respect, and encouragement. Building supportive communities ensures that children are valued for what they say, not how they say it. In sum, treating school-age children and teens who stutter is a multifaceted process that combines individualized strategies, emotional support, and environmental change. Caregivers play an essential role in extending these lessons beyond the therapy room, working alongside skilled speech-language pathologists to help children communicate with confidence. For more information about stuttering in school-age children and teens, see   School-Age Stuttering: Information and Support for Parents and Other Caregivers  from Stuttering Therapy Resources.

Private Therapy When seeking out a speech-language pathologist (SLP), it is important to consider their training, clinical experience, and perspectives on the assessment and treatment of stuttering. For example, SLPs may hold different perspectives relating to fluency and stuttering acceptance. In speech therapy, some SLPs may focus primarily on the speech behaviors associated with stuttering, while others may target communication holistically without attempting to minimize stuttering in addition to exploring thoughts and emotions. In addition, some speech-language pathologists may hold the certification of Board Certified Specialist in Stuttering, Cluttering and Fluency Disorders (BCS-SCF) to signify the hours of training and clinical practice they have completed in the area of stuttering. However, there are many other specialists in the area of stuttering who do not hold this certification who may be a great fit for your child. Before starting treatment, see what information is available online or talk with the SLP regarding their training, experience, and perspectives on the treatment of stuttering. Below are questions you may consider when trying to find the right clinician: What is the SLP’s specific approach to stuttering? What strategies do they teach, how do they teach those strategies, what programs influence their approach to therapy? Is their approach to therapy a good match for you or your child’s personality, goals, and values? If you are seeking an SLP for your child, you may be able to meet the SLP beforehand to determine whether their personality and approach is a good match for your child. If possible, bring your child with you to observe how they interact with the SLP. What is the SLP doing to stay current and informed? Do they attend continuing education (CE) training, such as conferences, workshops, seminars? Does the SLP establish realistic goals for therapy? Are the goals in line with what you expect from therapy? Do they acknowledge that there is not a “cure” for stuttering? You, your child, and the therapist should all be on the same page. Does the SLP treat the whole person by addressing thoughts, emotions, and goals relating to communication? Do they hold space for your child to share about their experiences outside of the therapy room? Do they appropriately involve family members in the treatment process? Do they include stuttering education and self-advocacy skills in treatment? Are they helping your child develop a positive self-image as an effective communicator? School In a school setting, your child’s speech-language pathologist (SLP) is often assigned to them. The information below will assist you in creating a positive speech therapy experience at school. Many school SLPs are not specially trained to work with kids who stutter in a meaningful or supportive manner. They may have only worked with a few children who stutter or are unfamiliar with stuttering treatments outside of fluency-focused therapy. There are also many school SLPs who specialize in stuttering. It is important to ask about your child’s school SLP’s  experience and how they will seek out further stuttering education if their experience working with children who stutter is limited. The school SLP should be agreeable to coordinating therapy with your child’s private SLP (if there is one). If you are utilizing a private therapist in addition to school services, it is important that your child receives the same information and messages about stuttering from each provider. Conflicting messages can be confusing to your child and result in less effective and supportive therapy.  In addition to providing speech therapy, the school SLP should assist with creating a supportive environment in the classroom. Part of the school SLP’s role is to keep the classroom teacher informed about what the teacher can do in class to support your child’s communication and ensure that your child receives the same communication opportunities as their peers who do not stutter.  The SLP should maintain open communication with the student, parents, and others involved in the child’s education. They should regularly update you on the student’s progress and involve you in the therapy process. This may occur during regularly scheduled team meetings, but you can also request meetings outside of the annual schedule. It is important to keep in mind that while the SLP at your child’s school may not have much experience providing therapy for children who stutter, they are dedicated professionals who want to do what is in the best interests of the children they serve. Keep the lines of communication open between you, your child, the private SLP, and the school SLP. Considering these factors, you can find the right speech-language pathologist who can provide effective and compassionate stuttering therapy tailored to the student’s needs and goals.

Stuttering is a misunderstood difference in speech pattern. Research now tells us that stuttering is a neurological condition that interferes with the production of speech to create disruptions, or “disfluencies” in a person’s speech. Unfortunately, false assumptions and negative stereotypes about stuttering still persist. These myths, if left unchecked, can lead to prejudice and discrimination from the public and can influence how people who stutter view themselves. Here are few myths about stuttering and the facts to debunk them: People stutter because they are nervous. Because people who do not stutter occasionally become more disfluent when they are nervous or under stress, some people assume that people who stutter do so for the same reason. While people who stutter may be nervous because they stutter, nervousness is not the cause. People who stutter are shy and self-conscious. Adults and children who stutter may sometimes be hesitant to speak up, even if they are not otherwise shy by nature. People who stutter can be assertive and outspoken, and many succeed in leadership positions that require talking. Stuttering is psychological or caused by emotional trauma. Emotional factors often accompany stuttering but it is not primarily a psychological (mental) condition nor is it caused by emotional trauma. Stuttering therapy often includes counseling to help people who stutter deal with attitudes and fears that may be the result of stuttering. There is a rare subtype of stuttering called functional stuttering (previously known as psychogenic stuttering) in which case psychological/emotional trauma plays a causal role. However, developmental stuttering (i.e., the most common type of stuttering) is not caused by mental health conditions. People who stutter are less intelligent or capable. People who stutter disprove this every day. The stuttering community has its share of scientists, writers, politicians, athletes, and college professors. People who stutter have achieved success in every profession imaginable. Stuttering is caused by bad parenting. When a child stutters, it is not the parents’ fault. Stress in a child’s environment can increase the frequency or intensity of stuttering moments, but is not the cause. Stuttering is a habit that people can break if they want to. Although the manner in which people stutter may develop in certain patterns, the cause of stuttering itself is not due to a habit. Because stuttering is a neurological condition, many, if not most, people who stutter as older children or adults will continue to do so—in some fashion—even when they work very hard at changing their speech. Children who stutter are imitating a stuttering parent or relative. Stuttering is not contagious. Since stuttering often runs in families, however, children who have a parent or close relative who stutters may be prone to stuttering themselves. This is due to shared genes, not imitation. Forcing a left-handed child to become right-handed causes stuttering. This was widely believed early in the 20th century but has been disproven in most studies since 1940. Although attempts to change handedness do not cause stuttering, the stress that resulted when a child was forced to switch hands may have increased stuttering for some individuals. Identifying or labeling a child as a stutterer results in chronic stuttering. This was the premise of an infamous study from 1939 testing the diagnosogenic theory of Wendell Johnson. The study was discredited decades ago, but this outdated theory still crops up occasionally. Today, we know that talking about stuttering unquestionably does not cause a child to stutter. People should avoid talking to children about stuttering Parents and clinicians report feeling uncomfortable talking to children about stuttering, or fear that talking about stuttering may cause it to persist. Providing children with education about what stuttering is and can feel like helps them self-advocate and describe their experiences to others. Talking with children about stuttering in a neutral way can help reinforce that it is okay to stutter. Bilingualism causes stuttering. There is no evidence to support that bilingualism causes stuttering.  Additionally, research indicates that learning more than one language provides children with various benefits such as socioemotional well-being, cognitive skills, and development of cultural identities. Bilingual children may experience an increased amount of disfluencies as they learn two languages, but this is a completely normal part of bilingual development and tends to balance out unless the child is otherwise predisposed to stuttering. People who stutter need to slow down. Stuttering is not caused by an increased rate of speech; it is a neurophysiological difference with a genetic predisposition. People who stutter simply need additional time to share their message. Telling someone who stutters to “slow down” is unhelpful. These are just a few of the common myths  that persist about stuttering. Instead of perpetuating such myths, it is important to learn and share the Facts About Stuttering ! Revisions provided (01.2024) by Caitlin Franchini, MS, CCC-SLP and Megan M. Young, ABD, CCC-SLP.

The more we understand stuttering, the better we can educate others about it. The NSA has partnered with leading stuttering specialists and researchers to provide accurate information about stuttering. Here are a few facts about stuttering: Stuttering usually begins in childhood, between the ages of 2 and 5 years. It’s estimated that about 1% of the world’s population stutters, though about 5% of children go through a period of stuttering. Stuttering can begin gradually and develop over time, or it can appear suddenly. Stuttering is a speech pattern involving involuntary disruptions, or “disfluencies”, in the flow of speech. Stutter-like disfluencies include sound/syllable repetitions (e.g., “n-n-no” or “wha-wha-whatever”), single-syllable whole word repetitions (e.g., “my-my-my”), audible sound prolongations (e.g., “shhhhe”), and inaudible sound prolongations (i.e., blocks; e.g., “...you”). Stutter-like disfluencies are typically produced with tension, arrhythmicity, and/or secondary behaviors (e.g., eye blinking, facial grimacing). Typical disfluencies produced by speakers who do and do not stutter include phrase repetitions (e.g., “who was who was that”), phrase revisions (“my frie- my best friend”), multisyllable whole word repetitions (“because-because”), and interjections (e.g., “um,” “you know”). When people stutter, they feel like they have lost control of their speech mechanism. This sensation of loss of control can be disconcerting and uncomfortable, and it can lead to embarrassment, anxiety about speaking, and a fear of stuttering again. Stuttering can be a genetically-influenced condition: most of the time, if there is one person in a family who stutters, there will be another person in the family who also stutters. Stuttering is associated with differences in the brain; it is not just a behavior that children learn or pick up from listening to other people who stutter. The way a person stutters (e.g., their types of disfluencies, tension patterns, secondary behaviors) may vary and change over time. A person who stutters who primarily displays blocks may begin to demonstrate repetitions later on. This variability is normal! Stuttering is more common among males than females. In adults, the male-to-female ratio is about 4 to 1; in children, it is closer to 2 to 1, with more male than female children continuing to stutter into adulthood. As many as 80% of young children who begin to stutter ultimately stop stuttering. Those who continue to stutter into the school-age years are likely to continue stuttering throughout their lives. Stuttering varies significantly over time: Sometimes, people will have periods in which the stuttering appears to go away, only to have it return. This variability is normal. People who stutter may try to avoid stuttering by speaking quickly, pushing through moments of stuttering, word substitution, circumlocution, avoiding feared speaking situations, or choosing not to speak at all when they fear they might stutter. These behaviors can cause psychological distress, increase physical tension, and lead to a greater adverse impact of stuttering on a person’s life. Stuttering also varies in frequency across speaking situations. Again, this variability is normal. For people who stutter, there is so much more to the stuttering experience than just the observable disfluencies. The overall impact of stuttering on their lives may  cause the most concern. Therefore, speech therapy for stuttering should also account for the ways that stuttering affects the speakers’ life. Citizens of every nation and speakers of every language across the world stutter. Multilingual speakers who stutter will stutter in every language that they speak; however, stuttering may present differently in each language. For example, sound and word repetitions are not even considered true stuttering in bilingual Spanish-English children, and blocks and prolongations hold a lot more weight in the determination of stuttering in these children. People who stutter can be effective communicators regardless of how much they stutter. They may require additional time to speak compared to speakers who do not stutter. These are just a few facts about stuttering. It’s important to know the facts about stuttering because it will help to dispel the common Myths About Stuttering

No one speaks with perfect fluency all the time—we all may experience some disruptions in our speech (saying "um" or "like" or repeating a word, or even finding it difficult to find a word and creating a pause), but this is not stuttering. For people who stutter, these disruptions have a more profound impact on their lives from feelings of loss of total control to intertwined emotions of shame, embarrassment, depression, and trauma. For some, stuttering goes away in childhood, for others, it persists throughout adulthood. Why is this? Researchers currently believe that stuttering is caused by a combination of factors, including genetics, language development, environment, as well as brain structure and function [1] . Working together, these factors can influence the speech of a person who stutters. Stuttering and Language Development Stuttering most often begins between the ages of 2 and 5, when children’s speech and language abilities are rapidly expanding. During this period of rapid growth, interactions among genetics, natural development, and brain differences are hypothesized to influence the development and persistence of stuttering. In all children (those who stutter, those who spontaneously stop stuttering, and those who don’t stutter at all), this period of language expansion can increase the cognitive demand of communication and affect the motor planning control necessary to produce fluent speech. Genetic Factors Family histories of stuttering demonstrate that stuttering runs in families and is influenced by genetic factors. Children who stutter, for example, often have relatives who stutter. Identical twins sharing the exact same genetic makeup have more similar patterns of stuttering than fraternal twins. We also know that stuttering affects males more than females and that females are less likely to continue stuttering as adults. Researchers haven’t pinpointed a specific gene that’s solely responsible for stuttering. However, it’s possible that if you carry certain genetic material, you may be more likely to stutter. Brain Activity in People Who Stutter While no one factor determines stuttering, the predominant theory suggests that a combination of genetics and brain organization can influence the onset and persistence of stuttering. The areas of the brain responsible for language may look and work differently in people who stutter. Findings from brain imaging studies indicate that there is more right hemisphere activity in adults who stutter, with less activity in the left hemisphere areas typically responsible for speech production. Some people who stutter have more difficulty processing auditory information and slower reaction times on sensory-motor tasks. In general, research has shown that the pathways in the brain responsible for language look and function differently when stuttering occurs. Emotions and the Environment If children begin encountering negative reactions to their disfluencies or face an increased number of communication challenges, negative feelings surrounding their communication may develop. Negative feelings and attempts to hide or prevent stuttering may increase tension and further affect their ability to communicate. Depending on their temperament, some children may experience more anxiety when speaking and negative feelings towards communication than others. Although emotional factors, nervousness, and anxiety do not cause  stuttering, they may place an additional cognitive burden on children who stutter during a critical period of language development. Characteristics associated with stuttering persistence Between 5% and 8% of all preschool-age children will develop stuttering; however, 80% of these children will stop stuttering during early childhood [2]. Certain clinical characteristics have been associated with persistence and recovery of stuttering. Specifically, research suggests that children who are male, have a family history of stuttering, or are older at stuttering onset are more likely to continue stuttering [3]. Other factors such as exhibiting a higher frequency of stuttering-like disfluencies, producing speech-sound errors, and demonstrating weaker (or stronger) language skills have also been associated with variability in stuttering persistence.  Acquired Stuttering Most people who stutter begin stuttering in childhood, during the developmental period in which they are learning to communicate. In rare cases, stuttering is the result of brain injury or psychological factors. This form of stuttering, known as “acquired” stuttering, differs from developmental stuttering in both its causes and manifestations. Common Stuttering Myths There are many common myths that include theories about what causes stuttering. It’s important to remember that no single cause has been found for stuttering. Stuttering is not caused by what a child’s parents do or don’t do Stuttering is not caused by pointing out a child’s disfluencies Stuttering is not a psychological problem (although it may have psychological effects) Stuttering is not a sign of reduced intelligence Stuttering is not caused by learning another language (although speech fluency may present differently in bilinguals) Stuttering is not caused by nervousness or anxiety Most importantly, stuttering is no one’s fault ! Original material provided by: Leslee Dean, M.A. in Latin American Studies, MS-SLP student at Florida International University and Angela M. Medina, Ph.D., CCC-SLP. Revisions provided (01.2024) by Caitlin Franchini, MS, CCC-SLP and  Dr. Megan M. Young, CCC-SLP. [1] Smith, A. & Weber, C. (2017). How stuttering develops: The multifactorial dynamic pathways theory. Journal of Speech, Language, and Hearing Research, 60(9), 2483-2505. [2] Yairi, E., & Ambrose, N.(2013). Epidemiology of stuttering: 21stcentury advances.Journal of Fluency Disorders, 38(2), 66–87.https://doi.org/10.1016/j.jfludis.2012.11.002 [3] Singer, C. M., Hessling, A., Kelly, E. M., Singer, L., & Jones, R. M. (2020). Clinical characteristics associated with stuttering persistence: A meta-analysis. Journal of Speech, Language, and Hearing Research, 63(9), 2995-3018.

What Is Stuttering? Stuttering  is a natural variation in speech  in which the timing and flow of spoken language include moments of repetition, prolongation, or blocking  of sounds and words. These moments are simply examples of the many ways humans produce speech. Commonly Observed Features Repetitions  – repeating sounds, syllables, or words (e.g., “I-I-I want to go”). Prolongations  – stretching out a sound (e.g., “ssssun”). Blocks  – pauses where speech momentarily stops, usually with a build up of internal and/or external muscle tension, even when the speaker knows what they want to say. These variations may occur more often when someone is excited, tired, feeling pressure to speak quickly, or navigating certain environments ( NIDCD, 2023 ). Stuttering is not only about what can be heard—it can also involve: Physical movements  like eye blinks, facial tension, or shifts in posture that may accompany moments of stuttering ( ASHA, n.d. ). Feelings and thoughts  about speaking, shaped by personal experiences and societal attitudes. Some people who stutter feel comfortable and confident speaking; others may experience anxiety or frustration in unsupportive contexts ( ASHA, n.d. ). Communication choices  such as word substitutions or avoiding certain situations—often not because of stuttering itself, but because of how others may respond to it ( Tichenor & Yaruss, 2019 ). Varieties of Stuttering While every person’s speech is unique, stuttering may be described in terms of how and when it begins: Childhood-Onset Stuttering  – often begins between ages 2–5 during speech and language development ( Yairi & Ambrose, 2013 ). Neurogenic Stuttering  – may appear after neurological changes such as brain injury or stroke ( Theys et al., 2024 ). Functional Stuttering  – rare, and often linked to psychological or emotional events ( NIH, n.d. ). What Causes Stuttering? The precise causes of stuttering are still unknown, but most researchers now consider stuttering to involve differences in brain activity that interfere with the production of speech. In some people, the tendency to stutter may be inherited. Although the interference with speech is sometimes triggered by emotional or situational factors, stuttering is basically neurological and physiological – not psychological – in nature.  Research points to a combination of genetic  and neurological  factors that influence speech timing and coordination ( Kang et al., 2010 ). Stuttering is not caused  by nervousness, poor parenting, or a lack of intelligence ( The Michael Palin Centre for Stammering, n.d. ). Social environments—especially those that value speed over connection—can influence how comfortable a person feels speaking ( Boyle, 2013 ). The most common type of stuttering (sometimes called developmental stuttering) usually develops of its own accord in childhood, most often between ages two and eight (although in rare cases it may begin much later). Roughly 4 to 5 percent of people experience stuttering at some time during their childhood. While the majority become fluent by the time they reach adulthood even without treatment, stuttering may continue to be a persistent experience for other people who stutter. Can Stuttering Be Cured? Despite scientific breakthroughs in our knowledge about stuttering, there is still no reliable, research-backed “cure” that works consistently, over time, and for all people who stutter. Many individuals benefit from various forms of speech therapy and from support groups like the National Stuttering Association. Meanwhile, researchers are experimenting with electronic devices, pharmaceuticals, and other still-unproven techniques and alternative treatments. It’s unrealistic to expect that any treatment will make stuttering completely disappear. Despite common myths, there is no therapy, device, or drug that is effective all the time or for all people who stutter. Methods that appear to benefit some individuals may not work for others, and stuttering commonly returns after periods of fluency. Managing stuttering is a long-term goal that may involve the acceptance of one’s stuttering and requires considerable patience and understanding. What the Research Shows About Recovery Spontaneous recovery : About 65–80% of young children who begin stuttering will naturally stop within a few years, usually within the first 2–3 years after onset ( Yairi & Ambrose, 2013 ). Persistent stuttering : For others, stuttering is a lifelong part of their speech pattern. Speech therapy can support communication confidence, reduce tension, and expand speaking choices, but it does not “erase” stuttering ( ASHA, n.d. , Boyle et al., 2013 ). What Speech Therapy Can Do Speech therapy and self-help approaches can: Support communication ease and confidence Reduce physical struggle  or tension Address negative feelings  about speaking Encourage self-advocacy and acceptance Importantly, the goal of speech therapy should be about thriving while stuttering  ( Tichenor & Yaruss, 2019 ). How Common Is Stuttering? It has been estimated that about 1% of the adult population stutters. This would amount to almost 3 million people who stutter in the United States alone. Stuttering is about 3 or 4 times more common in males than females. Stuttering Is Variable The severity of stuttering varies widely among people. It may also vary in the same individual from day to day and depending on the speaking situation. Saying one’s name and speaking to authority figures may be particularly difficult. For some people, fatigue, stress, and time pressure can increase their tendency to stutter. When people who stutter feel compelled to hide their stuttering, it generally becomes more intense and/or frequent. Patterns of stuttering behavior also vary. People who stutter may experience repetitions (D-d-d-dog), prolongations (Mmmmmmilk), or blocks (an absence of sound), or can experience some combination of these disfluency types. Some people who stutter will also try to avoid stuttering by pausing before words, substituting words, and interjecting words or phrases such as “you know,” “well actually,” “um,” etc., whenever they anticipate a moment of stuttering. As a result, the person may create the false impression of being hesitant, uncertain, or confused. A job interview may be the single most challenging speaking situation a person who stutters will ever encounter. Stuttering is likely to be at its most frequent or intense. Therefore, the degree of stuttering at the interview should not be used to predict how the person will actually speak on the job. What Assistance Is Available? Although there is no simple “cure” for stuttering, people who stutter can learn to speak more comfortably, feel better about themselves and their speaking ability, and communicate more effectively. Because stuttering typically starts between the ages of 2 and 5, early intervention is the most effective way to help children continue to speak comfortably and confidently despite stuttering, before they acquire a negative response to their stuttering. Therefore, it is important for parents and pediatricians to seek an evaluation by a qualified speech-language pathologist as soon as they become concerned about a child’s stuttering. School-age children, adolescents, and adults can also all benefit from treatment. For these individuals, treatment is designed to help them learn to manage their stuttering so it is less disruptive to their communication. Treatment can also improve their self-esteem and their self-confidence so they can communicate more freely and effectively, which may in turn reduce the tension and frequency of stuttering moments. Support Groups for People Who Stutter  The National Stuttering Association  provides an extensive network of support groups for adults, kids, and teens who stutter, and their families across the United States. The NSA’s motto: If You Stutter, You’re Not Alone, is what our local chapters are all about! For many, NSA chapter meetings are the first time they have ever talked about stuttering with other people who stutter. Local support groups are a proven way to build self-confidence, practice speaking in a safe environment and explore new ways to cope with stuttering. People who stutter (of all ages), their family and friends, and speech-language pathologists (SLPs) are welcome at our chapters! Find the NSA Chapter nearest you. References American Speech-Language-Hearing Association. (n.d.). Stuttering . https://www.asha.org/public/speech/disorders/stuttering/ Boyle, M. P. (2013). Psychological characteristics and perceptions of stuttering of adults who stutter with and without support group experience. Journal of Fluency Disorders, 38 (4), 368–381. https://doi.org/10.1016/j.jfludis.2013.09.001 Kang, C., Riazuddin, S., Mundorff, J., Krasnewich, D., Friedman, P., Mullikin, J. C., Drayna, D., & the NIDCD Genetics of Stuttering Consortium. (2010). Mutations in the lysosomal enzyme–targeting pathway and persistent stuttering. The New England Journal of Medicine, 362 (8), 677–685. https://doi.org/10.1056/NEJMoa0902630 National Institute on Deafness and Other Communication Disorders. (2023, August 18). Stuttering . https://www.nidcd.nih.gov/health/stuttering National Institutes of Health. (n.d.). Functional neurological disorder . https://www.ninds.nih.gov/health-information/disorders/functional-neurological-disorder The Michael Palin Centre for Stammering. (n.d.). What causes stammering? https://michaelpalincentreforstammering.org/learn-about-stammering/what-causes-stammering/ Theys, C., van Wieringen, A., & De Nil, L. F. (2024). A review of neurogenic stuttering: Diagnosis and treatment. Journal of Fluency Disorders, 79 , 106006. https://doi.org/10.1016/j.jfludis.2024.106006 Tichenor, S. E., & Yaruss, J. S. (2019). Stuttering as defined by adults who stutter. Journal of Speech, Language, and Hearing Research, 62 (12), 4356–4369. https://doi.org/10.1044/2019_JSLHR-19-00137 Yairi, E., & Ambrose, N. G. (2013). Epidemiology of stuttering: 21st century advances . Journal of Fluency Disorders, 38(2), 66–87. https://doi.org/10.1016/j.jfludis.2012.11.002

Why Sibling Conversations Matter A child’s stutter affects the whole family, and siblings often notice differences in communication without fully understanding them. How you talk to siblings about stuttering can shape both their relationship with their brother or sister and how the child who stutters sees themselves. No matter if your children are toddlers, tweens, or teens, having open conversations helps nurture empathy, prevent teasing, and create a more supportive home. Talking about stuttering early—and often—makes a difference. This blog offers age-appropriate ways to guide those conversations, build understanding, and strengthen sibling bonds. “In many ways, parenting a child who stutters is not different from parenting a child who doesn’t stutter; it is about meeting each child's unique needs.” — Stacey Nierman, parent of a child who stutters Start with a Clear Message Before you adjust the conversation for your child’s age, one message applies across the board: Stuttering is okay. It is how some people talk and nothing to be ashamed of. Children tend to follow the emotional lead of the adults around them. If you speak about stuttering with ease, acceptance, and warmth, siblings are more likely to do the same. “Our first Annual Conference in Dallas had a deep impact on everyone in our family. Most importantly, my older two children learned about the challenges people who stutter face. They left the Conference with friends who stutter and an understanding that making fun of their brother's stutter was off limits. I would not have been able to teach them this as effectively as their peers did. As I've heard many times at NSA Conferences, the obstacle is the path and no one gets through life unscathed.” — Liz Gómez, parent of a child who stutters Talking to Toddlers and Preschoolers Young children may not have the words to describe stuttering, but they are observant. They may notice that their sibling talks differently and ask direct questions. Here are some ways to respond: “Yes, your brother sometimes takes longer to say his words. That is how he talks and it is okay. Please be patient and listen to him like anyone else.” “Everyone talks differently. We all use our voices in different ways.” At this age, it is helpful to model patience and full attention. Show your toddler that it is okay to wait, listen, and let their sibling finish speaking. Avoid making stuttering into something secret or “wrong.” Normalize it just like you would any other difference in the family. Talking to Elementary-Age Kids School-age children are developing empathy and reasoning. They may ask more complex questions, especially if they have noticed other kids reacting to their sibling’s speech. Your goal in these conversations is to give them information, encourage compassion, and remind them that their support matters. Try these talking points: “Stuttering is part of how your sister talks. It is not her fault and she is not doing anything wrong.” “Sometimes talking can feel hard for her and it helps when people wait and listen.” “You can show her you care by being patient and not interrupting.” Let them know it is perfectly okay to ask questions. Give honest, age-appropriate answers without judgment or fear. If teasing comes up at home or school, use it as a learning opportunity to reinforce kindness and respect. Talking to Tweens and Teens Older siblings may feel unsure how to respond to stuttering in public or at school. They may even feel protective or frustrated. It is important to give them space to talk honestly, while continuing to reinforce your family’s values of acceptance and support. Here are some ways to open the conversation: “Have you noticed how your brother feels when he is talking and people interrupt him?” “What do you think it is like for him when others laugh or rush him?” “How do you think you can support him when you are together?” At this age, you can also encourage siblings to be advocates when they feel ready. That might mean standing up to teasing, explaining stuttering to a friend, or just offering quiet support in everyday conversations. Let them know it is not their job to fix or speak for their sibling, but that being a kind and supportive brother or sister makes a real difference. What to Do When Questions or Conflicts Arise Even in the most supportive homes, siblings may sometimes get frustrated, compete for attention, or accidentally say something hurtful. When this happens, try to respond with curiosity rather than correction. For example: “I noticed you were upset earlier. Can we talk about what was going on?” “It seemed like your sister felt hurt when you said that. Let us think together about a better way to say it next time.” Avoid framing stuttering as a burden. Instead, talk about how every family member has different strengths and needs. These conversations help build emotional intelligence and show your children how to navigate differences with compassion. “One struggle we face is when our stuttering child starts talking to us when we are already doing something and aren’t entirely ready to listen. He gets frustrated with us because he thinks we aren’t listening due to his stutter. However, it’s because we were already talking to someone else or focused on a different task, such as working, doing household chores, or listening to something with our AirPods in. In these instances, we let him know it wasn’t his stutter that caused us not to hear, but we were in the middle of something. Then we will give him our attention to listen truly.” — Stacey Nierman Let Your Child Who Stutters Take the Lead Whenever possible, include your child who stutters in these conversations. Ask them how they want their siblings to respond when they are speaking. Give them space to share their feelings and experiences. Some children may want to explain stuttering in their own words. Others may prefer that parents do the talking. Respect their preferences and revisit the topic regularly as everyone grows and changes. By including the child who stutters in sibling conversations, you give them ownership of their voice and show that their experience matters.   Talking to siblings about stuttering is not a one-time conversation. It is an ongoing opportunity to build empathy, strengthen relationships, and create a family culture where every voice is valued. “Being a parent to a child who stutters has forced us to slow down and focus our attention on being active listeners. We also model this for our non-stuttering children, specifically not interrupting or finishing sentences.” — Stacey Nierman When parents normalize stuttering, respond with compassion, and guide conversations with honesty and care, siblings learn to do the same. From the first words your children speak to the steps they take toward adulthood, what you say helps shape how they—and their siblings—understand what it means to stutter. “A hard thing for parents to do is to pay equal attention to their kids, and it can be harder to do that if one needs more attention via therapies, etc., but you need to find ways to do so.  One example is going to the NSA Conference. We go early to have a few days to vacation just as a family, then when the event starts, it’s more about Ethan, our son who stutters, and his friends. We think this helps prevent jealousy.” — Linda Twiss Gioscia, parent of a child who stutters Learn More and Find Support Looking for more ways to support your children? The National Stuttering Association (NSA) offers expert-backed resources, family-friendly programs, and a welcoming community of people who understand.  Explore parent and sibling support at WeStutter.org/parents  and WeStutter.org/families .

If you are a parent of a child who stutters, there may be a few heavy questions you have asked yourself, like:  “Did I cause this? Could I have done something to prevent this? What did I do wrong?” It’s so easy to play the blame game. These are some of the most common and emotionally difficult questions we hear from parents of children who stutter. They often come from a place of concern and a deep desire to protect them from anything that may cause them emotional harm. “When we noticed my son, Evan (three years old at the time), stuttering, I immediately went into fix-it mode. I researched, read books, and sought out speech therapists who could help. Once things had settled in, I was sad, fearful, and overwhelmed with the idea that this could be a lifelong condition. I remember thinking, ‘How will people treat him? Can he get a job? Will he get married?’” — Kelly Kaczmarski, a parent of a 17-year-old boy who stutters We want to begin with a clear and compassionate answer: you did not cause your child’s stutter and you are not to blame. Parenting does not cause stuttering. In fact, your role as a supportive and informed parent can make all the difference in how your child experiences communication and builds confidence! This blog post will explore stuttering, explain why parent guilt is common but unnecessary, and offer strategies for helping your child thrive. Most importantly, it will help you shift from helplessness and blame to “How can I best support my child now?” What Causes Stuttering? Stuttering is neurodevelopmental in nature. It is not caused by parenting or anything a child or parent has done. Research shows that stuttering is linked to differences in how the brain processes speech and language. Here is what we currently know: Stuttering tends to run in families. Brain imaging has shown differences in the timing and coordination of speech-related brain regions in people who stutter. Stuttering typically emerges between the ages of 2 and 6, a period of rapid language development. Although a stutter may begin during a time of stress or transition, that does not mean stress caused it. Just because two things happen around the same time does not mean one caused the other! If your child began stuttering after a move, during a family change, or at a time when they were especially emotional, this may have made the stutter more noticeable (which is very normal), but it did not cause it. You did not  cause it. Why Guilt Happens Even with this understanding, many parents still experience some sort of guilt. That feeling is valid. Parenting is one of the most challenging jobs in the world. When something feels hard for your child, asking yourself what you could have done differently is natural. Guilt is a fickle thing that often shows up in small moments: replaying conversations and what you said, wondering if you corrected too much, or feeling unsure if you responded the right way. However, it’s important to realize that it can quickly become a burden that prevents you from fully supporting your child in the present. “I think mom guilt is real. Many of us feel guilty for many things. So, yes, I did feel guilty for a bit of time. The more I learned about stuttering and surrounded myself with stuttering supporters, the more I was able to slowly let go of guilt and focus on giving Evan the tools he needed. When you meet others who stutter, or parents of kids who stutter, you realize you are in this together and it just turns into advocacy and support. Guilt doesn’t make it go away, but advocating and educating others can make the world a bit kinder for those who stutter.” — Kelly Kaczmarski Letting go of guilt ≠ letting go of responsibility. It’s freeing yourself from blame so you can focus on caring for your child in the way they need it. The Importance of a Parent’s Response You cannot control whether and how your child stutters, but you can help shape their feelings about it. Your attitude toward stuttering plays a key role in how your child sees themselves and their voice. Children who stutter thrive in environments that are supportive (where they feel listened to and not rushed), affirming (where stuttering is acknowledged and talked about without shame), and calm (where communication is not pressured and active listening is practiced). You can support your child by giving them space to finish their thoughts and showing them that their words are valuable. Here are a few simple things you can say: “I value what you have to say.” “You can do anything you set your mind to.”  “You can take all the time you need to say what you want to say.” “Your voice matters.” These messages, with consistency and warmth, help build resilience and self-acceptance in your child who stutters. “I think what we do to help Evan feel confident is just let him speak. No matter how long it takes and no matter where we are. The hardest places are when we are with people he doesn’t know, like ordering in a restaurant or interacting with new people.  They get restless or uncomfortable.  I continue to smile and make eye contact with Evan so that he knows we will wait, so the world can wait. Hopefully, the new person sees that I am not worried and will be patient.  We live in a fast-paced world.  I hope that slowing down and patiently waiting shows him we have confidence in him, too. As the NSA teaches the world, what he has to say is worth waiting for!” — Kelly Kaczmarski What You Can Do If you are unsure how to support your child, you definitely are not alone! Many parents feel the same. The good news is that your presence and intention matter more than you might think. Here are a few supportive steps you can take: Learn more about stuttering from trusted resources, like the National Stuttering Association (NSA) . Connect with other parents   who are navigating the same questions. Partner with a speech-language pathologist (SLP)   who is knowledgeable and affirming of stuttering. Every SLP practices differently and it’s extremely important to find one who specializes in stuttering and  affirms the stuttering experience. Focus on building your child’s communication confidence rather than fluency. When you let go of guilt, you create more space for meaningful conversations, emotional safety, and a stronger bond with your child. Your child does not need a perfect parent. They need a parent who believes in them and celebrates their voice. “We tell our son to let his voice take up space and he deserves respect when speaking like others. It is okay to stutter and verbal diversity is everywhere! Going to his first NSA conference in July was amazing for him; he was with other kids who stutter and he can’t wait to see them all again in Scottsdale!” — Julie Peles, a parent of a 10-year-old boy who stutters “Finding the NSA, my world was rocked (in a good way!). I realized not only would he do the things I feared he couldn’t, but he could also be a fierce advocate for himself and others with the NSA behind him.” — Kelly Kaczmarski You do not need to have all the answers right now. Those will come with time. You only need to create space for your child to be heard and to feel safe speaking. If You Made Mistakes, You Are Still a Good Parent Many parents look back and remember moments when they interrupted, corrected, or unknowingly pressured their child to speak more fluently. This is common. It is also okay. We unfortunately live in a very fast-paced, fluent-focused world where harmful misconceptions about stuttering still run rampant in TV shows, movies, and media.  You are only human, and you are learning—we all are. What matters now is how you choose to move forward with more knowledge, compassion, and confidence in your ability to support your child without shame. “My daughter began stuttering at age three after a speech delay, so at first, we weren’t worried; she was simply finding her voice. By age five, though, it was clear her stutter was here to stay. With no family history and little knowledge of stuttering, my husband and I were determined to fix it. Years of unsuccessful speech therapy and then connecting with the NSA shifted our perspective. As her mom, I've struggled over the years with how hard I pushed speech therapy when she was younger. I just wanted what I thought was best for her. After connecting with the NSA and meeting other parents who really understood, I worked hard to forgive myself for what I didn't know. Parents need support, too!” — Denise Deitchman, a parent of a 17-year-old girl who stutters You Are Already the Parent They Need The fact that you are here, reading this blog, means you care deeply. That care is the foundation of everything that follows.  You did not cause your child’s stutter. But you can absolutely be part of their strength. “At almost 18, my daughter has become her own strongest advocate. Each year, she emails her teachers before school begins with information about stuttering and how they can support her. While she has accommodations for oral presentations, she rarely uses them anymore. She speaks up for herself in class and in any situation where it’s needed. Though tough days still happen, I always remind her how far she’s come.” — Denise Deitchman The NSA is here for you. We offer resources, events, support groups, and a growing network of families just like yours. Visit WeStutter.org/parents  to learn more.