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For many people who stutter (PWS), being quiet feels safer. As kids or teens, we may have learned that speaking up invites stares, interruptions, or worse—mocking or laughter. Over time, we adapt. We avoid reading aloud. We let others order for us. We smile or walk away entirely instead of introducing ourselves. These behaviors aren’t personality quirks. They’re survival strategies. But they can also lead us to misidentify ourselves as shy or “just not a people person.” Sometimes, we label ourselves as introverts—not because that’s who we actually are, but because silence was the only safe option for us growing up. The Turning Point: When Hiding Isn’t Enough At some point, many of us reach a moment of reckoning. Maybe it’s a group project in college. A job interview. A colleague who says, “You don’t talk much.” For PWS, that moment can feel absolutely terrifying—but also freeing, because it opens the door to something new. It finally shifts from “How do I avoid stuttering?” to “How do I show up fully—even if I stutter?” “Even when I still stuttered, I began speaking up when I realized that my communication partners were more interested in what I had to say than how I said it. As people who stutter, we can hyper-fixate on the way in which we speak. When I started to let go of the need to be perfectly fluent, it became apparent that my communication partners paid little attention to the ‘how’ of my speech and were only concerned with the content of our discussions.” — Mackenzie Smith, a person who stutters  What It Means to Become an Extrovert—On Your Terms Let’s be clear: Extroversion doesn’t mean you just… never feel nervous. It doesn’t mean stuttering disappears. And it doesn’t mean you become the loudest person in the room. What it does  mean is you speak up, even when it’s hard, you start conversations, you share your story, and you get it through your brain that connection matters more than fluency. “I remember being told by adults in my life that what I had to say was worth waiting for. It made me realize that what I was saying was far more important than how I said it.” — Edmund Metzold, a person who stutters Tips for Building Communication Confidence Whether you’re naturally quiet or learning to come out of your shell, here’s how to build social confidence while honoring your voice: Join a community where stuttering is normal Being around others who stutter changes everything. You hear stories like yours. You stop feeling alone. You realize that stuttering doesn’t need to be hidden or fixed. “I stopped trying to ‘fix’ my stuttering when I realized that we as humans are all uniquely different, each with our own complexities and quirks. For so long, I wrestled with the idea that my speech must conform to that of a ‘typical’ speaker. However, this act of conforming would essentially erase a large part of what made me, me.” — Mackenzie Smith Start small, but start often Say hi to a cashier. Share your opinion in a group call. Introduce yourself in a Zoom meeting. Confidence is built in tiny moments of courage. Use disclosure to take control Letting people know you stutter can ease pressure and invite connection. Try something simple like, “Just so you know, I stutter. Thanks for your patience.” Celebrate your wins (yes, even the “small” ones) Did you speak up, even if you stuttered through every word? That’s a win. Every time you use your voice, you're practicing being seen. “There have been so many moments when doing theatre where I had to make the choice between being fluent but emotionless, or emote while stuttering. I almost always chose the latter, which helped me choose self-expression in real life as well.” — Edmund Metzold Redefining the Narrative There’s no “right” way to be a person who stutters. Some PWS are introverts. Others are extroverts. Many are somewhere in between. What matters most isn’t where you fall on the spectrum—but whether you feel empowered to communicate as you are . You don’t have to change your personality to grow. But if silence has been a protective shield, it’s okay to put it down. Stuttering doesn’t have to make your world smaller. Sometimes, it’s the very thing that pushes you to grow bigger and braver. “I realized that confidence does not depend on fluency when I started observing those around me—in the workplace, with friends, and in public spaces. When you really listen, it becomes clear that no one's speech is 100% fluent 100% of the time. We all stumble, mispronounce, rephrase, and for some, stutter. This is inherently what makes us imperfectly human.” — Mackenzie Smith Final Thoughts The journey from introversion to extroversion isn’t about changing who you are in every sense of the word—it’s about reclaiming who you were before fear took the mic. You don’t have to be fluent to be social. You don’t have to be fast to be heard. You just have to show up and speak in your own way. “Never be the one to tell yourself you cannot do something. You have to be your biggest supporter. If you aren't, there's no telling how many incredible opportunities you may let pass you by in fear of what others may think. Your thoughts and opinions matter, and the way in which you convey them does not take away from the messages themselves.” — Mackenzie Smith Looking to connect with others? Join an NSA Chapter  or explore our virtual events .

For children who stutter, school is a place of connection and learning—but it can also be a source of stress. Teasing and bullying from peers about how they speak can deeply impact self-esteem, confidence, and willingness to communicate. It is a fear many caregivers share and one that deserves proactive solutions. “Teasing/bullying has been a mommy fear of mine from the beginning. One time, our son came home and told us that he was teased on the bus after school. We have always told him that if there was any issue on the bus or at school, he should find a trusted adult. He tried to handle things himself, so along with his private SLP, we started self-advocacy. As a parent not with him 24/7, it hurts my heart to think about him in these positions. We have really tried to help him realize we can't control others, but we can control how we respond.” — Melinda Eairheart, mom of a 12-year-old who stutters The good news is that you are not powerless. With the right tools and support, you can help your child feel safe, build resilience, and ensure that their voice is not silenced by fear. This guide walks you through what to watch for, what to say, and how to work with schools to enact meaningful change. Recognizing the Signs of Teasing and Bullying Children do not always tell their caretakers when something is wrong. Many kids who stutter may try to hide how often they are teased—or feel that nothing can be done. That is why it is important to watch for signs, both subtle and direct. Red flags may include: Reluctance to go to school or participate in class Changes in mood, sleep, or appetite Avoidance of speaking situations, even at home Negative self-talk like “I hate my voice” or “No one listens to me” An increase in stuttering severity or signs of tension while speaking While these behaviors may have many causes, they are definitely worth exploring gently with your child. Ask open-ended questions like, “How do you feel about talking in class?” or “Has anyone ever made you feel bad about how you talk?” Coaching Confident Responses at Home You can’t control what others do or say, but you can prepare your child to respond in ways that advocate for themselves while protecting their self-worth and confidence. Responses don’t have to be perfect. They just need to help your child feel in control and supported. “As a person who stutters, my son Colton has watched me stutter throughout his life. My confidence with speaking, stuttering, and acceptance has helped him be confident and have acceptance as well. Our entire family is patient with Colton and me when we speak and it has created a welcoming, normal, accepting environment across all settings. Also, Colton created a stuttering presentation with the assistance of his SLP starting in kindergarten that he would share each year with his teacher and classmates. This opportunity to educate others about stuttering has created a supportive and accepting environment throughout his time in school. The presentation provided info about stuttering and ways to help someone who stutters.” — Holly Nover, person who stutters and mom of a 14-year-old who stutters Here are some ideas to explore together: “Yeah, I stutter. I am still talking—please let me finish.” “I just talk differently. That’s okay.” “You don’t need to fix or help me. I’m just fine the way I talk.” Role-playing these moments at home can be helpful. Practice different scenarios together. Encourage your child to use their voice, pause when they need to, and know they can always come to you. Also remind them that it’s okay to walk away, ignore rude comments, or get help from an adult. “In elementary grades, his SLP had him make a "This is Me" slideshow in August to send all of his teachers, explaining facts about himself, including information about his stutter and how teachers can support him. He has continued through seventh grade! Partner with NSA, use their online resources, find a Local Chapter (or online version), and embrace your child and their speech journey together! Finally, find someone who also stutters that your child can relate to. My son/family came together to watch Mitch Guerra on Survivor and I think it was great for him to see a person who stutters represented!” — Melinda Eairheart Building a Safe and Supportive School Environment Your child’s school should be a place where they feel safe, respected, and included. If bullying is happening—or even if you suspect it might—it is important to engage with teachers, counselors, and administrators proactively. Here is how you can start: 1. Schedule a meeting. Talk directly with your child’s teacher or school counselor. Share your observations and ask if they have noticed any behavioral changes. “I've emailed teachers asking to keep an ear out and let me know. This last year, I guess a group of middle school boys said something about his stutter. Sadly, he just doesn't speak around them in that class. He stutters freely at home. He stutters around those he knows are okay with his stutter. He says when he's around those whom he doesn't feel comfortable, he either uses strategies or refrains from speaking.” — Melinda Eairheart 2. Educate about stuttering. Many educators are not familiar with the emotional impact of stuttering. Provide resources (like those from the National Stuttering Association [NSA]) that explain what stuttering is  and how to support students who stutter . 3. Request a classroom-wide approach. Work with the school to ensure that kindness, empathy, and inclusion are modeled for all students. Anti-bullying messages should not single out your child, but promote respect for everyone . 4. Know your rights. If teasing or bullying continues, or if your child’s speech is affecting their academic experience, you may be entitled to accommodations or support through an Individualized Education Plan (IEP) or 504 Plan . The NSA offers tools to help caregivers advocate within the education system and guide these conversations effectively. Supporting Your Child Emotionally Even with strong advocacy, teasing still hurts. Your child may feel embarrassed, ashamed, or want to avoid speaking altogether. This is where your consistent support makes the greatest difference. Try the following: Reassure your child that stuttering is not their fault and that they are not alone Celebrate their bravery, not  their fluency Talk openly about feelings and encourage emotional expression Normalize asking for help and practicing self-care Let your child know that being teased says more about the other person than it does about them. Their voice is not broken and it does not need to be hidden. Connecting With Other Families and PWS One of the most powerful antidotes to bullying is connection. When children who stutter meet others like them, they often feel more confident and less alone. NSA Family Chapters, virtual events, and youth programs create safe spaces for children and caregivers to find community and share experiences. These connections help children reclaim their voice—not just in school, but everywhere. “Attending NSA Conferences with Colton has given him the opportunity to meet and speak with other people who stutter. Support your child by asking what you can do to help them advocate and what they want you to do when they stutter.” — Holly Nover Stuttering should never be a reason for a child to feel excluded, unsafe, or afraid to speak. As a parent, you are your child’s strongest advocate. By recognizing the signs of teasing, preparing them with confident language, and partnering with schools, you are helping build a world that hears and respects every voice. The NSA is here to support you with resources, education, and a community that understands. “Attending the NSA Conferences has greatly helped my understanding of the brain and speech science and overall support for people who stutter. Six years ago, the goal was correction and now the goal is supporting him to raise his confidence for all of life's next steps. COME TO THE NSA CONFERENCE! Our whole family was able to attend the last two years and we have all got so much out of the experience. Our son has loved getting to know his group of friends.” — Melinda Eairheart Learn More and Get Involved Explore more tools for caregivers at WeStutter.org/parents . Connect with others through Family Chapters and virtual meetups at WeStutter.org/families Find an NSA Chapter today at WeStutter.org/join-a-chapter .

The National Stuttering Association is proud to highlight Dr. Christopher Constantino, Associate Professor at Florida State University, whose research is uncovering how stuttering identity shapes emotional well-being. A recipient of the 2019 Canadeo Award, Dr. Constantino is exploring what it means to truly feel good about being a person who stutters. Why Stuttering Research Matters Dr. Constantino’s project began with a question: How does stuttering impact someone’s sense of self and their emotions during everyday speaking? “I was interested in how aspects of a speaker’s stuttering identity impacted their well-being while speaking,” Dr. Constantino explained. “Specifically, I measured stuttering’s centrality (how important it is to a speaker’s sense of self), private regard (their attitude toward stuttering), and positive and negative affect (how they were feeling in a particular moment).” He also tracked stuttering’s salience—how aware participants were of their stuttering during conversations—and measured spontaneity and fluency. Studying Life as It Happens Rather than relying solely on lab settings, Dr. Constantino took his research into the real world. He used the experience sampling method, asking adults to complete brief surveys on their smartphones multiple times a day for a week.  “This allowed me to measure their subjective experience of speaking in the real world, as it occurred during their everyday life,” he said. What Dr. Constantino Found The results are striking: When someone is highly aware of their stuttering (high salience), having stuttering as a central part of their identity can help them feel better. Feeling good about being a person who stutters (private regard) supports positive emotions, especially when stuttering is highly noticeable. The less effort a speaker puts into speaking, the better they feel. In contrast, speaking fluently with effort can make someone feel worse. “This is the first study documenting that salience of stuttering can be anything other than negative,” Dr. Constantino said. “Furthermore, stuttering salience was not just neutral; it was positive! This is a real, documented benefit of stuttering. We have measured stuttering gain.” Implications for Therapy and Support These findings have major implications for how people who stutter—and the professionals who support them—approach therapy. Traditional approaches often aim to create fluent speakers at all costs, but Dr. Constantino’s research suggests a different path. “These findings show that therapies that pursue a false fluent identity forfeit the potential well-being gains of a positive stuttering identity,” he said. “Increasing private regard for stuttering improves psychological outcomes and may be tied to speaking more spontaneously. Therapy should target integrating stuttering into one’s sense of self and cultivating a sense of stuttering pride.” This perspective is central to Stutter-Affirming Therapy, which Dr. Constantino developed to help speakers embrace stuttering rather than reject it. The approach has three main priorities: Reject fluency by reducing stutterphobic reactions and increasing stutterphilic reactions. Value stuttering by discovering what speakers gain from it. Create an environment in which it’s easier to stutter through education, advocacy, disclosure, and voluntary stuttering. Looking Ahead Dr. Constantino is continuing to expand this research. His work promises to influence not only therapy practices but also how stuttering is understood, discussed, and valued in everyday life. “The next step is to study how to facilitate a more positive stuttering identity by increasing centrality and private regard,” he said.  For those interested in learning more, Dr. Constantino presented his findings at the Oxford Stuttering and Cluttering Research Conference and plans to publish them soon.

Since 1999, the National Stuttering Association (NSA) has proudly supported a growing body of research aimed at understanding, treating, and destigmatizing stuttering. This archive honors all past and present researchers, award recipients, and NSA Research Committee-approved projects that have contributed to our collective knowledge of stuttering. Graduate Student Research Award Recipients $5,000 grant  supporting graduate-level research in stuttering. Previously known as the NSA Research Fund Award. Year Recipient(s) Research Title 2025 Amir Hossein Jokar Rasoli How Do Teens Who Stutter Define Stuttering? 2024 Haley Warner, M.S., CCC-SLP How the Perception of the Listener Impacts Stuttering in Early Childhood 2023 Cody Dew, MA, CCC-SLP How People Who Stutter Experience and Navigate Stigma and Discrimination in the U.S. Labor Force: A Phenomenological Analysis 2022 Ryan Millager, MS, CCC-SLP Parent-Oriented Features in Early Childhood Stuttering: A Pilot Study 2021 Xiaofan Lei, MA Stuttering and Emotion in Daily Life 2020 Robyn Croft, MS, CF-SLP; PhD Student & Dr. Courtney Byrd Improving Quality of Life for Adults Who Stutter Through an Online Self-Compassion Intervention: A Pilot Study 2017 Cara M. Singer, M.A., CCC-SLP The Contribution of Cognitive-Emotional and Speech-Language Vulnerabilities to Stuttering Chronicity 2016 Kim Bauerly, PhD, CCC-SLP The Effects of Social Stress on Speech-Motor Control in Adults Who Stutter 2015 Mary Weidner, MS, CCC-SLP Mitigating Non-Stuttering Children’s Attitudes Toward Their Peers Who Stutter 2014 Sujini Ramachandar, MS, CCC-SLP and J. Scott Yaruss, Ph.D, CCC-SLP, BRS-FD, ASHA Fellow Identifying Neuroanatomical Differences in People Who Stutter Using High Definition Fiber Tracking Canadeo Research Award Recipients Award recognizing outstanding contributions to the field of stuttering research. Year Recipient(s) Research Title 2019 Christopher Constantino, Ph.D., CCC-SLP Stuttering Identity’s Contribution to Well-Being Among Adults Who Stutter 2018 Rodney Gabel, Ph.D., CCC-SLP, BCS-F & Michael P. Boyle, Ph.D., CCC-SLP Being Open About Stuttering: What Are the Effects? 2017 Victoria Tumanova, PhD, CCC-SLP Autonomic Nervous System Response to Speech Production in Stuttering and Normally Fluent Preschool-Age Children 2016 Hatun Zengin-Bolatkale, M.A., CCC-SLP 2015 Michael P. Boyle, Ph.D. Reducing the Stigma Associated with Stuttering: A Comparison of Three Strategies for Change 2014 Chagit Edery Clark Linguistic Dissociations, Attention Regulation, and Childhood Stuttering 2013 Emily O’Dell Garnett, M.S., CCC-SLP and Dirk-Bart den Ouden, Ph.D. Effects of Cortical Stimulation on Self-Monitoring Performance in People Who Stutter 2012 Geoff Coalson, MS, CCC-SLP & Courtney Byrd, PhD, CCC-SLP Phonological Syllabification in Adults Who Do and Do Not Stutter CASE Research Grant Recipients $15,000 grant supporting research in Community, Advocacy, Support, and Education (CASE) Year Recipient(s) Research Title 2025 Dr. Sujini Ramachandar Reading Fluency in Children who Stutter 2024 Dr. David Evans Jenson The Impact of Self-Disclosure on Autonomic Activity in People Who Stutter and Conversational Partners 2023 Dr. Jeanne Nakamura Fluency and Flow Experiences in the Daily Lives of People Who Stutter 2022 Dr. John Tetnowski & Dr. J. Cecil Use of Virtual Reality Simulations to Promote Carry-Over in Older Children and Adolescents Who Stutter 2021 Dr. Nan Ratner Establishing an Evidence-Base for Recommendations to Parents of Young Children Who Stutter

Contributor: Chantel McAlonan, S-LP, Reg. CASLPO and PWS Stuttering is more than repetition, prolongation, or blocking. It is an individualized experience that shapes how someone communicates and navigates the world. While many people know about childhood-onset stuttering, known as developmental stuttering, fewer are aware that stuttering can also begin later in life after a stroke, head injury, a reaction to certain medications, or as part of neurodegenerative disorders. This is known as acquired stuttering, an umbrella term that neurogenic stuttering falls under. By understanding both developmental and neurogenic stuttering, people who stutter, their families, and allies can deepen awareness and advocate for more inclusive communication spaces. It also reflects what research shows: that stuttering is multifactorial, influenced by genetics, neurology, motor coordination, language, and the environment. What is Developmental Stuttering? Developmental stuttering is the most common type of stuttering. It typically begins between the ages of 2 and 6, likely due to rapid language development when children learn to construct more complex sentences. Around 5-10% of children will experience stuttering at some point. Many of these children develop fluent speech and a smaller group will continue to stutter into adolescence and adulthood. The causes of developmental stuttering are complex. Despite common myths, research has shown that it is not due to nervousness or poor parenting. Instead, it is linked to differences in how the brain coordinates speech planning and motor control. Genetics also plays an important role, with stuttering often appearing across multiple generations of a family. Children who stutter may also have subtle co-occurring differences in neurological processing, speech and language planning, emotional reactivity, or regulation of attention and executive functioning. These differences reflect the complex nature of stuttering and how it can interact with other aspects of development. Developmental stuttering usually follows a gradual course. The stuttering often appears at the beginning of words, phrases, or sentences and is typically more noticeable on content words like nouns and verbs. However, this pattern does not occur in all cases, and some children may stutter on function words, like “and or “the”, especially in the early stages of developmental stuttering. Children may repeat sounds or syllables, stretch out certain sounds, or become momentarily blocked when trying to speak. Over time, some children and adults develop physical tension, secondary characteristics (e.g., eye blinks, avoiding eye contact), or avoidance behaviors (e.g., changing words) as ways of coping with moments of stuttering. These learned reactions reflect how stuttering involves both involuntary speech patterns and the effortful strategies people develop to manage them. Living with developmental stuttering can shape a person’s confidence, social choices, and willingness to speak in front of others. This is why early support matters so much. Speech therapy can provide helpful tools to become a more effective and confident communicator, while emotional support from family, teachers, and peers helps reduce stigma. Just as important is community: finding a space where stuttering is understood, such as National Stuttering Association (NSA) Chapters, allows people to feel accepted for who they are. What is Neurogenic Stuttering? Neurogenic stuttering begins after a neurological change in the brain. Someone who has never stuttered before may suddenly develop stuttering after experiencing a stroke, a traumatic brain injury, a brain tumor, a degenerative neurological condition, or as a reaction to certain medications. Neurogenic stuttering can occur more evenly across a person’s speech. Stuttering may appear on both content words and function words, such as “the” or “and.” Stuttering may also be heard at the beginning, middle, and end of words. Unlike developmental stuttering, it often does not lessen during singing or choral reading. Because neurogenic stuttering arises suddenly and is usually tied to a significant health event, people may not immediately develop the coping strategies commonly seen in developmental stuttering. However, neurogenic stuttering frequently coexists with other communication or motor challenges, such as aphasia, apraxia of speech, or difficulties with executive functioning, memory, and attention. This can make communication more complex and requires a comprehensive approach in therapy. When stuttering appears as a side effect of medication, doctors may consider adjusting or replacing the medication. In some cases, reducing or stopping the drug lessens the stuttering. Antipsychotics such as clozapine, some antidepressants, anticonvulsants, and other central nervous system medications are among the best-documented causes of drug-induced stuttering. In situations where medication changes are not possible, speech-language pathologists (SLPs) can support individuals by helping them develop coping strategies, improve communication confidence, and explore fluency techniques if desired. In these cases, therapy focuses on effective, comfortable communication rather than achieving perfect fluency. Key Differences at a Glance Living with a Neurogenic Stutter: Elizabeth Minton’s Story Elizabeth Minton, from Greensboro, North Carolina, is in her second year of graduate school for speech-language pathology and hopes to one day earn her doctorate so that she can one day research neurogenic stuttering. “I’ve been involved with the NSA for over four years,” Elizabeth said. “I discovered the NSA after a homework assignment! I went back to school and I took a class with a professor who stutters. He gave us an assignment that mentioned the NSA. I looked it up and went to my first Annual Conference in 2022. I am a member of the Young Adults Committee and I’ve loved every minute.” Elizabeth began to stutter suddenly on August 8, 2020.  “I began a new medication (gabapentin) and began to stutter within 48 hours. I stopped the medication within 6 days, but the stutter never went away.” But at first, she didn’t think anything of it. Because her stutter was due to a medication, there was the assumption that it would go away and that it was just a side effect. But after the days turned to weeks and weeks into months, that’s when Elizabeth started to panic. “I was convinced my life was over,” Elizabeth said.  The COVID-19 pandemic made things harder for Elizabeth since seeing doctors at that time, as she described, was “very difficult.” “I have to explain the difference [between developmental and neurogenic stuttering] often,” Elizabeth said. “This usually happens with speech therapists who did not get a thorough explanation of acquired stuttering in school and have never seen a case before. I have to explain that neurogenic stutters are acquired later in life due to some type of change in the brain. We stutter on all syllables, not just the initial one. Traditional therapeutic techniques don’t work on acquired stutters.” She’s also had to clarify that emotional and physical reactions can be part of the stuttering experience. “Just because the textbooks say that people with acquired stutters don’t develop emotional issues and secondary behaviors, it doesn’t mean you shouldn’t ask about them. I developed secondaries. I developed major emotional issues.” Outside of professional circles, her explanations sound a little different.  “I’ve also had to explain the difference to random people in my life,” she said. “This is mainly because I’ve had to explain to people why I went from totally fluent to sounding like a lawnmower (according to a toddler I knew a few years ago!). Those explanations are usually simpler than the ones I give to speech professionals. Thankfully, most people are understanding!” But Elizabeth realized that her voice could still have power. She went back to school in 2022 because her initial degree was in Communications Studies (which she calls ironic). She decided to recreationally take an Intro to Communication Disorders class to try to learn more about stuttering. She didn’t expect her professor to be a person who stuttered.  “In that moment, I thought, ‘Wait, he has a job where he talks all the time. And no one cares. He’s got a job and a life,’” she said. “That was when I realized I could have that too. My voice could still be worth it.” After that, she took two years of speech therapy once a week. She said her therapy included a lot of desensitization and Acceptance and Commitment Therapy (ACT). She had the opportunity to speak to a group of mostly strangers. Bravely, she spoke for 15 minutes in front of people who didn’t even know her.  “And that was when I really knew that my voice was worth listening to,” Elizabeth said. “Now, I speak to all kinds of people. I work with students who stutter, as well as other students. I speak to other classes. I’m a regular on my friend’s livestream. I talk just as much as I used to. It just takes me longer (and half the time it’s longer because of all the dumb jokes I say).” When asked if the stuttering community has space for neurogenic experiences, Elizabeth said it does.  “I was welcomed with open arms when I joined,” she said. “Despite having no experience in the community, I was able to dive right in. I have never felt othered in the community for having a different kind of stutter.” Here’s her message to the general public, clinicians, and allies: “First, please don’t dismiss someone’s experience because it’s something you’ve never heard of! My case is incredibly rare, but that doesn’t mean it’s in my head or anything like that! I’m not faking (believe me, I’m way too lazy to fake it). I’m not cold. I’m not unintelligent (trust me, I’ve been in school way too long to be unintelligent). My voice is worth hearing and if you aren’t willing to take the time to wait, then you probably aren’t worth the effort it takes for me to speak in the first place. I am valid. My voice is valid.” Treatment & Support for Stuttering Both developmental and neurogenic stuttering can benefit from speech therapy, but the goals and approaches are tailored to the individual. In developmental stuttering, therapy may focus on managing moments of stuttering, building communication confidence, reducing fear or avoidance, and stuttering modification or fluency-enhancing approaches if desired. In neurogenic stuttering, therapy is similar, but often addresses the co-occurring neurological or cognitive changes that affect speech and language to improve overall participation in daily life. In cases of medication-induced stuttering, a medical review is essential. Adjusting the prescription under a doctor’s supervision can sometimes reduce or eliminate the stuttering. No matter the type of stuttering, it’s not simply about achieving fluent speech. It is about communication and participation in everyday life. That is why emotional support and community connection are equally important for self-acceptance and communicating with confidence. Final Thoughts Whether stuttering begins in early childhood or after a life-changing event, every person who stutters deserves respect and understanding. Developmental and neurogenic stuttering may differ in terms of their cause and presentation, but both require patience, understanding, and listening. Allies play a key role in this. Waiting for someone to finish, giving them space to express themselves, and showing openness to communication differences sends a message that stuttering is just how some people speak. By listening to and learning from those with lived experiences, we build the most important skill of all, empathy. Finding others who share the experience can be life-changing. The NSA community offers various spaces where individuals and families discover they are not alone and stuttering is celebrated. At the NSA, we believe that every voice matters. You are not alone. Please visit our website at WeStutter.org  for more information and resources about stuttering.

Fear shows up at least once in a while for everyone, but for people who stutter (PWS), it can feel amplified in otherwise “everyday” or “ordinary” moments. Like ordering a coffee, introducing yourself to someone new, or sitting across from a potential employer during an interview.  But advocate and author Matice Morris   reminds us that fear can become the very thing that helps us grow in our stuttering journey. She shared her story  with the National Stuttering Association (NSA) community during the 2023 Annual Conference, offering reflections that continue to inspire years later.  She reminds us that courage is not about waiting for the fear to fade. It is about moving forward while it is still there. When the World Doubts People Who Stutter Unfortunately, many PWS know what it feels like to be underestimated or undermined. Matice described one of those moments: “I had a job recruiter tell me I would have a hard time getting a job because the employers would think I was mentally challenged. I was facing constant rejection and adversity.” That moment could have discouraged her. Instead, she chose to keep going, fueled by the belief that her stutter was not something to hide. Doing the Thing That Scares You The Most Fear often signals that growth is just around the corner. Matice shared an empowering lesson that resonates with anyone seeking to find courage in their voice: “Do the thing that scares you the most. It’s in the scary, hard moments where we see what we’re made of. Most times, we’re stronger than our fears by far.” By stepping into what felt uncomfortable, she discovered her strength: “I refused to let my stutter hold me back from another job opportunity. I felt the fear and did it anyway. After one interview, I was hired.” Courage doesn’t mean being fearless. It means acting despite the fear and seeing what is possible on the other side. Redefining Confidence Confidence grows from empathy, self-acceptance, and community: “When I started the job hunt again, I still stuttered, but I knew there was absolutely nothing wrong with it. In fact, it made me that much better, empathetic, and attentive to others. I believe my inner confidence showed externally, and I received multiple job offers.” Her closing message continues to inspire: “Feel the fear and do it anyway. Do the thing that scares you the most, and you’ll see that fear is only a mental mountain, where, on the other side, is confidence.” Fear is not the end of the story. It is often the beginning of strength. Conclusion At the NSA, we celebrate voices like Matice’s. Join an NSA Chapter near you or connect online at WeStutter.org to find your community today.

The National Stuttering Association® is honored to share this updated 2025 directory of workshops, summer camps, intensive programs, and retreats  that provide education, therapy, and community support for people who stutter. Whether you are a parent looking for a safe camp experience for your child, a teen seeking peer connection, or an adult interested in intensive therapy, this list highlights trusted opportunities across the U.S. and internationally. If you’d like to update your program or add a new listing, please contact Sarah Onofri   National / Multi-State Camp SAY Who:  Ages 8–18 When:  July 19 – August 1, 2025 Where:  Morgan’s Wonderland Camp, San Antonio, TX Highlights:  Two-week sleep-away camp with traditional activities + supportive community. Also runs Camp SAY: Across the USA  weekend pop-ups. American Institute for Stuttering (AIS) Who:  Children, teens & adults Where:  New York City, Atlanta, Los Angeles, and Online Highlights:  Group & individual therapy, intensives, Avoidance Reduction Therapy for Stuttering (ARTS©), speaker events, and support groups. Northeast Camp Dream. Speak. Live. (Arthur M. Blank Center) Who:  Children ages ~5–15 Where:  Varies annually (2025 host: Binghamton University, NY) Highlights:  Free camp focused on communication confidence, community, and leadership. Camp Words Unspoken (Pittsfield, MA) Who:  Children & teens, ages 7–17 When:  Summer 2025 session open (tuition details available) Highlights:  Overnight camp blending recreational fun with therapeutic speech sessions. SPEAK NOW! (Temple University, Philadelphia, PA) Who:  Children & teens When:  Summer 2025 Highlights:  Day camp combining speech goals, peer connection, and therapy-led activities. Hope for Stuttering ‘Flourish Retreat’ Who:  Older teens, college-age, and adults Where:  Milford, CT Highlights:  A transformative 5-day retreat emphasizing belonging, growth, and social confidence. Includes daily sessions and beachside community building. Mid-Atlantic / Southeast Positive Responses to Stuttering Program (PRSP, East Carolina Univ.) Who:  Children (6+), teens & adults Highlights:  Intensive summer program targeting overt and covert stuttering behaviors. Camp T.A.L.K.S. (Vanderbilt Bill Wilkerson Center, Nashville, TN) Who:  Ages 8–16 + families When:  June 2–6, 2025 Highlights:  Day camp with a strong family involvement component. Volunteer Your Voice (University of Tennessee) Who:  Ages 9–16 When:  May 28–30, 2025 Where:  Tremont, TN Highlights:  Three-day overnight camp with outdoor activities and communication practice. Central South Comprehensive Stuttering Therapy Program (CSTP, Texas State Univ.) Who:  Teens & adults (14+) When:  July 14–19, 2025 Where:  San Marcos, TX Highlights:  Six-day intensive program focusing on real-world communication. Central North UMN “Kids Who Stutter” Summer Camp (University of Minnesota, Minneapolis) Who:  Students entering grades 5–9 When:  Summer 2025 Highlights:  A fun, inclusive camp experience focusing on self-acceptance, communication, and peer connection. Star Lake Out Loud Who:  Kids & teens who stutter, ages 8–17 Where:  Crosslake, MN Highlights:  Wilderness camping experience building confidence, communication, and lifelong friendships. Northwest Camp More (Rockaway Beach, OR) Who:  Kids & teens, ages 7–18 When:  August 16–21, 2025 Where:  Camp Magruder, Rockaway Beach, OR Highlights:  Overnight camp designed to build friendships, confidence, and communication skills. Successful Stuttering Management Program (SSMP, Eastern Washington Univ.) Who:  Teens & adults When:  June 18–27, 2025 Where:  Cheney/Spokane, WA Highlights:  Nine-day residential intensive focusing on avoidance reduction and stuttering modification. Mountain West University of Utah Intensive Stuttering Clinic Who:  Ages 15+ (participants must be mature enough for intensity) When:  July 20 – July 31, 2026 (2025 details forthcoming) Where:  Salt Lake City, UT (University of Utah Research Park Campus) Highlights:  2-week intensive program combining fluency shaping and fluency management. Morning sessions emphasize structured drills; afternoons include transfer tasks, conversation practice, and field trips. Contact:   Julia Lidgard (Director) Catamount Intensive Stuttering Program (CISP) Who: Individuals who stutter, ages 14+ When: July 27–31, 2026 Where: Western Carolina University, Cullowhee, NC Highlights: A free 5-day intensive focusing on stuttering modification and avoidance reduction. Learn more: Western Carolina University – Catamount Intensive Stuttering Program Colorado Speaks Camp (University of Colorado Boulder) Who:  Ages 12–18 When:  June 2025 (exact dates TBA) Where:  University of Colorado Boulder Campus, Wolf Law Building – 2450 Kittredge Loop Drive, Boulder, CO 80309 Highlights:  A week-long day camp offering full days of fun, games, and real-life social-communication skill building for young people who stutter. Participants gain confidence, advocacy skills, and tools for managing stuttering in everyday situations. Contact :  Shelley Sheppeck, Director of Clinic Operations – slhc@colorado.edu  | 303-492-9949 Learn more:   CU Speech, Language & Hearing Clinic Virtual & International Oxford Stuttering & Cluttering Research Conference Who:  Clinicians, researchers & people who stutter When:  September 23–26, 2025 Where:  St Catherine’s College, Oxford, UK Highlights:  International conference with leading voices in stuttering and cluttering research. SPACE Community & Arts (Online) Who:  Youth (7–18) & young adults (18–22) Highlights:  Virtual arts and advocacy programs across the U.S. and Canada. The Unblockables – Improv for People Who Stutter Who:  Adults who stutter Format:  Virtual cohorts, led by professional improv coaches Highlights:  Builds confidence and expression through performance-based practice. The Care Clinic at Perley Health (Ottawa, Canada; Virtual Available) Who:  All ages Highlights:  Bilingual (English/French) assessment and therapy, with telepractice options. McGuire Programme (Global) Who:  Teens & adults (14+) When:  Courses run year-round; 2025 calendar published Where:  Worldwide (in-person & virtual) Highlights:  3–4 day intensive courses combining speech techniques, confidence-building, and peer support. We encourage families and individuals to reach out directly to each organization for the latest details. Want to explore more support? Visit our NSA Annual Conference page  and Find a Chapter page  to connect with the community year-round.

At the National Stuttering Association (NSA) , our mission is to empower speech-language pathologists (SLPs)  with research-driven knowledge, clinical tools, and community connections to help people who stutter (PWS) communicate with confidence. Addressing stuttering can feel complex, and even experienced clinicians may wonder how to best support clients of different ages and experiences. The NSA exists to make that process easier—with continuing-education opportunities , research collaborations , and local chapters  that strengthen both professional skill and human connection. Empowering SLPs to Support People Who Stutter Our resources are designed to help you stay informed, inspired, and connected to the larger stuttering community. Whether you’re an SLP working in schools, private practice, hospitals, or universities, the NSA provides reliable information and a supportive professional network that enhances the care you provide. Professional Development & Continuing Education Stay current with ASHA-approved continuing-education workshops , NSA webinars , and clinician-focused sessions  offered at our Annual Conference —the premier national event for stuttering awareness and professional growth. Each program blends the latest research with real-world strategies so you can apply new insights immediately in therapy. Conference participation also offers CEUs   and the opportunity to engage directly with leaders in stuttering research and clinical practice. The NSA’s Professional Relations Committee offers free in-service presentations for SLPs, available via Zoom for schools, clinics, and other professional settings. These sessions provide practical tools and up-to-date insights to better support people who stutter in educational and clinical environments. The committee also hosts quarterly NSA Connects sessions, designed specifically for SLPs to exchange ideas, share experiences, and strengthen their professional community. For more information or to schedule an in-service, contact Courtney Luckman . Research Collaboration Opportunities Join us in advancing the science of stuttering. The NSA regularly partners with universities and clinicians to study fluency, identity, and quality of life for people who stutter. SLPs are invited to contribute data, participate in studies, or collaborate on upcoming research projects. Together, we can expand evidence-based understanding and shape the next generation of stuttering intervention. Learn more on the NSA Approved Research page. Local Events and Chapters Throughout the year, the NSA hosts One-Day Conferences , fundraisers , and community events  that bring together people who stutter, their families, and professionals. These gatherings allow SLPs to connect with the lived experiences of stuttering, deepening empathy and insight that translate directly into therapy. Find ongoing peer support through our nationwide network of   Local NSA Chapters  for adults, teens, kids, and families. Chapter meetings are open to SLPs and offer a welcoming space to learn, listen, and grow alongside the community you serve. Helpful Educational Resources for Speech-Language Pathologists' Expand your clinical toolkit through our evidence-based learning pages: What Is Stuttering?  — Understand the neurological and linguistic foundations of stuttering. Treatment Options  — Explore fluency-shaping, stuttering-modification, and stutter-affirming approaches. Find a Speech Therapist  — Access referral networks and professional directories to support your clients. These resources are continually updated to reflect current research and clinical best practice. Join the NSA Professional Community The NSA is more than an organization—it’s a community of professionals, researchers, and people who stutter  united by a shared goal: to create a world where every person can communicate freely and authentically. Join us to stay informed, contribute your expertise, and advocate for inclusion in every speaking environment. Last Updated: October 2025 Author: National Stuttering Association Marketing & Education Team with contributions from Nicole Kulmaczewski, MS, CCC-SLP and Jacqueline Toscano, SLP.D. CCC-SLP

Pediatricians play a vital role in recognizing the early signs of stuttering, guiding caregivers, and referring families to qualified speech-language pathologists. Parents often turn first to their child’s doctor for reassurance and direction, which means pediatricians are uniquely positioned to promote early intervention and reduce stigma. The National Stuttering Association provides educational resources and professional insights to help pediatricians support children who stutter and their families with empathy, understanding, and evidence-based guidance. 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 reflect the diversity of human communication and are not signs of reduced intelligence or poor parenting. According to the American Speech-Language-Hearing Association (ASHA) and current research, stuttering is part of normal variation in how people produce speech. Commonly Observed Features Repetitions:  repeating sounds, syllables, or words, for example “I I I want to go.”  Prolongations:  stretching out a sound, for example “ssssun.”  Blocks:  pauses where speech stops momentarily, often with visible or internal tension even though the speaker knows what they want to say. These speech differences can occur more often when a person is excited, tired, feels pressure to speak quickly, or is in specific social environments. Beyond What You Hear Stuttering is not limited to speech sounds. It may include physical movements, emotional responses, and behavioral adaptations. Physical aspects  can include eye blinking, facial tension, or shifts in posture during speaking.  Emotional and cognitive aspects  involve thoughts and feelings about speaking that may be shaped by personal experiences and reactions from others.  Communication behaviors  such as word substitution or avoiding certain words or situations may reflect concern about how others respond to stuttering rather than the stutter itself. Varieties of Stuttering Although every individual’s speech is unique, stuttering can be described in several ways depending on how it begins and what causes it. Childhood Onset Stuttering  often begins between ages two and five during rapid speech and language development.  Neurogenic Stuttering  may occur following neurological changes such as a brain injury or stroke.  Functional Stuttering  is rare and can sometimes follow psychological or emotional events. Causes of Stuttering Stuttering is a complex neurological condition that involves multiple contributing factors. It cannot be explained by nervousness, personality, or speaking too quickly. Developmental stuttering originates in the areas of the brain responsible for speech and language processing. Genetic, environmental, and developmental influences all interact to affect fluency. While stuttering may occur along with other speech or language differences, it is neurological rather than psychological in origin. ADVISING CAREGIVERS Misunderstandings about stuttering are widespread, and parents often feel responsible for their child’s speech. Pediatricians play an important role in helping parents understand that stuttering is nobody’s fault. When speaking with caregivers, pediatricians should: Reassure families that stuttering is a normal variation of communication. Emphasize that creating a relaxed and accepting environment helps more than correction. Explain that an early consultation with a speech-language pathologist can support positive outcomes. These conversations can help reduce guilt, ease anxiety, and empower families to respond to their child’s speech with confidence and support. SPEECH THERAPY FOR CHILDREN For Young Children For preschoolers, speech therapy focuses on helping children and families build healthy and positive responses to moments of stuttering. Therapy supports acceptance and confidence in communication, helping children develop a sense of ease and pride in how they speak. The goal is not to eliminate stuttering but to prevent negative reactions to stuttering from the child or others, and to nurture positive attitudes about speaking. For Older Children and Adolescents For older children, therapy continues to address emotional and social responses to stuttering while focusing on individualized goals that promote communication confidence and self-advocacy. Effective therapy is tailored to each child’s needs and may evolve as they grow. EARLY IDENTIFICATION Early identification is one of the most valuable ways to improve outcomes. Pediatricians can use evidence-based tools such as the Childhood Stuttering Screening for Physicians (CSS-P) to determine whether referral to a speech-language pathologist is appropriate. Observation alone is not enough to measure severity or determine the need for therapy. Pediatricians should consider referring when: Parents express concern about speech or communication frustration. The child shows visible struggle or physical tension when speaking. The child demonstrates awareness or anxiety about talking. Discussing these factors helps families make informed choices about pursuing speech therapy early. EARLY INTERVENTION Up to seventy-five percent of preschoolers who stutter experience spontaneous resolution, but early identification remains essential. A wait and see approach may delay support for children who are at risk of persistent stuttering. Early referral to a speech-language pathologist can reduce the likelihood of long-term negative experiences with speaking and help children develop healthy and empowered attitudes about communication. When and How to Refer Speech-language pathologists certified by the American Speech-Language-Hearing Association (ASHA) are trained to diagnose and treat stuttering. Pediatricians can refer families directly to a speech-language pathologist or connect them with national organizations like the National Stuttering Association. To find a speech-language pathologist who specializes in childhood stuttering, click here. How Pediatricians Can Support Families Recognize early signs of stuttering and take caregiver concerns seriously. Reassure parents that stuttering is not caused by anxiety, trauma, or parenting style. Refer to a qualified speech-language pathologist rather than waiting to see if stuttering resolves on its own. Encourage families to foster open, pressure-free communication at home. Share evidence-based resources  from the National Stuttering Association By providing informed, empathetic guidance, pediatricians can play a meaningful role in ensuring that children who stutter receive timely support and encouragement for confident communication. Last Updated:  October 2025 Author:  National Stuttering Association Marketing & Education Team with contributions from Nicole Kulmaczewski, MS, CCC-SLP and Jacqueline Toscano, SLP.D. CCC-SLP.

Understanding Speech Therapy for School-Age Children Who Stutter Therapy for school-age children and teens who stutter is different from therapy for preschoolers. For younger children, goals often focus on preventing negative reactions and supporting parents through early concerns. While these remain important, therapy for older children expands to include emotional growth, self-advocacy, and communication comfort. As children grow, therapy must evolve with them. A broad-based approach is essential—one that goes beyond fluency to address feelings, confidence, and the child’s experience in school and social settings. Individualized, Supportive, and Holistic Therapy Every child who stutters has unique needs. Caregivers should be cautious of any clinician who promises a “one-size-fits-all” treatment. Effective speech therapy is always individualized , built around the student’s specific goals and challenges. The aim of therapy for school-age children and teens is to help them communicate freely and confidently  without fear of stuttering holding them back. This does not mean fluency is the goal—most people who stutter will continue to stutter throughout life—but that stuttering should never limit participation, self-expression, or success. How Therapy Helps Children Communicate Comfortably Speech-language pathologists (SLPs) work collaboratively with children and families to identify strategies that make communication easier and more enjoyable. Therapy may include: Techniques for speaking with greater ease, such as easy onsets or paced speech . Learning to stutter with less physical tension by easing through  moments of disfluency. Exercises to reduce avoidance  and increase comfort  during conversations. Emotional support to build self-acceptance and reduce fear of judgment. Since stuttering often involves physical tension, fear, or shame, therapy should address both the speech behaviors  and the emotional experience  of stuttering. Fostering Acceptance and Identity Acceptance is a key part of successful therapy. Children who learn to view stuttering as a natural part of themselves are less likely to avoid speaking situations and more likely to participate fully at school and in daily life. When peers, teachers, and families also accept stuttering as a normal form of communication difference, children gain confidence and resilience. Therapy that emphasizes acceptance not only reduces struggle but also empowers children to use their voices authentically . Creating Supportive School Environments A major part of therapy involves helping teachers, classmates, and caregivers understand stuttering. Children who stutter may be misunderstood or even bullied, so education and awareness are essential. Supportive classrooms can be built when educators: Allow extra time for responses during discussions and presentations. Focus on the content of communication , not fluency. Reassure students that everyone communicates differently. Model patience and encourage classmates to listen respectfully. An inclusive classroom helps children who stutter feel seen, valued, and safe to participate. The Role of Caregivers and Collaboration Caregivers play an important role in extending therapy beyond the school setting. They can help by reinforcing positive communication strategies, maintaining open dialogue with the school SLP, and ensuring consistent support between school and home. Regular communication among the child, parents, teachers, and SLP ensures everyone is working toward the same goal— building confident, capable communicators. A Team Effort for Lifelong Confidence Effective stuttering therapy for school-age children is a team effort . It combines individualized speech strategies, emotional support, and advocacy to help each child reach their full potential. By promoting understanding in both the classroom and at home, caregivers and educators can make sure that stuttering never stands in the way of a child’s voice. For more detailed guidance on therapy approaches, visit Stuttering Treatment Options . For parent resources and caregiver support, see Selecting the Right Therapist for Your Child . Last Updated:  October 2025 Author:  National Stuttering Association Marketing & Education Team with contributions from Nicole Kulmaczewski, MS, CCC-SLP, Jacqueline Toscano, SLP.D. CCC-SLP , Caitlin Franchini, MS, CCC-SLP and Megan M. Young, ABD, CCC-SLP

No one speaks with perfect fluency all the time. Everyone occasionally says “um”  or “like,”  repeats a word, or pauses to find the right one. These normal disfluencies differ from stuttering , where interruptions in speech occur more frequently and can impact communication, confidence, and emotional well-being. For people who stutter, these moments can bring feelings of loss of control, frustration, shame, or even trauma. For some, stuttering resolves in childhood; for others, it continues through adulthood. Why does this happen? Researchers agree that stuttering results from a combination of factors  — including genetics, language development, environment, and brain structure and function  (Smith & Weber, 2017). These factors interact dynamically to influence how speech develops and is produced. Stuttering and Language Development Stuttering most often begins between the ages of two and five , when speech and language are developing rapidly . During this stage, children’s brains are learning to coordinate complex skills such as vocabulary, sentence construction, and speech motor control. Researchers believe that interactions among genetic predisposition , natural language growt h, and neurological timing differences contribute to whether stuttering emerges or continues over time. For some children, stuttering naturally resolves on its own , while for others, it remains a part of how they communicate . This stage of development places high cognitive and motor demands on speech, and for children predisposed to stutter, those demands may temporarily or persistently disrupt fluency. Genetic Factors Family histories consistently show that stuttering runs in families . Children who stutter frequently have relatives who also stutter, and identical twins (who share all genes) exhibit more similar stuttering patterns than fraternal twins. While no single “stuttering gene” has been identified, researchers have linked several gene variants to the condition. These genes influence how the brain develops and maintains the pathways responsible for speech and motor coordination. Stuttering also shows a gender difference : it affects males more than females, and females are more likely to recover before adulthood. Genetic predisposition alone does not determine outcome—it interacts with brain organization, language growth, and environment. Brain Activity in People Who Stutter The prevailing theory suggests that neurological organization  influences both the onset and persistence of stuttering. Brain imaging studies reveal differences in how people who stutter plan, time, and execute speech: Greater right-hemisphere activity , paired with reduced activation in traditional left-hemisphere speech centers. Differences in white-matter connections  that link motor and auditory areas of the brain. Less efficient auditory feedback processing  and slightly slower sensory-motor reaction times. These neurological findings reinforce that stuttering is not psychological —it’s rooted in how the brain coordinates language and movement. Emotions and the Environment Children who experience negative listener reactions or teasing may develop fear, shame, or avoidance behaviors  around speaking. Attempts to hide or prevent stuttering can increase physical tension, further disrupting fluency. Although emotional factors and nervousness do not cause stuttering , they can amplify its frequency or visibility. Supportive, patient environments—where communication is valued over speed—help children and adults communicate with more confidence. Characteristics Associated with Persistence Between 5% and 8%  of preschool children develop stuttering, but roughly 80% recover naturally . Children may be more likely to continue stuttering if they: Are male Have a family history  of stuttering Are older at onset Exhibit frequent stuttering-like disfluencies  or speech-sound errors Demonstrate variable or extreme language skills These factors don’t guarantee persistence but can help SLPs identify children who may benefit from early intervention. Acquired Stuttering While most stuttering begins in early childhood, some adults develop acquired stuttering  following neurological or psychological events. Neurogenic stuttering  may occur after stroke, head injury,  or degenerative disease. Psychogenic stuttering  can emerge after emotional trauma or stress. These cases differ from developmental stuttering and require specialized assessment to determine the underlying cause. Common Myths About Causes There are many myths surrounding the origins of stuttering. It’s vital to understand what does not  cause it: Stuttering is not caused by parenting  or how parents react to speech. Stuttering is not a psychological problem , though it can have emotional effects. Stuttering does not reflect low intelligence . Stuttering is not caused by bilingualism , though fluency may vary across languages. Stuttering is not caused by nervousness or anxiety . Most importantly, stuttering is no one’s fault. Learn More & Get Involved Understanding the multifactorial nature of stuttering helps professionals and families respond with empathy and evidence-based care. Read What Is Stuttering?   for an overview of stuttering as a neurological difference. Explore Stuttering Treatment Options   to see current therapy approaches. Join our Research Initiatives  to support ongoing studies. Connect locally through NSA Chapters  for community support and insight. References Smith, A., & Weber, C. (2017). How stuttering develops: The multifactorial dynamic pathways theory.   Journal of Speech, Language, and Hearing Research, 60 (9), 2483-2505. Yairi, E., & Ambrose, N. (2013). Epidemiology of stuttering: 21st century advances. Journal of Fluency Disorders, 38(2), 66-87.  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. Original material provided by: Leslee Dean, M.A. (Latin American Studies), MS-SLP student, 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. Last Updated:  October 2025 Author:  National Stuttering Association Marketing & Education Team with contributions from Nicole Kulmaczewski, MS, CCC-SLP and Jacqueline Toscano, SLP.D. CCC-SLP

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 their communication needs are recognized and that they have equal opportunities to participate fully in classroom and school environments. Preschool: Early Identification and Evaluation Parents or preschool teachers usually refer preschool children for assessment if stuttering appears to impact daily communication. Parents typically contact the school district’s services coordinator to request screening. A multidisciplinary team —including preschool teachers and speech-language pathologists (SLPs)—screens developmental areas such as cognitive, motor, social/emotional, self-help/adaptive behavior, and communication. Vision and hearing screenings are also conducted. Based on the child’s performance and parent concerns, the team may recommend a full evaluation. Parents are advised of their due process rights, including the need for signed consent  before evaluation. In some districts, evaluations occur with parents present. The speech-language pathologist  gathers a detailed case history and assesses areas including: Voice quality Receptive and expressive language Social-pragmatic communication Speech sound production Fluency Speech samples are analyzed across contexts such as conversation, storytelling, and play. Parents may be asked to provide a recorded sample if the child is shy or hesitant to speak. The SLP determines whether the disfluencies are typical for language development or indicate Childhood Onset Fluency Disorder  (stuttering). Based on results and history, the evaluation team decides if the child qualifies as Speech-Language Impaired  and whether services are needed. If eligible, the SLP and parents develop an Individualized Education Plan  describing the child’s needs and how they will be met. Districts must conduct the IEP meeting and begin services within 60 calendar days  of parental consent. School-Age IEP Process For school-age children, the process is similar. It often begins when a parent, teacher, or staff member raises concerns about a student’s speech or academic participation. After a written referral , the school seeks parental consent to evaluate the student. A multidisciplinary team —including an SLP—conducts comprehensive evaluations using observations, standardized assessments, interviews, and classroom samples. The team examines how stuttering affects: Classroom participation Oral presentations Social interactions Testing performance Eligibility for an IEP is based not only on stuttering severity, but on how it impacts educational access and social-emotional well-being . If the student qualifies under Speech or Language Impairment , the IEP includes measurable goals, accommodations, services, and progress tracking. Parents are equal partners in this process, and written consent is required before implementation. IEPs are reviewed annually , with reevaluation every three years  to reassess eligibility and needs. Accommodations and Supports for Students Who Stutter An IEP for a student who stutters should focus on access, participation, and self-advocacy . Support may include both accommodations  (how learning is accessed) and services/goals  (skills targeted through therapy). Flexible Response Options Extra time for oral presentations or class discussions Option to respond in writing, by video, or in smaller groups Reduced Communication Pressure Teachers avoid interrupting or finishing sentences Students are not forced to participate in timed or random reading Students may volunteer instead of being called on unexpectedly Supportive Classroom Environment Teachers model patience and provide wait time Peers are educated about stuttering to reduce teasing Preferential seating near supportive classmates or teachers Testing Accommodations Extended time for oral test sections Alternative formats when appropriate Assistive Technology Access to recording devices or apps that support communication, if the student prefers Examples of Stutter-Affirming, Functional IEP Goals Self-Advocacy The student will identify two strategies for explaining their stuttering to peers or teachers and practice using them in role-play with 80% accuracy. Communication Confidence The student will increase participation in class discussions by initiating at least two contributions per week, self-rating comfort and confidence afterward. Education and Awareness The student will explain what stuttering is and share two things that help them communicate best in structured practice sessions. Strategy Use (if applicable) The student will choose and use preferred strategies (such as voluntary stuttering or easy onset) during structured tasks with 70% independence. Emotional Support The student will use self-rating scales to reflect on comfort and tension when speaking, sharing results weekly with the SLP. Related and Collaborative Services Speech Therapy:  Focuses on understanding stuttering, building self-acceptance, exploring communication strategies, and co-creating goals with the student. Counseling and Collaboration:  SLPs, teachers, and counselors coordinate to address anxiety, bullying, or self-esteem concerns related to communication. Navigating Transitions Between School Levels As children transition between elementary, middle, and high school, parents play a vital role in maintaining continuity. Parents should get to know their school SLP early and advocate for open collaboration. Annual IEP reviews typically occur at the end of the school year to assess progress and plan next steps. Ideally, both current and future teachers and SLPs attend transition meetings to discuss: Summer experiences and communication attitudes Updated goals and new concerns Support strategies for the upcoming year Middle school transitions benefit from informal meetings that include the child when appropriate. High school transitions require increased student autonomy . Teens should help set their own goals and decide whether to continue school-based therapy, seek private services, or take a break. Parents can encourage open dialogue and request introduction meetings with new SLPs to review goals and build rapport. How Often Is an IEP Reviewed Under IDEA, every IEP must be reviewed at least once every 12 months  and reevaluated every three years . However, reviews can be requested at any time if a child’s needs change—such as new communication challenges, social pressures, or classroom difficulties. Schools use progress monitoring  to track each student’s advancement toward goals. Data collected helps determine if the student is making adequate progress, if current supports remain effective, and if goals require adjustment. Parents receive progress reports at least as frequently as academic report cards. IEP vs. Section 504 Plans Both IEPs and 504 Plans  provide legal protection for students with disabilities but differ in scope. An   IEP (under IDEA)  includes specialized instruction, related services, and individualized goals. A 504 Plan (under Section 504 of the Rehabilitation Act)  ensures access and accommodation for students who do not require specialized instruction. For students who stutter, both plans can provide valuable support, depending on how stuttering impacts educational access. IEP Ideas for Parents of Children Resisting Therapy If a child or teen dislikes traditional pull-out speech sessions, parents can consider asking the IEP team to modify services to a “Monitor” model  instead of discontinuing services completely. A Monitor model includes regular check-ins by the SLP with the student, teachers, and parents. This keeps the IEP active and allows the child to maintain Specially Designed Instruction  and classroom supports without weekly sessions. If therapy later becomes appropriate again, reinstating direct services is simple and quick. Completely discontinuing services would require restarting the entire evaluation process, which can take months. Keeping the IEP current ensures continuity of support and quick re-entry to therapy when needed. Parent Advice and Advocacy Tips Build collaborative relationships with school SLPs and teachers. Learn as much as possible about stuttering to advocate effectively. Encourage your child to talk about their experiences, fears, and successes. Keep communication open during transitions to new schools. Advocate for your child’s voice and preferences to guide decisions about therapy. Last Updated:  October 2025 Author:  National Stuttering Association Marketing & Education Team with contributions from Nicole Kulmaczewski, MS, CCC-SLP, Jacqueline Toscano, SLP.D. CCC-SLP , Lynne Remson, CCC-SLP, Karen Kumar, CCC-SLP , Dr. Scott Yaruss, CCC-SLP and Joan Duffield  (Special Education Teacher and Parent)