Respiration (Breathing for Speech)

When you breathe in, your vocal folds open, and your lungs expand and fill with air.

When you breathe out, air rushes out from your lung and between your vocal folds.

Phonation (Creating Sounds)

Just before you speak, you exhale and your vocal folds close.

Sound is created when air rushes through your closed vocal folds.

Articulation (Shaping Sounds into Speech)

The sound created by your vocal folds travels up your throat and out of your mouth and/or
nose.

You move your tongue, lips, jaw, and palate (back of the roof of the mouth) to shape all the
speech sounds.

2. Reduced Speech Rate

The patient starts by producing about 1 syllable per second, stretching out each sound, and
inserting pauses between syllables and words.

Reduced Speech Rate While Reading:

Read aloud in unison with your patient, using a slow rate

Slowly fade out the amount you read aloud in unison

Eventually model reading aloud at a slow rate, then ask the patient to copy you

3. Prolonged Speech

Also known as “smooth speech”. It reduces speech rate and stuttering behaviors by prolonging
syllables. Gradually train the patient to speak at a normal rate.

“Heee leaves ooon Friiidaaay.”

4. Breath Curve

The breath curve is a simple image that helps PWS visualize how to coordinate respiration with
phonation. 5. Easy Onsets

Avoid hard vocal attacks by using /h/. This is a phoneme that allows for maximum, easy
airflow.
Ask the patient to begin by producing /h/ plus a vowel sound. Follow with /h/ initial words, /h/
initial sentences, then phrases that begin with vowel sounds.

6. Light Articulatory Contacts

The articulators move and touch gently. To reduce articulatory tension, teach your patient the
difference between a hard versus a light contact.

For instance, teach the difference between producing /h/ and /p/. Ask the patient to use light
contacts while completing the following contact drills:

Light vs. Hard Sounds

Ha/Pa

How/Pow

Hoe/Poe

He/Pea

Hi/Pie

Ham/Pam

Hop/Pop

Heal/Peel

Hang/Pang
Host

7. Continuous Voicing and Airflow

Ask the patient to “keep the motor going” by saying the entire production or sentence without
any breaks (until they need to take a breath).

8. Cancellations

Teach the patient to first pause for a few seconds after stuttering and then say the word again,
with less tension.

“F-f-f- [pause]. Ffffriday.”

9. Pull Outs

When a patient stutters, ask them to pull or slide out of it as they continue voicing to avoid a
stoppage or block.

“H-h-h- [slide out] hhhhe leaves on Friday.”

10. Preparatory Sets

When a patient anticipates that they will stutter on a sound, ask them to “ease” into the word
by slightly prolonging the initial sound.

“He [ease into it] llleaves on Friday.”

11. Metronome

Help your patient to self-pace and speak at a slower rate by using a metronome.

Prompt the patient to produce one syllable or word per beat. Gradually increase the speed to a
normal speaking rate.
There are plenty of free metronome apps that you and your patients can download on your
phones or tablets.

12. Choral Speech

Read aloud in unison with your patient. Fade out until the patient is reading aloud alone.

13. Shadowing

The patient reads from a script in unison with a recording of the same script.

14. Pacing

Write out target words or phrases for your patient. Place a dot under each syllable.

Ask your patient to touch each dot and produce one syllable per dot.

Continue the pace of one dot per syllable.

Gradually move on to phase completions then sentences.

15. Pseudostuttering

Pseudostuttutering is stuttering on purpose. The PWS may choose to stutter at specific

intervals (every 3rd word, the beginning of every sentence, etc.) or on specific sounds (all the
hard consonants, etc.)

By stuttering on purpose, the person can feel more in control of their speech, which can
reduce the anxiety of unintentional stuttering.

Resources

Voluntary Stuttering: How Can it Help with Fluency?

Stamuri Stuttering Treatment App/Post