Therapy Techniques

There is a core group of speech therapy techniques (targets) which is used in the vast majority of treatment programs for stuttering. These speech targets are described in this section.

Generally clients focus on one or two (and sometimes as many as three) speech targets in their therapy. Occasionally the targets are used consecutively in the course of therapy, but most commonly they are used concurrently. When techniques are employed concurrently, the transition from one target to practicing another target needs to be clearly delineated for the client.

Targets are generally selected based upon the treatment philosophy of the clinician, the target's applicability to the specific symptoms of the stuttering, a client's willingness to use the target, and the effectiveness of the target to enhance speech fluency. Further explanation is provided below.

	Philosophical Considerations. Some clinicians operate from a specific ideology or theory of how stuttering behaves. Other clinicians are more eclectic, and their selection of targets is more strongly influenced by other factors. In either case, the clinician needs to be able to explain their rationale for their selection of techniques used in therapy to the client.
	Symptomatic Considerations. Targets are usually selected because they address a specific stuttering symptom evident in the client's stuttering. For example, when a client demonstrates excessive force in articulating plosive sounds, a 'light articulatory contact' may be chosen to correct this characteristic of the client's stuttering. If a client has many symptoms, only one or two targets are selected for use for an extended period in therapy to enable mastery of each target.
	Effectiveness Considerations. Effectiveness is usually a function of selecting a technique that remedies the symptoms of stuttering. However, it is also dependent upon the client's ability to master and utilize a technique effectively. Generalization is a related consideration. One or sometimes two targets often emerge that have a "spillover" effect. That is, one technique may prove beneficial to other symptoms or aspects of disfluency, beyond the specific symptoms of the target addresses. This "keystone target" usually becomes the primary focus of later therapy.

Speech targets are tools (or techniques) for a client to master in a series of graded situations of increasing stress-provoking circumstances. These therapeutic tools may be used on a "as needed" basis in specific situations, or preferably, to change the general manner in which the person who stutters speaks, making it more compatible with fluency. For example, slow rate is a technique that might be used situationally. When giving an oral presentation for example, slow rate benefits not only fluency, but also it makes it easier for an audience to follow and process what is being said. The speaker also sounds and appears relaxed, which often make them feel relaxed too.

As a client becomes more capable of managing their stuttering using their targets, their speaking confidence increases while their fears and anxieties decrease; this is a true turning point in their therapy.