Treating early stuttering

Research has consistently noted that for the majority of people who stutter, the onset of the disorder is preschool (Andrews & Harris, 1964; Conture, 2001; Dalton & Hardcastle, 1989; Gregory, 2003; Van Riper, 1982; Yairi & Ambrose, 1992b). The literature on therapy for younger children is considerable (see, for example, Adams, 1980; Bloodstein, 1993; Conture, 1990; Costello, 1983; Guitar, 1998; Onslow, et al., 1994, 2003; Pindzola, 1987; Rustin et al., 1996; Ryan, 1974; Shames & Florence, 1980; Shine, 1980, 1988; Van Riper, 1973; Wall, 1995). This chapter must by necessity, be selective. In order to try to characterize the breadth of therapeutic procedures currently available to clinicians, we focus largely on two approaches that illustrate very different rationales, methods and procedures for the treatment of early stuttering. One offers a motor speech explanation and a direct operant approach to deal with it. The other takes a more multifactorial perspective to aetiology, treating the problem from an (indirect) cognitive and interactional perspective. Both approaches are well established and widely practised. Between the range of possibilities exposed by these two therapeutic models, we can place the rationale and therapeutic procedures of the whole spectrum of integrated approaches that may be loosely labelled “mainstream therapies”.