Goal: Use Stuttering Modification Strategies to Move Past Moments of Stuttering

Stuttering modification strategies, originated by Van Riper (1973), aim to reduce associated physical tension and struggle by helping children to identify core stuttering behaviors, recognize physical concomitant behaviors, locate the point of physical tension and struggle during moments of disfluency, and ultimately reduce that physical tension.

Preparatory set (before stutter)
Pull-out (during stutter)
Cancellation (after a stutter)

(Source: http://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935336&section=Treatment)

We can teach our clients how to use these stuttering modification techniques to help them through moments of stuttering. Our goal is to teach the client all of these and let him choose which one he needs in each moment of stuttering.

Sample Goal:

Client will demonstrate the ability to independently use stuttering modification strategies (as needed) during 4 out of 5 structured conversation tasks in the therapy room with zero clinician prompts.

Download the No-Prep Therapy Kit:

We have a start-to-finish therapy kit that will give you everything you need to practice this skill in therapy and send home homework. Click the packet below to open it. Then, print it out and place it in the child’s notebook or binder.

Open the No-Prep Kit for Preparatory Set

Open the No-Prep Kit for Pull Out

Open the No-Prep Kit for Cancellation

Therapy Phases:

Learn About the Speech Mechanism: Student will be able to describe the basic structures and functions of the speech mechanism system, including how the breath works together with the larynx and articulators to produce speech.
Practice Stuttering Modification Techniques in Structured Tasks: Student will demonstrate use of the stuttering modification techniques in a controlled, structured task in the therapy setting.

Preparatory set

1. Client will use preparatory set stuttering modification strategy when producing single words with 80% accuracy independently.

2. Client will use preparatory set stuttering modification strategy when producing two-word phrases with 80% accuracy independently.

3. Client will use preparatory set stuttering modification strategy when producing carrier phrases with 80% accuracy independently.

4. Client will use preparatory set stuttering modification strategy when reading sentences with 80% accuracy independently.

5. Client will use preparatory set stuttering modification strategy when reading short paragraphs with 80% accuracy independently.

6. Client will use preparatory set stuttering modification strategy when describing a picture scene with 80% accuracy independently.

7. Client will use preparatory set stuttering modification strategy when completing structured conversation activities with 80% accuracy.

Pull Out

1. Client will use pull out stuttering modification strategy when producing single words with 80% accuracy independently.

2. Client will use pull out stuttering modification strategy when producing two-word phrases with 80% accuracy independently.

3. Client will use pull out stuttering modification strategy when producing carrier phrases with 80% accuracy independently.

4. Client will use pull out stuttering modification strategy when reading sentences with 80% accuracy independently.

5. Client will use pull out stuttering modification strategy when reading short paragraphs with 80% accuracy independently.

6. Client will use pull out stuttering modification strategy when describing a picture scene with 80% accuracy independently.

7. Client will use pull out stuttering modification strategy when completing structured conversation activities with 80% accuracy.

Cancellation

1. Client will use cancellation stuttering modification strategy when producing single words with 80% accuracy independently.

2. Client will use cancellation stuttering modification strategy when producing two-word phrases with 80% accuracy independently.

3. Client will use cancellation stuttering modification strategy when producing carrier phrases with 80% accuracy independently.

4. Client will use cancellation stuttering modification strategy when reading sentences with 80% accuracy independently.

5. Client will use cancellation stuttering modification strategy when reading short paragraphs with 80% accuracy independently.

6. Client will use cancellation stuttering modification strategy when describing a picture scene with 80% accuracy independently.

7. Client will use cancellation stuttering modification strategy when completing structured conversation activities with 80% accuracy.

4. Generalize Stuttering Modification Techniques in Other Environments: Student will demonstrate use of the stuttering modification techniques in natural conversations in a variety of other settings. Click Here to View the Generalizing Skills Workbook

Disclaimer (For Copy and Paste): Feel free to copy and paste these sample goals into your plan but make sure you modify them to meet the individual needs of the child. This should include individualized level of cueing, such as "independently" or "with verbal prompts".

Supplemental Materials

Here are some other resources that may help you when working on this skill:

Preparatory Set worksheet

(Use Before Anticipate Stutter)

Pull-Out Worksheet

(Use In the Middle of a Moment of Stuttering)

Cancellations Worksheet

(Use at the End of a Moment of Stuttering)

Desensitization Prompts Worksheet

Once your client can use these quickly and easily during conversations in the therapy room, start practicing them in increasingly more difficult situations. Have him use them in a conversation with the secretary in the office, or when relaying a message to the school librarian.

Fluency Cheat Sheets

A list of the different types of disfluencies along with therapy activity ideas for every level.

Improving Awareness of Stuttering and Addressing Negative Emotions

Help for children who aren’t aware of their stuttering or who are being affected by negative emotions of their stuttering.

Improving Breath Control and Function for Voice or Fluency Therapy

Help for children who are struggling to coordinate breathing with their speech.

Training Videos:

Need some extra help on treating this skill? Check out these related training videos:

Generalizing Fluency Strategies Outside of the Therapy Room

Overview of Fluency Therapy for Middle Schoolers

Webinar Recordings:

If you need some in-depth information related to this skill, check out our related webinar recording(s):

Stuttering/Fluency Therapy Activities – Webinar Recording

The Whole Child Approach to Evaluating and Treating Stuttering – Webinar Recording