Written by Taylor Worsham, NSA Community Coordinator, Person Who Stutters Stuttering is often misunderstood, especially within structured environments like the military, where communication is key. But that’s not to say that individuals who stutter cannot serve effectively in various roles. What is the military like as a person who stutters (PWS)? How does an intense, robust environment impact a PWS’s ability to communicate? We sat down with two PWS involved in the armed forces to get their perspective. Understanding Stuttering Stuttering is a speech difference in which the flow of speech is involuntarily disrupted. It may involve repetitions, prolongations of sounds, or blocks in speech. It’s crucial to note that stuttering is not a psychological issue but has neurological and genetic roots. Additionally, it does not affect intelligence or emotional stability. It affects about 1% of the population, meaning nearly three million people stutter in the U.S. alone. Stuttering and Military Service In the military, where clear and efficient communication is often perceived as essential, people who stutter may face unique challenges. However, many individuals who stutter perform exceptionally well in roles that require public communication and decision-making under pressure. The notion that people who stutter cannot serve effectively is a misconception. Breaking Stereotypes Common stereotypes suggest that people who stutter are nervous or lack confidence. However, these are myths. Stuttering does not reflect a person’s emotional state or ability to perform under pressure. In fact, military personnel who stutter often bring unique qualities to their roles, such as heightened patience, perseverance, and empathy—skills that are invaluable in high-stress environments. Meet Shea Quinn Shea Quinn has served in the U.S. Coast Guard for 15 years. He is a Lieutenant Commander serving as a helicopter pilot for maritime search-and-rescue missions and counter-narcotics interdictions. He is currently stationed at US Northern Command in Colorado Springs, CO. While he’s stuttered since second grade, he experienced no hesitation in joining the military. “I don’t know if it was any different than what I expected to encounter in my everyday life,” Quinn said. “I knew it was going to be an issue whether I was in the military or not. I don’t recall feeling reservation about it, I don’t recall ever wondering if I would be able to do it, I just knew that it would likely be challenging. I was just going to have to work through those challenges as they arose.” Even entry into the Coast Guard Academy was challenging for Quinn. When he applied to the Academy, the initial medical screening included a read-aloud test, where “his stutter advertised itself.” In addition to self-disclosing, there was enough information in his medical record that it was known that he stuttered. Because of this, he was medically disqualified. However, Quinn obtained a waiver through additional interviews with medical officers, eventually allowing him entry. In the summer between academic years in the Academy, Quinn would be underway aboard Coast Guard cutters or assigned to air stations to learn more about how operations work in-service. Upon graduation, Quinn was thrust into a leadership role and was in charge of a dozen individuals. Thanks to the therapy he received in middle and high school, he learned how to advertise his stutter, which helped him tremendously in the Academy and during his service. Early in his career, he met with his supervisors and disclosed his stutter. While this helped relieve some pressure to be fluent, Quinn said this disclosure didn’t eliminate the innate challenges of stuttering or the expectation to communicate effectively under stress. The operating environment, atmosphere, and duties provoke challenges related to stuttering more often for Quinn. His primary role in his first assignment was as an Underway OOD (Officer of the Deck), stationed on the bridge while at sea, responsible for the save navigation and operation of the ship as the direct representative of the Commanding Officer. This position, in which he worked 8 hours daily, required making announcements throughout the ship and many scripted phone calls. For example, if Quinn’s ship was close to another boat at sea, he had to explain the situation over the phone in a very certain way. So no substituting words! “Having to read a script on the phone to a supervisor in front of an audience, it [would be] a challenging situation for anybody who stutters,” said Quinn, “I can’t say that I didn’t try not to stutter, but I do know that I was not successful in hiding it. So I had to work through it, which, oftentimes, was accepting the struggle in the moment and just finding a way through it. That’s where I think advertising helped me a lot.” Quinn almost always self-disclosed his stutter during his first introduction to a new unit. He said this disclosure helped shipmates be more receptive and willing to listen to what he had to say, ensuring he could communicate effectively even during moments of tension with his speech. Throughout his career in Coast Guard aviation, Quinn has connected with many people who stutter and share a passion for flight. Aware of their concerns about the communication demands—such as briefings, radio calls, and crew interactions—he emphasizes the importance of sharing his experiences to reassure others that they are not alone in navigating these challenges while pursuing their dreams. “Sure, some of the pre-flight briefings can be challenging, but stuttering has never been an issue for me in the aircraft. I don’t know if it’s a similar phenomena to not stuttering when learning a new language [the language of aviation], if it’s aided by the ‘delayed auditory feedback’ of hearing yourself speak in your headset/helmet, if having so many other tasks to focus on keeps me from remembering that I stutter, or some combination of all the above, but stuttering isn’t on my mind when I’m in the air.” And one unique advantage of being a PWS in the military? Knowing how to push through when it matters. "We have to unlock our speech mechanism every day, all the time,” Shea said. “We know what to do when it locks up. If someone who doesn't stutter freezes under stress, they may not have the ability to quickly unlock their speech. And that could be detrimental to the job." Here is Quinn's valuable advice for people who want to join the military but fear that their stutter will impact their ability to do their jobs: “Externally, advertising [your stutter] up front is really helpful … By acknowledging it, you don’t allow folks who would have an issue with it to raise it as an issue … Internally, I always try to remember how I would feel if I either didn’t say what I wanted to say or I somehow let the fact that I stutter influence my actions…" Meet Michael Molino, USN (Ret), SLP Michael Molino served in the Navy for over 24 years before retiring in spring 2011 as Chief Petty Officer (Surface Warfare/Aviation Warfare). He was responsible for up to 125 people at one time. At 20 years old, during his third semester of college, he realized that higher education wasn’t what he wanted to do at that time in his life. “One day on my way home from school, I pulled into a parking lot, where I stared at a big sign, ‘NAVY RECRUITING,’” Molino recalled. “I walked in and I joined. Of course, when I went in, my speech was pretty noticeable. I sat down and I said, ‘Well, I stutter,’ and they would just look up jobs. I was pretty set on what I wanted to do.” Molino’s initial admittance into the military was relatively struggle-free, aside from various one-off speaking situations. During his final medical review, a medical doctor told him, “No flight school,” and he was in. When Molino first got in, he served in aviation. After four years, he switched jobs. He tried to be a diver but was disqualified for not meeting the criteria for “perfect speech.” After looking at other jobs, he found a special warfare program, but after an interview, he again faced disqualification. “Now, that doesn’t go to say that if I use my techniques every minute of the day, I could probably get in, just like Shea did. He came back and showed them … and they allowed him to fly. He’s flying a helicopter and has to talk all day long. He does a remarkable job." When it came to job performance, Molino was evaluated just like any other employee. However, he was rated lower in communication abilities despite having a perfect rating in all other areas. Because of this, he missed making the next rank by less than a point three times in a row. “I finally had enough of it,” Molino said when he approached his superiors. “I said, ‘I don’t agree with the communication line. I have a stutter, it’s obvious, but it doesn’t impede me from getting my point across. I think I should be at a 4.0 instead of a 3.8.’ My supervisor said, ‘I agree’ and changed the mark to a 4.0." Molino advanced off the next exam cycle. In addition to honing his self-advocacy skills as a PWS, Molino also discovered community during his service. It wasn’t until his third ship working downstairs in engineering that Molino finally encountered another PWS. When he went to shore duty years later as a chief, he discovered he had a yeoman (who handles clerical and administrative matters for ships and personnel) who was a PWS. Once Molino realized this, he called the yeoman into his office. That was when Molino disclosed his stutter, and the two had a “long, intimate conversation” about it, as well as an instant connection. Molino said he specifically advocated for this yeoman to go to speech therapy, which the Navy eventually paid for. When Molino started his next command on a bigger ship, he met two other PWS. Molino developed an unspoken bond with these people, so much so that he essentially created his own unofficial stuttering support group. Right before retiring, he gathered all four PWS on board, including himself, to spend a few hours together to talk about stuttering. “The majority of them were junior sailors,” said Molino. “There was only me and another guy who were senior enlisted. At first, [the junior sailors] were a little apprehensive … It’s not every day that you have something in common with a person three or four ranks above you.” Since the military does not have a traditional Human Resources department or any Employee Resource Groups, Molino said that having this kind of support as a PWS during the earlier years of his career would’ve been “tremendous and immeasurable.” Now, Molino is paying it forward by guiding other PWS who aspire to pursue a career in the military and helping them achieve their goal of service through recommendation letters. But that’s not all Molino is doing to show support to the stuttering community. In 2017, Molino helped start a private military support network/group for PWS on Facebook in connection with the National Stuttering Association (NSA). While everyone should be able to serve their country, concise and quick communication is vital in the military because it enables clear, efficient exchanges of critical information, often in high-pressure or life-threatening situations. Molino emphasized this point in his interview. “Today, everyone thinks a disability needs to be looked at in a different way and they should let everyone in, or PWS should do anything they want,” Molino said. “That would be nice in a perfect world, but … it’s the government … they don’t have to follow [disability laws]. I firmly believe there are some jobs where you need to communicate effectively. If you have a disorder of some sort, maybe that’s not where you need to be.” Navigating a military career as a person who stutters involves more than just mastering ships or helicopters—it demands navigating complex physical and mental challenges beyond the typical demands of other professions. While a perfect world would be free of discrimination, the reality is that individuals who stutter may face unique barriers and may need to devote additional effort to manage their stutter before pursuing a military career. According to Molino, maximizing your chances of joining the military and advancing in rank requires honing your ability to effectively manage the struggles of stuttering. This is necessary in order to help to reduce potential obstacles along the way. Promoting a Supportive Environment It is crucial to create a supportive environment where individuals feel comfortable stuttering and discussing their stuttering. Encouraging openness helps reduce anxiety and can actually decrease stuttering severity. Military organizations should also consider providing resources, such as access to speech therapy and support groups, to help those who stutter navigate their careers successfully. People who stutter have much to offer the military, from unique problem-solving skills to empathy and resilience. By fostering an inclusive culture that values diverse communication styles, the military can ensure that it does not miss out on the valuable contributions of individuals who stutter. For more information about stuttering, visit our website at WeStutter.org. The NSA extends its deepest gratitude to Shea Quinn and Michael Molino for their service and courageously sharing their stories with us. We also honor and thank all currently serving or have served in the U.S. military for their dedication and sacrifice.

La tartamudez es una diferencia en la forma en que una persona habla. Puede incluir repeticiones, prolongaciones o bloqueos al intentar decir una palabra o sonido. Algunas personas también pueden hacer movimientos físicos o usar estrategias para intentar evitar o esconder un momento de tartamudez. Una persona que tartamudea sabe lo que quiere decir. La dificultad no está en encontrar las palabras, sino en decirlas físicamente en ese momento. La tartamudez puede variar de una persona a otra. También puede cambiar según el día, la situación, el nivel de cansancio, la presión del momento o cómo se siente la persona al hablar. La tartamudez no es culpa de nadie La tartamudez no es causada por nerviosismo, poca inteligencia, mala crianza ni falta de confianza. La investigación actual entiende la tartamudez como una condición neurológica y fisiológica que puede tener una base genética. La tartamudez no define la capacidad, el valor, la inteligencia ni el potencial de una persona. ¿Existe una cura para la tartamudez? Actualmente no existe una cura conocida para la tartamudez. Muchas personas se benefician de la terapia del habla, el apoyo comunitario, la educación y las herramientas de autoayuda. El objetivo no siempre es eliminar la tartamudez. Para muchas personas, el apoyo adecuado ayuda a fortalecer la confianza, reducir el miedo a hablar, mejorar la comunicación y crear una relación más saludable con su voz. Si tartamudeas, no estás solo La National Stuttering Association existe para apoyar a las personas que tartamudean, sus familias y los profesionales que las acompañan. A través de recursos, comunidad, educación y defensa, la NSA ayuda a crear espacios donde las personas que tartamudean puedan sentirse comprendidas, respetadas y apoyadas. Recursos gratuitos en español Esta página incluye recursos seleccionados en español para personas que tartamudean, familias, educadores, empleadores, aliados y oyentes. Actualmente no todos los recursos de la NSA están disponibles en español. Para ver la biblioteca completa en inglés, visita nuestra página de recursos imprimibles en inglés. Elige el recurso que necesitas Use esta sección para encontrar el recurso en español que mejor se ajuste a sus necesidades. Para aprender sobre la tartamudez Estos recursos ayudan a explicar qué es la tartamudez y cómo puede diferenciarse de otras condiciones o formas de comunicación. Tartamudez vs. Tartajeo Este recurso explica las diferencias entre la tartamudez y el tartajeo, dos trastornos de la fluidez que a veces pueden confundirse o presentarse juntos. Diferencias fundamentales entre la tartamudez y el síndrome de Tourette Una guía visual que ayuda a diferenciar la tartamudez del síndrome de Tourette, incluyendo síntomas principales, edad de inicio y características comunes. Diferencias fundamentales entre la tartamudez del desarrollo y la tartamudez neurogénica Este recurso compara la tartamudez del desarrollo con la tartamudez neurogénica y puede ayudar a entender cómo y cuándo puede aparecer cada una. Para personas que escuchan a alguien que tartamudea La tartamudez: notas para oyentes Una guía sencilla para amigos, familiares, maestros, compañeros de trabajo y cualquier persona que quiera aprender cómo escuchar con paciencia, respeto y comprensión. Para padres, familias y niños Padres e hijos que tartamudean Un recurso para padres y cuidadores que desean comprender mejor la tartamudez y apoyar a sus hijos con paciencia, información y esperanza. Ayudar a los niños que tartamudean Una guía para apoyar a los niños que tartamudean, fortalecer su confianza y recordarles que no están solos. Para escuelas y salones de clase Tartamudez: una presentación en el aula Este recurso ayuda a niños, terapeutas del habla y maestros a hablar sobre la tartamudez en clase. Puede ayudar a reducir mitos, responder preguntas y crear un ambiente escolar más comprensivo. Para empleadores y profesionales La tartamudez: lo que los empleadores deben saber Un recurso para empleadores, gerentes, equipos de recursos humanos, supervisores, reclutadores y entrevistadores. Ayuda a aclarar conceptos erróneos y promover una comunicación respetuosa e inclusiva en el lugar de trabajo. Para aliados y comunidad Aliados: ¿Qué significa ser un aliado de las personas que tartamudean? Una guía para amigos, familiares, colegas y miembros de la comunidad que desean apoyar mejor a las personas que tartamudean. Aliados: la regla de oro para ser aliado Un recurso práctico sobre cómo escuchar, hacer preguntas abiertas, respetar las preferencias de cada persona y apoyar sin hablar por ella. Recursos de divulgación de la tartamudez Estos recursos pueden ayudar a una persona que tartamudea a explicar su tartamudez en situaciones cotidianas, escolares, laborales o sociales. Tarjeta de Divulgación de Tartamudez Una tarjeta breve que puede ayudar a explicar la tartamudez de forma clara y sencilla cuando una persona decide compartir esta información con otros. Tarjeta física de divulgación de tartamudez También hay una versión física disponible en la tienda de la NSA. Esta tarjeta puede ser útil para viajes, escuela, trabajo, citas médicas o situaciones en las que explicar la tartamudez rápidamente puede ayudar. Apoyo adicional La información ayuda. La comunidad también. Si usted o alguien que usted ama tartamudea, la NSA está aquí para ofrecer apoyo, educación y conexión. Nadie debería tener que enfrentar la tartamudez solo.

Seeing your experience as a person who stutters reflected back to you in a way that feels joyful and honest can be life-changing. That’s why the National Stuttering Association (NSA) is so excited to announce our collaboration with Willemijn to release special edition NSA art! The artwork, centered around our slogan, “If you stutter, you are not alone,” brings the spirit of the stuttering community to life. It’s not only a visual, but also a reminder that art can be a meaningful outlet for expressing who we are and how we experience the world. 100% of purchase proceeds support the NSA’s mission to create a more understanding world for people who stutter. Creative Process: From Idea to Illustration “I really wanted to capture the joy of the stuttering community, so I chose a colorful and playful style for this illustration,” Willemijn said. “I first drew the tagline in the center and then sketched different characters around it, interacting with each other in a positive way. Some of them are inspired by friends from the community, which makes the art feel more authentic and meaningful.” Willemijn’s process reflects the same sense of connection that the artwork represents. By centering the message first and building outward, she created a world where community quite literally surrounds the idea that no one who stutters is alone on their journey. Symbols of Connection & What She Hopes You Feel “I enjoy playing with the shapes of speech bubbles to show different ways of speaking and stuttering,” Willemijn said. “The intersecting speech bubbles symbolize the connection we can experience through our speech.” These details invite you to look a little closer. The variation in speech bubbles highlights the diversity of communication, while their intersections point to something shared: understanding and community. “When people who stutter look at this artwork, I hope they feel joy or even pride in being part of this community,” she said. “I hope they think of friends they have met, or new friends they might meet in the future.” That sense of possibility of remembering past connections and imagining new ones is at the heart of this artwork. Inspiration Behind the Work “In terms of style, I am inspired by artists who draw in a loose and playful way,” Willemijn said. “I want to convey joy in my work, which I also aimed to do in this piece. The topics that inspire me most are stuttering, mental health, and finding connection. I enjoy creating very personal work and sharing stories from real people. That's why some of the characters in this piece are based on my real friends from the community.” Willemijn’s art is rooted in stories and experiences. That’s what makes this collaboration feel so meaningful. It reflects the community not just in message, but in spirit. This art is designed to meet you wherever you are and is available as a digital bundle, including an 18x24 print, desktop background, and mobile background. Download the digital print from our merch store.

For people who stutter (PWS), there are some days when talking just feels heavy and burdensome. When the words are right there, you know exactly what you want to say, but they just can’t come out. You take a breath, try again, and push through. Speaking is a seemingly small but mighty and courageous act for PWS every single day. But courage doesn’t only live in our voices. Sometimes, it lives in color, movement, music, rhythm, and light. Art. Art gives us the medium to express everything the stuttering experience offers to us—the frustration, pride, humor, hope, and everything in between—in our own time and way. When words feel hard, creativity makes space The great thing about art is that it tells a story without needing fluency. It’s the smooth sound of a brushstroke on canvas, the shuttering of a camera taking a picture of a beautiful sunset, the pause before a chord change. It conveys what speech sometimes just cannot. A painting might show the swirl of thoughts before a block. A dance could portray the release of finally saying your name out loud. A photograph might capture the strength it takes to keep trying. Art lets you show your inner world to others—not to fix stuttering, but to show the person beyond it. “Especially as a teenager, I would turn to art to express myself or explain things about stuttering. I used illustrations and animations to show the adults in my life what my stutter felt like. Sometimes I even used art to try to understand what I was struggling with. Art often helped me share emotions that I didn’t feel comfortable talking about.” — Willemijn Bolks, PWS and comic artist Healing through creativity The process of creating art doesn’t need to be super serious or picture-perfect. It can be messy, funny, loud, or soft. What truly matters is that it’s yours. Many PWS find that art helps release the tension that can sometimes build within themselves and gives their emotions a safe place to live. This can look like sketching during a hard day or writing lyrics that mirror your speech. Either way, creativity can help you process your emotions behind difficult experiences and can even shift how you see yourself. While everyone who stutters stutters differently, you might notice that your stutter has its own rhythm. Maybe the pauses and repetitions have some kind of beat. When you turn that rhythm into something creative, you stop fighting against it. You start working with it. “There was one time when I drew a comic strip for the STAMMA blog that unexpectedly helped me process a stinging memory from high school 30 years prior. The comic strip was about that incident, and it was very hard for me to draw. However, once I finished, I found myself thinking how things would have been different if I had known what I know now about stuttering being okay. The sting instantly disappeared and never came back.” — Daniele Rossi, PWS and creator of Franky Banky comics Art builds connection When you share your art, you share a piece of yourself with the world. And that can have a big impact. Maybe your drawing helps someone realize what anxiety before a presentation feels like. Maybe your short film makes another teen who stutters feel less alone. Or maybe your music helps a PWS find peace in their voice. That’s exactly what community is: not people who all sound and look the same, but people who make space for one another’s differences. “It has been tremendously healing to have other people connect with my art. In the beginning, I made art just for myself to process difficult feelings, such as loneliness. Being able to share those experiences and have people relate to them turned that loneliness into connection. Sharing heavy feelings with others made them a lot lighter!”— Willemijn Bolks Your voice is already art You might not realize it, but the way you speak already has rhythm. The way you navigate a block, the way your breath moves before a prolongation, the way you hold eye contact when you finish a thought—all of it is art. When you create something from that, you take ownership of your story, you decide how it’s told, and you define what strength looks like for you. “Drawing is like communicating without words. And I don’t mean that from the point of view of avoiding speaking. I mean it in a way of communicating with your soul and making a connection through one’s own form of creative expression. For instance, one 10-year-old boy was inspired by a scene I drew where Franky Banky is interviewed on the radio. Stutter and all. The boy took the initiative to give a presentation about stuttering in front of his class that same week! Then once again in front of his whole school! I also enjoy learning from speech-language pathologists (SLPs) and how they use my comics in therapy sessions to generate discussion and to explore feelings and emotions.”— Daniele Rossi Your art matters If you stutter, your voice and art matter. It is part of how the world learns to listen. Everything you create says, this is who I am, this is how I speak, this is how I shine. Those who are doodling in a notebook, recording a song, or filming a short story, your creativity reminds others that stuttering is something to understand, not something to fix. If you’re creating digital art that reflects your experience as a person who stutters, we’d love to see it. Reach out to us anytime if you’re interested in sharing your work with the NSA.

This week marks National Stuttering Awareness Week (also famously known as NSAW), and we’re excited to once again celebrate and spotlight our community. As we began planning this year’s campaign, we paused to reflect on what we’re really working toward. We continue to believe that awareness matters, but awareness alone isn’t enough. At the National Stuttering Association (NSA), our mission goes deeper: We’re here to challenge outdated stereotypes and help build a world where stuttering is not just recognized, but understood and accepted. That’s why last year, we introduced a shift in how we talked about this week, choosing to use “National Stuttering Acceptance Week.” We heard from members of our community who felt strongly about that change. We want to make it abundantly clear that we respect the history of NSAW. The conversations that came out of last year only reinforced that this community cares deeply about how stuttering is represented. So this year, we’re continuing forward with intention. We’ll once again be using “National Stuttering Acceptance Week” to reflect the future we’re working toward, one where acceptance is the standard. But why does that distinction matter? We’re glad you asked. But first, a little background: The History of National Stuttering Awareness Week This week's roots go back to 1986, when we were still known as the National Stuttering Project (NSP). That’s when the vision for a national week dedicated to raising awareness about stuttering began to take shape. Thanks to the relentless determination and advocacy of passionate NSP members like Paul Castellano, who testified before several U.S. Congressional subcommittees, Barbara Koval, and so many others who rallied their representatives, then-President Ronald Reagan signed a proclamation in April 1988 officially designating the second week of May as National Stuttering Awareness Week. (Source: Minnesota State University, Mankato) But the party didn’t stop in 1988! Each year, the second week of May has remained a dedicated time to raise awareness and celebrate stuttering as a valid way of communicating. In 2026, we’re proud to mark the 38th annual National Stuttering Awareness Week! We are grateful to the NSP members whose tireless advocacy brought National Stuttering Awareness Week to life. Their commitment in the early days paved the way for a week that has since raised national awareness, fought against stigma, and commemorated people who stutter in countless ways for decades. Without their vision and hard work, National Stuttering Awareness Week would not be what it is today. We honor the history that shaped it and are excited to witness its continued growth. The Future of National Stuttering Awareness Week We remain committed to carrying forward the legacy the NSP members began, continuing to advocate for the stuttering community for generations to come. While the official designation remains “Awareness Week,” we’re continuing to shift the language because we believe it’s time to move the needle forward. People who stutter should always have the freedom to define their own relationship with stuttering and choose the path that feels right for them. However, we firmly believe it’s time for people who don’t stutter (and the general public) to move beyond awareness and toward a deeper understanding and acceptance of stuttering. We’re using awareness to drive acceptance. You’re probably wondering where this shift in language came from. Again, we’re glad you asked! Last year, we drew inspiration from the Autism Society of America, which transitioned from “Awareness” to “Acceptance” in 2020. Their reasoning deeply resonated with us, and we’re proud to continue following their lead. If you want to learn more, we strongly encourage you to read their article. Why These Conversations Must Go Beyond the Stuttering Community As we continue evolving this week, we also want to be intentional about who these conversations reach. For many years, conversations about stuttering have largely taken place within the stuttering community itself. While those spaces are essential, if we want to create a world where people who stutter are accepted, these conversations can’t stay only within our own circles. Stuttering acceptance happens when people who don’t stutter begin to listen and rethink what they believe about stuttering. That’s why this week is about inviting others in, not just celebrating in isolation. We want this week to help educators better support students who stutter. To encourage employers to create more inclusive workplaces. To challenge everyday assumptions. Whether you want to call it National Stuttering Awareness Week or National Stuttering Acceptance Week, we urge you to join us in celebrating this meaningful week together as we continue pushing for a future where people who stutter are fully accepted.

Just before the National Stuttering Association (NSA) celebrates National Stuttering Acceptance Week from May 9-15, it's also important to remember another key awareness day in May that resonates with parents, speech-language pathologists (SLPs), and mental health professionals: National Children’s Mental Health Day. National Children’s Mental Health Day is observed annually on the first Thursday of May. This year, it falls on Thursday, May 7, 2026. Established by the Substance Abuse and Mental Health Services Administration (SAMHSA) in 2006, this day aims to highlight the mental health needs of children and teens. A 2021 study found that nearly 20% of children aged 3 to 17 had been diagnosed with a mental, emotional, or behavioral issue during childhood. Students with communication differences, like stuttering, often face ongoing communication challenges that can heighten anxiety and depression. These students may feel isolated, have difficulty advocating for themselves, and experience depression. To address the decline in mental health, proactive strategies can support students who stutter and promote their well-being at home and at school. These include in-school resources such as school counseling and speech therapy, as well as external services provided by licensed mental health clinicians. Let’s explore how mental health affects children and teens who stutter and how to honor NSAW in ways that support their social-emotional health: Supporting the Emotional Experience of Stuttering If you are parenting a child who stutters, the challenges of childhood stuttering can sometimes feel isolating, especially when others don’t see or understand what your child is experiencing. How do you support your child wholeheartedly while also managing the realistic demands of raising a neurodivergent child or teen with an invisible disability, like stuttering? Using Stuttering-Affirming Language at Home Being mindful of how you talk about stuttering at home can create a powerful, positive shift in your household. Stuttering-affirming language moves the focus away from trying to “fix” stuttering and instead fosters an uplifting, supportive view of your child’s communication difference. For example: Instead of: “Slow down, take a breath, start over,” try: “I’m listening. Take your time.” Instead of: “Use your strategies,” try: “What would help you feel more comfortable?” “Adults can support children by normalizing stuttering, responding with patience, and modeling acceptance. It’s also important to listen without interrupting or finishing sentences, and to validate the child’s feelings without trying to immediately ‘fix’ them. When children feel emotionally safe, their confidence and communication naturally grow.” — Nicole Terhune, MS, CCC-SLP Creating Confidence in Your Child Who Stutters Just as the language you use around stuttering matters, being intentional about your actions around stuttering can have a powerful impact on your children who stutter. Instead of focusing on how your child speaks, focus on what they say. You can create “low-pressure” speaking opportunities to have your child practice their speech, like: Family game nights where everyone takes turns telling stories or jokes Letting the child choose when they’d like to order at restaurants In these practice situations, you can also teach and model self-advocacy scripts for your child: “Sometimes my words get stuck. Please give me a bit more time.” “I stutter. It’s just how I talk.” Practicing Mindfulness as a Family Mindfulness means being fully present with a calm mind and body. Incorporating relaxation and grounding exercises into your family’s daily routine can improve your family’s social-emotional well-being. Many parents overlook how their emotions influence their children, but dedicating just 10 minutes daily to mindfulness can significantly benefit both their nervous systems. Consider trying one of the following methods: Finger breathing Trace the outline of your hand with a finger, breathing in as you move up and out as you move down. Progressive muscle relaxation Tense different muscle groups while breathing in, and release them while breathing out to release stress. Body scan Listen to a script that allows you to focus your attention on different parts of your body, from your feet to the muscles in your face. Practicing mindfulness together with your child fosters co-regulation, a process in which two people help each other stay calm. The Child Mind Institute explains that co-regulation is supported by science: our emotions, such as anger, can influence others to feel the same way. Effective co-regulation between an adult and a child involves guiding the child to self-soothe, which is why managing your own stress in a healthy way is the first step. “Learning grounding and mindfulness techniques can help regulate the nervous system, tolerate distress, and support emotional regulation…When everyone slows down, breathes, and stays present, it supports the child who stutters and creates a calmer, more supportive environment.” — Nora O’Connor, LCSW Creating Safe Spaces: A School Counselor’s Role in Supporting Students Who Stutter As a certified school counselor in Pennsylvania, I support students’ social-emotional development. A 2021 American School Counselor Association study found that these interventions can improve stress tolerance, social curiosity, executive functioning, and academic achievement. Here’s how a school counselor can support students who stutter: Identifying Emotions Stuttering can be difficult for others to understand, and it can be hard to explain the internal struggle of dealing with a communication barrier. As a school counselor at an elementary school, I help students identify their feelings using visual tools, like a Feelings Wheel. You choose an emotion and its associated color, such as "worried" and "purple," then follow that color to the outer ring, where more specific emotions appear. You can also have them practice using the feelings in sentences, for example: “I am feeling worried and insecure about stuttering during my class presentation.” Example of a Feelings Wheel for Children/Youth from OpenEmotionWheel As adults, it’s our role to help children understand that it’s okay to have upsetting or frustrating emotions. For example, you might say, “It sounds like you’re having a rough speech day and feeling frustrated and embarrassed.” When you acknowledge their stutter and the challenging feelings around it, you show your student that their entire stuttering experience is recognized, understood, and accepted. “When children are hurt, or in pain, our instinct [as parents] is to rescue them, but that’s often because we have a hard time seeing them suffer. What all of us need to hear is that it’s okay to be in pain, to feel sad, or to be in a difficult situation. I think that once we, as parents, teachers, and other caregivers, shift our thinking to recognize that it’s genuinely okay for our kids to struggle and have a hard time, we can be much more present with them...” — Eric Mendoza, PsyD Developing a Growth Mindset As a school counselor, I particularly enjoy teaching the distinction between a Growth Mindset and a Fixed Mindset. While it may seem straightforward, a Growth Mindset is about embracing challenges, feeling confident, and believing that effort leads to success. In contrast, a Fixed Mindset involves negative self-perceptions and doubts about one's abilities, as shown below: Carol Dweck, the author of Mindsets and the Growth vs. Fixed theory, wrote, “The best things parents can do is to teach their children to love challenges, be intrigued by mistakes, enjoy effort, and keep on learning.” For parents of children who stutter, you can foster positive thinking in your child by: Meeting your child where they are at: praise them for their efforts, not their abilities Understanding the power of “yet”: encourage positive language by suggesting someone say, “I can’t do this…yet" instead of, “I can’t do this!" Along with our different types of mindsets, I also enjoy teaching my students about resilience, the ability to “bounce back” from challenges. If you're attending this summer’s NSA Annual Conference in Charlotte, North Carolina, your children can join my social-emotional learning workshop, “Grow As We Go: Building Resilience from the Inside Out,” as part of the Kids conference programming. Advocating for Students who Stutter Being an “advocate” for all students is a foundational pillar of school counseling, as it is reflected in our professional guidelines. The ASCA Ethical Standards (2022) state that school counselors must “advocate for equitable, anti-oppressive and anti-bias policies and procedures, systems and practices, and provide effective, evidence-based and culturally sustaining interventions to address student needs.” There are several ways a school counselor can advocate for students who stutter, both directly and indirectly: Classroom lessons Facilitate lessons on diversity, conflict resolution, bullying, and respect. Use books like “Just Ask! Be Different, Be Brave, Be You” by Sonia Sotomayor, which features a child who stutters and explains that he sometimes repeats words or gets stuck, requiring more time to express himself! Anti-Bullying Initiatives Create a school-wide program like Kindness Day to focus on inclusion and teach conflict-resolution skills to prevent tension, such as using “I-Statements” (for example, “I didn’t like how you said I can’t talk… I wish you would please be nicer to me.”) 504 Plans Students who stutter are often eligible for Section 504 Plans (legal accommodations) to address their communication needs. A school counselor facilitates 504 meetings, ensures teachers implement the accommodations, and may even serve as the 504 Case Manager responsible for the plan. You can learn more about 504s here! Finding Your Voice: An SLP’s Role in Supporting Communication and Confidence Nicole Terhune, M.S., CCC-SLP, is a SLP, clinical educator, and stuttering advocate on Instagram as @TheStutterAlly. Her experience working with children and teens who stutter helps her shift from a fluency-focused approach to a client-centered one. Nicole promotes a positive view of stuttering in youth by sharing that: “I’ve seen how focusing only on speech can unintentionally communicate to children that the way they talk is 'wrong,’ which can impact self-esteem and willingness to participate. Professionally, working with children and families has shown me that stuttering is not just about speech. It’s incredibly complex and overlaps in the areas of identity, participation, and emotional safety. I prioritize creating spaces where children feel heard and do not feel constantly judged or criticized. I emphasize consciously validating their experiences, supporting their autonomy, and helping them express themselves in ways that feel authentic to them.” Supporting Children Who Stutter Through Challenges Nicole approaches situations like classroom presentations, social anxiety, and bullying with a balance of emotional support and practical strategies: “We talk openly about stuttering and explore how it feels in different situations. From there, we build individualized strategies that often include learning about stuttering, role-playing difficult moments, practicing self-advocacy phrases, and identifying supportive people in their environment. When it comes to bullying, children must know it’s not their fault and that they have the right to be respected. I talk with my clients about others’ perspectives. I emphasize that the bully may not know anything about stuttering and that the behavior may stem from ignorance. I also collaborate closely with teachers and families to ensure the child is supported across settings. Most importantly, I help children understand that their voice is valuable regardless of how it sounds and that they deserve to take up as much space as they need.” Collaborating with Caregivers and Educators Nicole emphasizes that supporting children who stutter is a shared effort, and that small shifts in adult behavior can have a meaningful impact: “Supporting a child who stutters can feel emotional for adults, especially when they want to help. One of the most important things is recognizing that you don’t have to ‘fix’ stuttering to support a child effectively. I recommend that adults focus on connecting with the child rather than correcting their speech, reflecting on their own beliefs and biases about communication, and seeking education and supportive communities to continue learning about stuttering and communication differences.I also collaborate closely with teachers and families so that strategies carry over across environments. When adults are consistent in how they respond and support communication, children have more opportunities to participate in ways that feel successful and sustainable.” Encouraging Self-Advocacy and Emotional Well-Being A key part of Nicole’s approach is helping children develop a sense of ownership over how they communicate and participate: “I often tell children: ‘You don’t have to change the way you talk to be worth listening to.’ We work on understanding stuttering, building confidence in their identity, and learning to advocate for their needs—whether that’s asking for more time, explaining their stutter, or choosing how they want to participate. I also find it helpful to remind children that it’s okay to change their minds about what feels helpful during moments of stuttering. One day, they might want someone to finish their sentence, and the next day, they may not. Protecting their mental health also means recognizing when something feels too hard and knowing it’s okay to take breaks, ask for support, or do things differently. Their voice matters, whether they feel ready to take on speaking challenges or need to stay in spaces that feel safe.” Holding Space for Emotions: Insights from Mental Health Experts on Stuttering Being a mental health professional requires significant vulnerability. You work closely with individuals to discuss their struggles and create a safe, therapeutic environment. A communication barrier, such as stuttering, can be especially challenging in a role that involves a lot of speaking, such as being a therapist. The NSA consulted with two mental health clinicians who stutter: Eric Mendoza, PsyD, and Nora O’Connor, LCSW, and author of the upcoming workbook Navigating the Emotional Response to Stuttering, for their expert insights: Meeting Children Who Stutter Where They Are When asking how their personal experiences with stuttering have shaped the way they support children as mental health clinicians, they shared the following reflections: “I meet the children I work with exactly where they are. I also allow myself to stutter loud and proud. I want to model for children that there's nothing wrong with the way they speak, and it's also okay to want to work on it. I remember exactly what it felt like to wish I didn't stutter, so I can make space for them to feel this way without trying to change it. I also strongly believe that when these children are having a difficult time, I can see their strong prognosis and future. With love, acceptance, and some courage, they can get to a place where stuttering doesn't need to disappear, but where they can be an authentic, confident, beautiful person who stutters in this world.” — Eric Mendoza, PsyD “My experience allows me to go beyond technique and into the emotional truth of stuttering. I understand the anticipation, the body tension, the shame, and the constant mental gymnastics. That lived experience helps me meet children, teens, and adults where they are and help them understand themselves, normalize their experiences, regulate their nervous system, and build a healthier relationship with their stuttering.” — Nora O’Connor, LCSW Making Space for the Emotions of Stuttering When asked about the emotional challenges children who stutter encounter and ways adults can support them, both mental health experts highlighted that: “I’d say the biggest emotional challenge I’ve seen, and one I deeply resonate with, is the feeling of being out of control… But instead of pulling them out of the hole, get in the hole with them. Sit with them. Listen. Validate… what helps most isn’t fixing it; it’s helping them feel like they’re not alone in it.”— Eric Mendoza, PsyD “Shame is the biggest issue. It’s not just the stutter; it’s what children begin to believe about themselves because of it… Adults can help by creating environments where a child feels safe, not rushed or judged, and by giving them the time and space to speak without interruption or pressure… Children are not failures.”— Nora O’Connor, LCSW Helping Children Who Stutter Thrive When discussing bullying and anxiety, Eric and Nora both emphasized the importance of parents acknowledging and validating their children’s feelings: “I don’t pretend [bullying] doesn’t hurt or that it shouldn’t matter, because it does. If a child is being picked on or feels anxious about speaking, that’s real. So the first step is helping them feel understood and not alone in that experience. A lot of it comes down to sitting with them in those moments and validating their feelings… At the same time, I want to help them build confidence in who they are, not in spite of stuttering but including it. We work on talking openly about their stutter, practicing how to respond if someone says something, learning to set a boundary, and slowly building their tolerance for those uncomfortable moments and a sense of control. I think something really important is helping them separate who they are from how others react. Just because someone laughs or doesn’t understand doesn’t mean there’s anything wrong with them. It says more about the other person. I also try to help them see that their voice matters, even if it comes out differently. And over time, the goal isn’t to eliminate anxiety completely. It’s to help them feel like, “Even if I feel anxious, I can still speak. I can still be myself." — Eric Mendoza, PsyD “Bullying is very serious and harmful. Being open and honest about how difficult that experience can be is essential. We talk about what’s happening, how it feels in their body, and what thoughts come up. If a child cannot speak up for themselves, parents and guardians are responsible for advocating on their behalf. Don’t assume bullying isn’t happening just because your child isn’t telling you. Let’s assume it might be occurring, so we can prepare them for what they can do and what parents can do. For social anxiety, we normalize it. It’s okay to feel anxious, and we explore it together. Learning grounding and mindfulness techniques can help regulate the nervous system, tolerate distress, and support emotional regulation. Adults can also consider whether a child would benefit from seeing a mental health provider. Speech-language pathologists are often expected to address all aspects of stuttering, but it’s important to recognize when something is outside their scope and to refer out. Mental health professionals are trained to treat social anxiety and the emotional impact of stuttering. An SLP and a mental health therapist can collaborate in the child's best interests.”— Nora O’Connor, LCSW Finding Strength Through Self-Acceptance When offering advice directly to children who stutter, both clinicians emphasized the importance of authenticity, connection, and self-expression: “Be your authentic self. The people you’re vulnerable with will become your strongest relationships. For me, stuttering, although it comes with many hardships, primarily internal but definitely shaped by external experiences too, is as corny and cliché as it sounds, has been an incredible gift. Find people who fully support you, where you don't feel the need to hide. I don’t think I’d be where I am today in my journey with stuttering without people who believed in me and mentors who helped me move toward acceptance…Lastly, people who stutter are just awesome! They're typically kind, genuine, and some of the best people I've ever met.”— Eric Mendoza, PsyD “Your voice is yours, stutter and all. You don’t have to hide it or rush it. The goal isn’t perfect speech; it’s real communication. The more you let yourself be seen and heard as you are, the stronger you become. It’s also okay to feel sad, frustrated, or angry. Those feelings are real and powerful. Finding outlets is essential, such as music, sports, art, books, dancing, and other ways to express yourself. There’s more to you than your stutter, and it’s important to explore that. Get connected. Attend a stuttering self-help event in person and virtually. Meet other kids who stutter. You’re not alone in this.”— Nora O’Connor, LCSW Prioritizing Self-Care While Caring for Others Finally, both clinicians reflected on how they maintain their own well-being with self-care, while supporting children with similar lived experiences: “Working with kids alone is healing. Accepting and genuinely loving every part of them heals the younger child in me. Having a daughter who stutters, loving every nuance of her voice, and making sure she knows that's what makes her unique and beautiful in this world, allows me to stutter openly. Embracing her stutter is healing for me.”— Eric Mendoza, PsyD “Staying connected to my body and voice. I practice self-care through yoga and meditation, and I make time for things I enjoy. Staying connected with my family is also important to me. I stay in contact with friends who stutter, and that connection continues to ground me. Stuttering can still be hard work, even after all these years. As I stay grounded, I’m able to be fully present for the children, teens, and adults who stutter and seek my support.”— Nora O’Connor, LCSW More Than Awareness: A Mental Health-Affirming Celebration of National Stuttering Acceptance Week Instead of “National Stuttering Awareness Week,” our organization promotes open conversations about how awareness alone is not enough for people who stutter. We focus on acceptance, ensuring they are heard, respected, and supported daily. Highlighting mental health encourages us to go beyond awareness and create safe, supportive environments for people who stutter. Here are some suggestions for children and family members to celebrate this week together while integrating social-emotional learning: Create a “What helps me when talking feels hard” toolbox with grounding exercises, reminders of supportive people, and self-advocacy phrases Draw or create an art collage on the topic: “My voice matters because…” Read books featuring characters who stutter and talk about feelings in the story “How do you think that character felt?” “What helped them feel supported?” Journal and reflect on “How does stuttering feel for me?” or explore your personal strengths besides your speech (example: your kindness, creativity, humor) You’re Not Alone: Connecting to Support, Resources, and Community No one needs to go through the stuttering journey alone. Community groups, in-school supports, or mental health services offer understanding environments that assist children, teens, and families. If your family is looking for support, explore these resources as your next step: National Mental Health Counseling Directory for Children Who Stutter This database helps families find mental health professionals who provide affirming, stuttering-informed care. Getting Involved with Your Local Stuttering Community NSA chapters and support groups offer opportunities to connect with others who stutter, share experiences, and build lasting community in a welcoming, judgment-free environment. Written by Lexi Hewitt for the National Stuttering Association, where people who stutter, families, and professionals find support, education, and community.

Speech therapy for stuttering has long struggled with one key issue: helping people use the skills and techniques in everyday conversations. Research led by John A. Tetnowski, PhD, CCC, is tackling this challenge using virtual reality (VR), offering a more practical and engaging path forward for stuttering therapy. “The main goal of this project was to investigate how skills learned in clinical settings can be transferred to real-world settings,” said Dr. Tetnowski. “This problem is common in all stuttering therapies.” Funded by the National Stuttering Association’s CASE Research Grant in 2022 and ongoing through 2025, this project focuses on adolescents and adults who stutter. Its goal is simple but critical: make therapy more applicable to everyday communication. By prioritizing outcomes, the research moves beyond traditional clinic-based success measures. The Therapy Room vs Real Life: How VR Bridges the Gap Traditional methods like role-play often fall short because they don’t fully replicate real-world situations. This creates a disconnect that can limit progress and confidence. VR introduces immersive environments where people can practice communication in realistic scenarios. Early findings show it helps transfer skills more effectively than traditional methods. “The gulf between a clinical setting and a real-world setting is quite wide,” said Dr. Tetnowski. “We found that VR is a viable option for promoting transfer and carryover of skills.” Read: How NSA-Funded Research Is Advancing Understanding of Stuttering Read: How This Researcher Advanced the Quality of Life for People Who Stutter Why VR Works One of the most surprising outcomes of the research is how quickly adolescents adapt to VR. Not only do they engage with it easily, but they also show increased motivation to practice independently. This shift could be a game-changer for long-term therapy success, especially for younger populations. “Adolescents not only enjoy this type of intervention, but they will also engage in at-home practice easily and without prompting from parents and therapists,” said Dr. Tetnowski. Beyond improving outcomes, VR also expands access to care. Individuals in rural or underserved areas can benefit from realistic therapy experiences without needing to travel to specialized clinics. This makes stuttering therapy more inclusive and widely available. How VR Is Changing the Future of Speech-Language Pathology The implications of this research extend beyond therapy sessions. VR is also reshaping how future speech-language pathologists are trained, offering immersive experiences that simulate the emotional and practical realities of stuttering. It provides a more accessible and ethical alternative to traditional training exercises. “Stuttering in a virtual environment can serve as an intermediate step that can give all speech pathology students to experience some of the feelings associated with stuttering,” Dr. Tetnowski said. His team is already implementing VR in clinical settings while continuing to refine and expand the technology. New simulations are being developed to increase realism and collect more detailed data. This ongoing work ensures that VR-based therapy will continue to evolve and improve. Read: How One Research Award Helped Launch a Career in Stuttering Research Read: Rethinking Early Stuttering Support: What Parent-Child Interactions Really Tell Us What’s Next for Virtual Reality in Speech Therapy? Looking ahead, the research aims to explore whether VR can support other areas of speech therapy beyond stuttering. If successful, this could open the door to a broader transformation in how communication disorders are treated. The future of therapy may be more accessible and effective than ever before. But Dr. Tetnowski is thinking of the future by asking just one important question: “Can VR applications be used in more types of speech therapy, not just stuttering?” To learn more about the NSA’s CASE Grant, visit WeStutter.org/case-grant.

Understanding Claim Denials Many families and individuals who stutter face insurance claim denials when seeking coverage for speech therapy. These denials often result from outdated policies that classify stuttering treatment as “non-medical” or “developmental.” In reality, stuttering is a neurological communication disorder, and speech-language pathology services are both medically necessary and evidence-based. Note: While stuttering is a natural variation of speech, speech therapy is medically necessary and should be covered by insurance when it significantly affects daily communication. The medical terms “fluency disorder” or “communication disorder” may sound inconsistent with the inclusive language used across other NSA resources, but they are important to include when communicating with insurance companies to facilitate coverage for stuttering therapy services. If your insurance claim has been denied, do not be discouraged. Many successful appeals happen when the right information and supporting documentation are provided. Steps to Appeal a Denied Claim 1. Review the Denial Letter Carefully Begin by reading the denial letter in detail. The reason for denial is usually stated clearly. Common reasons include: “The service is not covered under the plan.” “The service is considered educational, not medical.” “Preauthorization was not obtained.” Understanding the exact reason helps you respond effectively. 2. Request Documentation and Clarification Contact your insurance provider to confirm what information they need for reconsideration. Ask whether they require a Letter of Medical Necessity, therapy reports, or diagnostic codes from your speech-language pathologist. 3. Obtain a Letter of Medical Necessity Your speech-language pathologist (SLP) can write a formal letter outlining why treatment is necessary. The letter should: Include the medical diagnosis (for example, ICD-10 code F98.5: Childhood-Onset Fluency Disorder). Describe the severity of stuttering and its impact on communication, social participation, and education. Explain that therapy is evidence-based and aimed at improving quality of life and communication confidence. Reference authoritative sources such as ASHA and the National Stuttering Association. 4. Write and Submit Your Appeal Letter Use a professional tone and reference policy details when writing your appeal. Be specific and include any supporting documents, such as therapy notes or physician referrals. Keep copies of everything you submit. Sample Appeal Letter (For Parents or Caregivers) [Your Name] [Your Address] [City, State ZIP] [Email Address] [Phone Number] Date To: [Insurance Company Name] Att: Appeals Department [Insurance Company Address] Re: Appeal for Denied Claim for Speech Therapy Services Policy Number: [Insert Policy Number] Claim Number: [Insert Claim Number] Dear [Insurance Representative Name], I am writing to formally appeal the denial of coverage for speech therapy services for my child, [Child’s Name], diagnosed with Childhood-Onset Fluency Disorder (ICD-10 Code F98.5). Stuttering is a recognized neurological communication disorder that affects speech fluency, timing, and physical coordination. Speech therapy for stuttering is a medically necessary service supported by the American Speech-Language-Hearing Association (ASHA) and the National Stuttering Association (NSA). Your denial stated that [insert reason for denial]. However, evidence-based treatment provided by a certified speech-language pathologist directly supports communication development, social participation, and mental well-being. Limiting coverage for stuttering therapy contradicts current medical understanding of the condition. Please reconsider this decision and approve coverage for continued therapy. I have enclosed documentation from our speech-language pathologist, including a Letter of Medical Necessity, progress reports, and supporting materials. Thank you for your prompt attention to this appeal. I look forward to your response and a fair review of this case. Sincerely, [Your Full Name] Sample Letter of Medical Necessity (From a Speech-Language Pathologist) [SLP Name, Credentials] [Practice or Clinic Name] [Address] [City, State ZIP] [Email] [Phone Number] Date To: [Insurance Company Name] Att: Medical Review Department Re: Letter of Medical Necessity for [Patient Name] Diagnosis: Childhood-Onset Fluency Disorder (ICD-10 Code F98.5) Dear Medical Review Team, I am writing to provide documentation supporting the medical necessity of speech therapy services for [Patient Name], a [child/adolescent/adult] with a diagnosis of stuttering. Stuttering is a neurodevelopmental communication disorder affecting speech fluency, timing, and coordination. The resulting disfluencies significantly impact [his/her/their] ability to communicate effectively in academic, social, and everyday settings. Speech therapy for stuttering is an evidence-based, medically necessary intervention aimed at improving communication confidence, reducing avoidance, and supporting functional communication outcomes. These interventions are consistent with best practices established by the American Speech-Language-Hearing Association (ASHA) and endorsed by the National Stuttering Association (NSA). I respectfully request reconsideration and approval for coverage of these services. Treatment is essential to support communication ability and improve participation in daily life. Sincerely, [SLP Name, Credentials, License Number] Speech-Language Pathologist Follow-Up and Additional Support If your appeal is denied again, you may submit a second-level appeal or request an external review through your state’s insurance commission. The National Stuttering Association can provide letters of support or assist in connecting you with advocates experienced in speech therapy coverage disputes. For assistance, contact the National Stuttering Association. Tips for a Successful Stuttering Insurance Appeal Stay organized and keep copies of all correspondence. Include clear documentation and supporting evidence with each submission. Reference clinical research and authoritative sources. Be persistent; multiple appeals are often necessary.

Stuttering is a communication difference that affects about 1% of the world’s population. It is not caused by parenting, anxiety, or personality. Research over the past several decades has strengthened our understanding of the neurophysiological foundations of stuttering and continues to refine how we support people who stutter and their families. At the  National Stuttering Association (NSA) , research is not separate from our community. It is part of our commitment to evidence-based education, stigma reduction, and meaningful support. Previous programs, such as the NSA Research Fund Award, the Canadeo Award, and the Advancement in Clinical Research Award, contributed meaningful insights to the field. Active programs, including the Graduate Student Research Award (GSRA) and the Community, Advocacy, Support, and Education (CASE) Research Grant, currently serve as our active research initiatives, continuing to advance work that informs practice and lived experience. The studies highlighted below represent just a portion of NSA-supported research shaping the field today. Exploring Self‑Compassion & Quality of Life of People Who Stutter NSA-funded stuttering research expands how we think about what really matters for people who stutter. One example comes from speech‑language pathologist (SLP)  and researcher Dr. Robyn Croft Albaum, whose work links self‑compassion with quality of life for adults who stutter. When Dr. Croft Albaum received the Research Fund Award early in her doctoral training in 2020, she pursued an innovative pilot study exploring online self‑compassion interventions —an area that hadn’t yet been widely examined in stuttering research. She found that: Adults who participated in the self‑compassion intervention showed notable increases in self‑compassion, adopting kinder, less self‑critical ways of relating to themselves in challenging moments. Increases in self‑compassion were linked with improvements in quality of life, suggesting that how people feel about themselves can be as meaningful as how they communicate. Psychosocial strengths like self‑compassion may play a vital and measurable role in overall well‑being for people who stutter—beyond speech fluency alone. These findings were published in the International Journal of Speech‑Language Pathology  and shared at major national and international conferences, helping shape conversations about psychological experience, identity, and communication confidence. Re-Examining Advice Given to Caregivers of Children Who Stutter For decades, caretakers of young children who stutter have often been advised to slow their speech, ask fewer questions, pause more between conversational turns, and/or simplify their language. Dr. Nan Bernstein Ratner, professor at the University of Maryland and recipient of the 2021 CASE Research Grant, sought to evaluate whether these commonly recommended strategies are supported by evidence . Using archival data from a large federally funded longitudinal study of 80 families, her team analyzed parent-child interactions over a three-year period. They examined speech rate, turn-taking patterns, questioning frequency, and language complexity in families of: Children who recovered from stuttering Children whose stuttering persisted Children who did not stutter The findings of this study found that these speech characteristics did not predict which children would recover and which would persist. As Dr. Bernstein Ratner noted, recommendations lacking evidence can unintentionally increase parental guilt if stuttering persists. Her work reinforces that a parenting style does not cause stuttering and that families should not bear misplaced responsibility. This research strengthens evidence-based practice and calls for more prospective studies to validate early intervention recommendations. How Identity, Awareness, & Emotional Well-Being Connect for People Who Stutter Stuttering is not only a speech difference; it’s also a lived experience shaped by identity, perception, and environment. Dr. Christopher Constantino, associate professor at Florida State University and recipient of the 2019 Canadeo Award, examined how aspects of stuttering identity relate to emotional well-being in adults who stutter . Using real-time smartphone surveys across daily life, he measured: How central stuttering is to a person’s identity How positively they feel about being a person who stutters How aware they are of their stuttering in specific moments His findings revealed that individuals who viewed stuttering as an important part of who they are and held positive regard for it had increased awareness, which was associated with improved emotional outcomes. This study documented, for the first time, measurable psychological benefits linked to a positive stuttering identity. These findings are influencing therapy models that prioritize integration, resilience, and authenticity rather than concealment. Understanding Why Stuttering Persists Stuttering research helps us understand not only how  people stutter but also why  some continue to do so. Cara M. Singer, PhD, CCC-SLP, associate professor of Speech-Language Pathology at Grand Valley State University, received the NSA’s Research Fund Award in 2017. She focused on why some children recover from stuttering while others don’t. Dr. Singer studied how cognitive, emotional, and language factors influence whether stuttering persists.  Her findings showed that attention, thinking patterns, and language skills all play a role—helping explain why some kids keep stuttering and others recover. She’s now expanding this work into practical interventions, like using books and activities to build resilience and confidence in young children who stutter. Her research shows that understanding the roots of stuttering directly shapes ways to support kids and their families. Bridging the Gap Between Speech Therapy & Everyday Life for People Who Stutter A common challenge in stuttering intervention is applying communication skills learned in therapy in everyday settings such as classrooms, workplaces, and social environments. Dr. John A. Tetnowski , the Jeanette Sias Endowed Chair in Speech Pathology at Oklahoma State University and a recipient of the 2022 CASE Research Grant, is investigating how virtual reality (VR) can help bridge this gap. His research with adolescents and adults who stutter uses immersive simulations to create realistic communication scenarios. Early findings suggest that VR can narrow the distance between gains achieved in the clinic and performance in everyday settings. Participants, particularly adolescents, adapted quickly to the technology and reported high engagement. VR offers repeated, structured exposure to challenging speaking situations in a controlled environment, potentially increasing confidence and carryover. This line of research represents how technology can expand access to meaningful practice opportunities, including for individuals in rural or underserved areas. The Connection Between Emotion & Speech Motor Control Understanding the interaction between emotional states and speech production remains an important area of inquiry. Dr. Kim Bauerly , associate professor at the University of Vermont and recipient of the 2016 Research Fund Award, examined how emotional states influence speech motor control in adults who stutter. Her findings reinforced that emotions do not cause stuttering. However, emotional states may interact with the neurological systems that coordinate speech movements. Research of this kind deepens our understanding of the complex biological and experiential factors involved in stuttering. Since receiving NSA funding, Dr. Bauerly has secured additional federal grants, including NIH funding, and continues to expand her research to include children who stutter. How the NSA Supports Emerging Scholars & Long-Term Impact The NSA’s GSRA has supported early-career researchers whose projects later grew into dissertations, peer-reviewed publications, and academic appointments. Dr. Ryan A. Millager, the 2022 GSRA recipient, began with a pilot study focused on young children who stutter and their interactions with caregivers . That pilot expanded into a successful dissertation and contributed to his appointment as an assistant professor at Rush University. He now continues this line of research while teaching future SLPs and developing clinical services to support people who stutter. Where Research Is Headed These examples illustrate how early-stage research support contributes to sustained impact within communication sciences and clinical practice. Despite significant progress in stuttering research, some important questions remain: Why do some children recover while others persist? Which early interventions meaningfully influence long-term outcomes? How can therapy best integrate identity, resilience, and real-world communication demands? How can technology enhance access and effectiveness? Addressing these questions requires rigorous, collaborative research and ongoing partnership between scientists, clinicians, and people who stutter. A Shared Commitment to Evidence & Community The NSA remains committed to supporting research that is scientifically sound, clinically relevant, and grounded in the lived experiences of people who stutter. Through funding initiatives, research-focused events, and translation of findings into easy-to-understand language, the NSA plays a unique role in connecting discovery to the stuttering community. Research informs how we educate families, train SLPs, shape DEI policy conversations, and strengthen our support networks. As the field continues to evolve, the work of NSA-funded researchers contributes to a clearer, more accurate understanding of stuttering—one that replaces assumption with evidence and stigma with knowledge. We are proud to support this work and to share its progress with our community! To learn more about our contribution to stuttering research, visit WeStutter.org .

For most people, public speaking is usually pretty nerve-wracking. You start to feel uncomfortable at the thought of being judged. But imagine telling jokes for a living as a person who stutters (PWS). Comedy and stuttering might seem like an unlikely pairing, but some amazing comedians have demonstrated that humor and speech diversity can flourish together.  Here’s a closer look at how comedians who stutter not only find humor in human expression but also challenge the stigma around stuttering while connecting with their audiences on a whole new level. Stuttering on Stage: Breaking the Ice Comedy thrives on timing, rhythm, and that unexpected twist. Stuttering might seem like an obstacle to a punchline, but in the hands of a skilled comedian, it becomes part of the act itself. For many comedians who stutter, embracing their speech difference on stage opens up fresh, original material. They’re not only telling jokes - they’re sharing something vulnerable and refreshing. After Drew Lynch  suffered an injury that triggered his stutter as a young adult, it didn’t shy Drew away from the spotlight. He made it to the finals on “America’s Got Talent,” turning his stutter into a comedic superpower.  “I feel like a sideshow. I feel like for so long my career has been about 'the way' I'm saying something—not 'the things I'm saying.' Which, on a human level, can really invalidate all efforts to communicate. My career started because I made jokes about what was obviously there. But I think stuttering has taught me that people are quick to reduce you to what they hear or see... Only things they're experiencing on a surface level. When really, we're just trying to communicate that we're so much more than that. And that's why the power stuttering had over me could only be relinquished when I accepted that their perception is out of my control. And therefore not my responsibility.”   — Drew Lynch, PWS and comedian When she was 22, Dallas-native Avy Taylor entered a pageant and, to prepare for the public speaking portion, decided to take a comedy class. What started as public speaking practice quickly turned into a love of making people laugh and making them happy. “I remember a time early on when I first started doing stand-up. I was still very nervous and just trying to survive my set. In the middle of my performance haze, I heard someone in the audience say, “What does she mean?” and it completely snapped me out of it. I realized I was speaking over everyone’s head, instead of interacting and engaging with the audience. That moment made me realize I was talking at people instead of with them. I was so focused on getting the words out that I wasn’t actually connecting. I learned that communication is a two-way street. People want to understand you. You can’t just speak at people and hope it lands. Even if you’re scared, you have to take the time to give people the opportunity to understand you.” — Avy Taylor, PWS and comedian Joze Piranian was afraid to speak for 25 years. Today, he shares his story with organizations such as the FBI, Meta, Google, and Netflix through motivational speaking or stand-up comedy. He also delivered a keynote titled ‘Can Stuttering and Confidence Co-Exist?' that impressed NSA conference attendees in 2023. “I would say that some of my stand-up material is about stuttering, and some of it is not. I think that if I do a short set, like a very brief one at a comedy club, all my jokes might end up being about stuttering. On the other hand, if I perform a longer set, like 30 or 45 minutes, then at least half of my material will likely cover a variety of topics, such as Hawaiian pizza or Pablo Escobar. I believe that the more experiences one has in life, the more sources of comedic material tend to emerge. Even if my comedy evolves with new experiences, I do think stuttering would remain at the core of my performance. The main reason I got into comedy was to change how I felt about being different. It was to address a deep insecurity. So, it's not that I became a stand-up comedian despite stuttering. I became one because of stuttering, or some might say, thanks to it. And that's an important distinction.” — Joze Piranian, PWS and comedian Spotlight: Voices That Break the Mold Aidan Greene  is Ireland’s most popular stuttering comedian, with his performances blending vulnerability and wit. On stage, Aidan transforms his stutter into a well-delivered comedic performance—using pauses and repetitions as unexpected punchlines. Off stage, he’s a proud stuttering advocate, reminding audiences that a stutter doesn’t dull the shine of a good story. Nina G  dubs herself as “The San Francisco Bay Area’s Only Female Stuttering Comedian”—a title she’s earned through years of carving out her place in the world of stand-up. When she started nearly a decade ago, she was the only woman with a stutter on the circuit. That’s no small feat in the male-dominated field of comedy, where stuttering itself is often misunderstood, laughed at, or sidelined. Laughing With, Not At There’s a difference between laughing at  something and laughing with  it. These comedians are reclaiming the narrative. They decide how to talk about their speech—often weaving their experiences into jokes that highlight the quirks and joys of everyday communication. In interviews, Drew often emphasizes that his stutter doesn’t define him. Aidan uses his voice to help destigmatize stuttering. Nina uses humor to push back against social norms around speech. In doing so, they remind us that comedy is more than just perfection; it’s finding one's place on the mic. “Stuttering changed me for the better because it taught me to have compassion while listening. Some people might take a little more time to communicate their thoughts, but that doesn't make it any less valid. It took me experiencing mistreatment in that regard first hand to have grace for both the person struggling to speak, and the person struggling to listen—because I've been both.” — Drew Lynch Avy encourages listeners to be patient with PWS:  “We are working our darn hardest to get the words out, so please don’t look away. I was talking to a girl recently and I was stuttering. Instead of getting awkward, she stayed with me. She kept eye contact, nodded along, and smiled while I worked through my speech block. Patience, eye contact, and a smile go a long way for someone who is stuttering.” — Avy Taylor Joze Piranian defends himself against the trolls who mock him with his iconic wit: “Since I do acknowledge my stutter right away, people usually get with the program and accept it, like "okay, we’re with him on this journey through the space-time continuum." However, I’ll be performing at a comedy club and hear someone laugh during the setup. That’s when I’m stuttering in the premise of the joke, and they laugh instead of waiting until the punchline. When that happens, I always acknowledge it. So, if I'm starting a joke and I hear someone laugh right after I get stuck on a word, I might think it’s just random at first. But if it happens again and they laugh each time I get stuck, I realize it’s becoming a pattern. Sometimes I'll ask, "Wait, are you still laughing at my previous punchline?" and then I'll say, "Look, I cannot go any slower than this, so you have to keep up," and I will acknowledge it in a way that makes it clear to the audience that I am aware of what’s happening.” — Joze Piranian Mainstream Comedy as Stuttering Advocacy When comedians talk openly about their stuttering, they set the example that stuttering is simply a human expression. They show audiences that stuttering isn’t something to be ashamed of or hidden—it’s one part of life; how we talk. “The biggest misconception in my experience with stuttering as a comedian is that I'm terrified to stutter. I used to make many jokes about my stutter, which helped me stay in control if I did... but now, even with years of rehabilitation, when I think I've got a handle on it, it shows up. I try to surrender to the idea that I'm never fully in control, which takes some pressure off of ‘expectation.’ In the event that I stutter on stage, I'm never frustrated. I try to be comfortable showing the authentic part of me that says, 'Hey, I'm okay with this detour right now because I'm okay being human.' I'm okay with you seeing me at my best, and I'm okay with you seeing me be vulnerable—because when I'm vulnerable is when I'm at my best.” — Drew Lynch When Avy first started in the comedy scene, she said she thought she had to hide her stutter to be successful. She said in reality, the audience wants to connect with a real person. People attend comedy shows to escape from the polished version of life that everyone is expected to portray.  And she encourages PWS to be brave: “You’ll be successful in comedy—heck, even in life—when you own everything that makes you different. The world needs to hear our voices. Don’t wait for permission to take up space. Be brave and refuse to shrink yourself. Stay persistent and keep making your voice heard. The world will change when we show up, speak up, and redefine what it means to be someone who stutters.” — Avy Taylor Joze’s global success as a comedian demonstrates that stuttering can be recognized across different languages, cultures, and continents: “On one hand, stuttering is universal. It can exist in every community, in every country, in every culture, in every language. And in that sense, there will always be at least a minimal understanding of stuttering among humans. So in that sense, when a comedian starts to stutter, no one is completely dazzled or astonished by the concept of someone getting stuck on their words, which helps. So the fact that it is a universal experience that exists cross-culturally means jokes that work in one language or in one country involving stuttering will typically work in another. At least that's what I have found in other countries and languages, too.” — Joze Piranian, PWS and comedian A Final Laugh—and a Challenge Next time you’re at a comedy show or scrolling through stand-up clips online, listen for the unexpected. Listen for the pause, the repetition, the realness that comes from a comedian who stutters. You might just find that the best punchlines are the ones that come with a little extra pause. Learn more about stuttering.

By Michele Murphy My now 17-year old son, Kevin, started stuttering around the time he began talking at age 3. His older brother, Sean, was around 4-1/2 years of age at the time, and was a model of fluency and advanced articulation skills. So when our pediatrician told us that Kevin’s delayed speech was because his brother spoke for him and he didn’t need to talk, that made sense. And when the pediatrician said that Kevin would grow out of his stuttering, that made sense too. So in those critical years from 3 to 7 years of age, we did nothing but listen to the ill-informed, ill-advised and patently wrong advice of our well-intentioned but stuttering-ignorant pediatrician. Our next big mistake in dealing with Kevin’s stuttering was in taking adequate comfort from the fact that he was seeing various elementary school speech therapists. We naively thought that every school speech therapist would know whatever was needed to effectively deal with speech disorders such as stuttering. The next blunder actually led us towards a path that has been most successful for Kevin. By age 12, it was apparent that Kevin wasn’t going to outgrow stuttering, and the school speech therapy was not helping. So when we heard about an experimental fluency technique using a bio feedback device we jumped at it and brought Kevin for a tryout. I remember my airflow cutting off when the speech pathologist conducting the trial run said that Kevin was one of the few persons that did not experience any greater fluency while using the device. It came as an even greater blow when he stated that Kevin was one of the most severe stutterers he had ever seen. That was one of the lowest points of my life. I was wracked with guilt (I must have somehow caused this awful disorder) and despair (what kind of life would Kevin have ahead of him if he couldn’t even express himself). In closing, the therapist suggested we contact Temple University in Philadelphia, where the speech-language pathology department had significant experience dealing with stuttering. When we took Kevin to Temple for a consultation, it was the first time I really came to terms with the severity of his stuttering. I sat behind a one-way mirror and watched in horror as my son blocked severely on almost every word. The tears that I had been holding back for years came cascading over my eyelashes. There was some good news, however. The speech therapist who interviewed Kevin was really impressed by Kevin’s self esteem and sense of humor in the face of his severe stuttering. They strongly recommended private speech therapy with a speech pathologist experienced in dealing with stutterers. Kevin soon began weekly speech therapy sessions with a well known speech pathologist who specializes in stuttering. Kevin gained a lot of fluency in the therapy sessions, but even more important, he started on the path towards becoming an expert on his own stuttering, and really connected with his therapist on an interpersonal level. Two years later, we moved to Utah. Within months, Kevin had lost what fluency he had gained and was at an all-time high level of disfluency. That’s when I heard a radio advertisement for the National Stuttering Project, the nation’s largest support organization for people who stutter. After a phone call to the NSP’s (now NSA) national office, Kevin and I signed up for the NSP’s Annual Convention in Denver that year. What happened at that first convention is almost impossible to put into words. Suffice it to say that Kevin and I both experienced a turning point in our lives. I was able to shed the guilt that I had somehow caused Kevin’s stuttering, and accept the realization that neither could I “fix” it. I became part of a support group of other parents of children who stutter that has been a lifeline to me ever since. And I started my journey to becoming educated on the subject of stuttering. With more than 400 people who stutter in attendance, Kevin truly came to know and understand that he is not alone in dealing with his stuttering. He also continued his journey of gaining the education necessary to become an expert in his stuttering. Most importantly, Kevin began friendships with renowned speech pathologists, adults who stutter and youth who stutter that are his lifeline. At that first NSP convention, we also met a speech-language pathologist from Utah who specializes in stuttering. Kevin has been in treatment with him for several years and has profited enormously. Kevin also attended the Successful Stuttering Management Program (SSMP), a three-week intensive stuttering program, two summers ago. We also have remained active in the NSP, and in three years Kevin hasn’t missed a single local NSP meeting or national convention. This combination of appropriate speech therapy, participation in the NSP and an intensive speech therapy program such as the SSMP has placed and kept Kevin on the best possible course for dealing effectively with his stuttering. Yes, Kevin still stutters, sometimes even severely, but he has tools that enable him to communicate better and he does not carry the psychological burden that often accompanies stuttering. In short, his pain and mine over his stuttering are gone. In its place is knowledge, understanding, acceptance and a family of NSP members who love and support us. In hindsight, what would I have done differently? I would have educated myself about stuttering as soon as Kevin began to experience it. There are many sources of information, especially on the web, including the NSP and the Stuttering Foundation of America’s web sites. Next, at the age of three, and for as long as necessary, I would have arranged private speech therapy for Kevin from a speech-language pathologist with successful experience in treating children who stutter. If we continued with school speech therapists, I would have worked to get Kevin the same type of appropriate speech therapy through the school system. Finally, I would have had Kevin participate in the NSP at an earlier age. Knowing what I know now, if that had been done, Kevin might truly have “grown out of stuttering” as wrongly predicted by his pediatrician, because of the proven success of early intervention. We do not spend a lot of time regretting that we did not act sooner, however. Kevin is wise, loving and compassionate beyond his years: in part because of his stuttering and not in spite of it. The adversity that he has experienced has helped him to grow in so many beautiful ways. What’s important, for anyone who stutters, is to get the kind of help Kevin got regardless of age. Early intervention is best, but it is never too late! … MICHELE MURPHY IS AN NSA MEMBER AND AN ATTORNEY IN SALT LAKE CITY UTAH. THIS PIECE FIRST APPEARED IN ADVANCE FOR SPEECH LANGUAGE PATHOLOGISTS.

Acquired Stuttering  – is a broad term that refers to non-developmental stuttering and is interchanged with other terms such as “adult onset stuttering”, “neurogenic stuttering”, and “psychogenic stuttering”. Advertising  – (also known as ‘disclosing’) stuttering refers to being open about the subject of stuttering; letting other people know from the start of a conversation that you are a person who stutters. Self-advertising can be an empowering strategy for people to use, especially covert stutterers, so they do not feel the pressing need to hide their stuttering. It can also reduce or eliminate avoidance and secondary stuttering behaviors. Through self-advertising, people can realize that it acceptable to stutter in front of others and that one does not need to have flawless speech to be an effective communicator.  See Disclosing. Block  – when vocalizing stops before or during a sound or word Bullying  – When words or deeds are used to hurt someone or cause harm. Bullies try to make the person they are bullying feel afraid, rejected, or hurt. (This is contrasted with Teasing which is what we have all experienced and enjoyed as harmless “ribbing” from our family and friends; a way to show love or good feelings toward others. Teasing is having fun. Unlike bullying, it is not meant to control or harm anyone). Cluttering  – a type of fluency disorder that can coincide with stuttering or occur by itself. Cluttered speech may include rapid and/or irregular speech rate, atypical pauses, excessive linguistic nonfluencies, decreased awareness of one’s intelligibility, collapsing or omitting syllables, and language issues in general. Covert Stuttering – Covert stuttering is a strategy employed by a person who stutters to hide an otherwise overt, audible stutter. A covert stutterer may use word substitutions, circumlocution, and avoid certain words and situations which may trigger stuttering. People who are covert stutterers may go to great lengths to conceal their stuttering from others. Desensitization  – A process through which people can successfully overcome their fears, as well as other negative emotions such as shame or guilt, by gradually experiencing them in a supportive environment following a systematic, controlled hierarchy. Developmental Stuttering – occurs in young children who are still acquiring speech and language skills. Most scientists and clinicians believe that developmental stuttering stems from complex interactions of multiple factors including neurophysiological differences and genetics. Disclosing – (also known as ‘advertising’) stuttering refers to being open about the subject of stuttering; letting other people know from the start of a conversation that you are a person who stutters. Self-advertising can be an empowering strategy for people to use, especially covert stutterers, so they do not feel the pressing need to hide their stuttering. It can also reduce or eliminate avoidance and secondary stuttering behaviors. Through self-advertising, people can realize that it acceptable to stutter in front of others and that one does not need to have flawless speech to be an effective communicator.  See Advertising . Dysfluency  – the interruption in the smooth flow of speech, such as a pause or repetition of a word or part of a word. Evaluation  – Certified speech-language pathologists (SLPs) perform evaluations, or formal assessments, to determine whether an individual has a speech or language disruption. During a typical evaluation for a child, the SLP obtains a case history from the parents and observes/interacts with the child. Standardized tests are administered and informal observational assessments are conducted for both children and adults to determine a proper diagnosis. In a stuttering evaluation, the SLP may ask the clients about their family history, the stuttering history, how stuttering affects their daily lives, how they perceive their stuttering and their personal goals for treatment. This information is used to determine what kind of dysfluencies the person demonstrates, whether there are any complicating factors, the prognosis for improvement and possible goals for therapy. Fluency Shaping – a behavioral speech therapy approach that aims to alter clients’ breathing, speech rate, voice production, and articulation to elicit fluent speech. Visit ASHA’s website to learn more about speech therapy. IDEA  – Individuals with Disabilities Education Act – A federal law that ensures services to children with disabilities (please see idea.ed.gov ). IEP  – Individualized Education Plan- As mandated by the Individuals with Disabilities Education Act (IDEA), an IEP is designed to meet the needs of a child who has a disability or special learning need. Children between the ages of three and 21 with speech/language disruption who are in the public schools can receive evaluation and intervention services free of charge. If a child qualifies for speech-language services through the school district, the IEP team identifies the needs of the student, what services will meet those needs, and the individual speech and/or language goals. Parents work with teachers and SLPs to develop the student’s IEP, including goals and procedures for achieving them. Intersectionality – Refers to how a person’s experience of stuttering is influenced by factors such as race, gender, class, and disability. Acknowledging intersectionality helps us understand the diverse experiences of people who stutter and promotes inclusivity and equity. Person Who Stutters (PWS) vs. Stutterer – The terms “person who stutters” (PWS) and “stutterer” both refer to individuals who experience stuttering, but they carry different connotations. “Person who stutters” is a person-first language, which emphasizes the individual before their condition. It is a way of acknowledging that stuttering is just one aspect of the person’s identity and that it does not define them completely. On the other hand, “stutterer” is an identity-first language, which places the condition before the person. While some people who stutter may choose to identify as a stutterer, it is important to note that not all people who stutter prefer this term. It is important to respect individuals’ preferences when it comes to the language used to describe their experiences with stuttering. Some may prefer person-first language while others may prefer identity-first language. It is recommended to ask the individual how they prefer to be referred to. Prolongation  – the involuntary lengthening of airflow or speech. Recovery  – generally, refers to returning to a normal health condition or normal state. Research suggests that around 80% of children who start to stutter naturally recover from stuttering. Repetition  – the involuntary repeating of a sound, word or part of a word. Self-help Support  – people with, or affected by, a common need or condition working to help others with the same condition, often in an informal manner with the goal of bringing about personal or social change Standardized  – Any measure that is given in the same way to all people who take it. For example, standardized tests are administered using a protocol that must be strictly followed. If the protocol is not followed, the results of the test may be invalid. Sometimes referred to as “formal” measures. Stuttering Modification  – The goal of stuttering modification therapy is not to eliminate stuttering, but rather to modify the moments of stuttering so the disfluencies are less severe. Other objectives of stuttering modification therapy include reducing the fear of stuttering and eliminating avoidance behaviors. Stuttering modification therapy often includes identifying core and secondary stuttering behaviors, learning desensitization techniques, and specific stuttering modification techniques such as stopping in the middle of a stutter (cancellations), pulling out of a stutter and transitioning into smooth, fluent speech (pull-outs) and using easy stuttering on words which the speaker may anticipate stuttering (prepatory sets). Visit ASHA’s website to learn more about speech therapy. Stuttering  – A frequently misused and misunderstood word that means many different things to different people. Primarily, it can refer to observable behaviors (e.g., “stuttered speech”) or it can refer to the stuttering, which comprises both the observable behaviors as well as a variety of “under the surface” features including fear, avoidance, attitudes, beliefs, etc., that are experienced by the person who stutters but are not seen by the listener. Many people confuse the two uses of the term. Secondary Characteristics (secondaries)  – In addition to speech dysfluency (word, sound or syllable repetitions, prolongations and blocks), many people who stutter exhibit secondary symptoms unrelated to speech production. Some secondary characteristics or “secondaries” include eye blinking, facial tension, lip tremors, head jerks or other unusual body movements. Secondary characteristics also include avoiding feared words, interjecting starter words (such as “um” or “you know”) or switching words midsentence. Edited by Angela Medina, PhD, CCC-SLP and Courtney Margulis, MA, CCC-SLP (5/2023)