Stammering, or stuttering, affects adults in ways that range from mild disruptions to significant impacts on daily communication and self-esteem. Fortunately, various speech and language therapy approaches have been developed to address these challenges effectively. In this guide, we’ll explore three major approaches commonly used to help adults with this condition: fluency shaping, stuttering modification and cognitive-behavioural therapy (CBT). Each method employs different techniques designed to serve different needs. Let’s discuss just how they work and who might benefit significantly from them.
Fluency shaping therapy
This therapy modifies speech patterns to achieve fluency by reducing stuttering through the modification of some speech aspects. Techniques used include prolonged speech, a technique in which sounds are stretched to maintain a regular rhythm and gentle onset, so that words are softly eased into, especially if they contain vowels, so avoiding sudden changes that may trigger the stammer. Other techniques are continuous phonation, which maintains the continued flow of voice without breaks or blocks, and breath management, which involves controlled breathing to relax the body while speaking.
Fluency shaping typically takes place in a controlled clinical setting with therapists, but the procedures are gradually integrated into natural speaking situations to ensure that fluency occurs in most speaking situations and is consistent. This can be very effective for adults with moderate to severe conditions who are interested in a structured approach towards smoother speech.
This method works best with dedicated regular practice and for those needing to see significant changes in their speech patterns, though some may find the technique less flexible for spontaneous speaking situations.
Stuttering modification therapy
Stuttering modification therapy is different from fluency shaping because it is not concerned with making the patient stutter less; rather, it focuses on modifying and managing stammering.
The therapy usually works in phases: first, people learn to identify unique patterns of stammering and become aware of when and how it happens. Then comes desensitisation – a gradual exposure to situations when they stammer, leading to a reduction in the anxiety and discomfort associated with it. Next is learning modification techniques, like cancellation, which is to pause and retry a word after stammering and preparatory set, which is about modifying speech before stammering occurs. Finally, there is the stabilisation stage, which guides people in implementing these methods in their conversations.
A positive intervention for adults, stuttering modification is an appropriate approach for those with mild to moderate cases who can draw some value in self-acceptance and want greater control over their speech without striving for perfect fluency.
Cognitive-behavioural therapy (CBT)
This therapy reduces psychological dimensions that often incite the stammering with negative thoughts and feelings associated with it. In the adult stammerer, anxiety, perceptions of self and fear about interacting in social situations lead to a vicious circle that increases speaking difficulty. CBT deconstructs the vicious circle by reducing any related anxiety to improve client confidence in communication situations.
Techniques include cognitive restructuring, where one learns to challenge and positively modify negative beliefs about speech, and exposure therapy, so gradually confronting feared speaking situations to build up resilience and self-assurance.
Relaxation techniques such as mindfulness and controlled breathing are adopted in the process to free a speaker from tension and stress during speech. CBT can be used alone or in combination with other techniques, such as fluency shaping or stuttering modification, to create a comprehensive treatment plan.
This is particularly useful for adults who experience a degree of social anxiety or have avoided situations in which they might need to speak as a result of negative past experiences. With a focus on the emotional aspects of stammering, CBT allows for a better attitude towards speaking, creating greater resilience and confidence.
Combine approaches for comprehensive improvement
Many people would benefit from a balanced approach of fluency shaping, stuttering modification and even CBT to deal with a stammer’s technical and emotional nature.
Often, speech therapists develop specific treatment plans after the first assessment, which helps a person focus on specific needs and personal goals. For instance, fluency shaping might help someone speak fluently, while working with CBT-based approaches can help overcome anxiety in social settings. Hence, if these approaches are applied together, a better balance can be achieved between enhancing fluency, self-confidence and easy communication.
The treatment approach chosen is very personalised. Fluency shaping is provided as an organised aid to those who prefer smooth and more predictable speech, whereas stuttering modification helps individuals manage their stammering better in terms of flexibility and control. CBT involves working on the emotional side of the issue, thereby helping decrease anxiety and reshaping any negative beliefs that someone might have about speaking.
It is advised to contact a therapist for guidance in formulating a strategy that fits your needs. An online search for “speech therapy near me“ can be an excellent starting point for finding local professionals, specialising in adult stammering therapy. Choosing the most suitable approach for your needs will take you towards more confident and effective communication.
