Stammering - Treating a stammer

There are many different treatments available for stammering, depending on a person's age and their individual circumstances.

A speech and language therapist (SLT) will work with you, your child, and educational staff to come up with a suitable treatment plan for your child.

An SLT can also work with adults who stammer to help find ways to improve the fluency of their speech, and psychological therapy may be available to help with any emotional difficulties occurring as a result of speech difficulties.

Speech and language therapy is often available on the NHS for people who stammer, although you may have to wait a few months to be seen because most departments have waiting lists and some treatments (such as feedback devices – see below) may not necessarily be funded.

SLTs with experience in assessing and treating stammering are also available privately, although private treatment can be expensive.

Some of the most commonly used treatments for stammering are described below.

Indirect therapy

In pre-school children, indirect therapy is the method commonly used.

This is often based on the 'demands and capacities model', which is based on the concept that children start to stammer when the demands on their speech are greater than what they are able to produce.

These ‘demands’ are often made by the child, as they put pressure on themselves to communicate in a way they can't yet manage.

The goal of indirect therapy is to create an environment in which a child feels more relaxed and confident about their use of language. This involves:

speaking slowly and calmly to the child
developing a positive parent-child interaction
avoiding criticising or drawing attention to the child's stammer
making the family environment as relaxing and calm as possible

Direct therapy

With school-age children, an SLT may be more likely to choose direct therapy, which may include:

helping to improve fluency
helping the person understand more about stammering
sharing experiences with others who stammer
working on feelings associated with stammering, such as fear and anxiety
improving communication skills
developing self-confidence and positive attitudes

Although stammering that persists beyond the age of six or has been apparent for more than three years is significantly more challenging to treat, direct therapy may also be helpful for some adults who stammer.

A widely used type of direct behavioural therapy in the treatment of young children is the Lidcombe Programme.

The Lidcombe Programme is designed to be carried out by the parents of the child under guidance from an SLT and is based on the principle of providing consistent feedback to the child about their speech in a friendly, non-judgemental and supportive way.

Other therapy options

In addition to direct and indirect therapy, there are some other options that can help people who stammer, particularly adults with a persistent stammer and those who develop a stammer later in life (acquired or late-onset stammer).

These include psychological therapy and feedback devices.

Psychological therapy

Psychological therapies include solution-focused brief therapy (SFBT), personal construct therapy, neuro-linguistic programming (NLP) and cognitive behavioural therapy (CBT).

These therapies do not treat stammering directly, but may be useful if feelings such as stress and anxiety make stammering worse, or if you experience these feelings as a result of your stammer.

The British Stammering Association has more information on all of the above alternative therapy options.

Feedback devices

Feedback devices alter the way the voice is heard. They include:

delayed auditory feedback (DAF) – these play your voice back to you a fraction of a second after speaking
frequency-shifted auditory feedback (FSAF) – these play your voice back to you at a lower or higher frequency
combined DAF/FSAF devices – these use a combination of both methods mentioned above

These devices are often fitted inside or around the ear, similar to a hearing aid, and they can help improve the fluency of some people's speech. There are also some applications ('apps') for smartphones and computers that work in a similar way.

However, these techniques do not work for everyone and the devices are generally not available on the NHS. However, the British Stammering Association, the main support organisation in the UK for people with a stammer, can provide a device on loan for two weeks if you are a member of the organisation.

You can read more about feedback devices and apps on the British Stammering Association website.