SpeechPathology.comPhone: 800-242-5183

New master brand. Same great company. Introducing continued! Read Our Story

CRA Therapy Careers

Reducing Laryngeal Tension During Stuttering

Craig Coleman, M.A.,CCC-SLP

September 5, 2005



I have three middle school students who are severe stutterers, whose greatest challenges appear at the laryngeal level. Two of them cannot get enough airflow during blocks to permit phonation and have difficulty finding a way to relax the constriction. Th


Treatment for school-age children who stutter typically involves "management" of the disorder, rather than elimination of stuttering. As such, goals of treatment should include reducing the number of disfluencies, reducing physical tension, increasing the child's knowledge of stuttering, increasing communication skills, and reducing any negative reactions to stuttering on the part of the child.

Your question involves reduction of physical tension during stuttering. Treatment for this area typically involves stuttering modification techniques. This typically begins with having the child identify the place of tension during a block. It is best to start with having the child identify this when the clinician does a purposeful block and then have the child move toward identification of place of tension in his own blocks. Once the child is able to do this, we typically move toward the use of cancellations, pull-outs, and easing out. For a full description of these techniques, you can visit a link on the Stuttering Center of Western PA (www.stutteringcenter.org) at http://www.stutteringcenter.org/PDF/PSHA Handout.pdf.

In addition to speech modification techniques, it is important to understand why blocks happen. In most cases, the presence of physical tension is a response on the part of the child to try not to stutter. Physical tension and other secondary behaviors typically arise from negative reactions to stuttering. Along with targeting the speech modification strategies, I would also heavily target attitudes, emotions, and knowledge of stuttering with all of these children. It seems like they may need some desensitization work. They, as well as others around them, may also need help accepting their stuttering. Because stuttering does not typically "go away" at the middle school level, these children and their families, peers, teachers, etc. will need to understand that stuttering is something they will likely be dealing with for a long time, and that an expectation for perfectly fluent speech is not a realistic goal.

Craig E. Coleman is a Clinical Coordinator at Children's Hospital of Pittsburgh and Co-Director of the Stuttering Center of Western Pennsylvania. He received his Bachelor's and Master's degrees at the University of Pittsburgh. Craig is a member of the National Insurance Advocacy Initiative and Chair of the National Stuttering Association's Insurance Advocacy Committee. In addition, Craig is an elected member of the ASHA Legislative Council.

Related Courses

Autism and Severe Cognitive Impairment - Where do I start?
Presented by Lynn M. Dudek, M.S., M.B.A., CCC-SLP


Lynn M. Dudek, M.S., M.B.A., CCC-SLP
Course: #6193 1 Hour
  'The case studies used and the specific examples given'   Read Reviews
Speech pathologists are faced with a varied caseload. When treating children with autism and severe cognitive disorders it can be very difficult knowing where to start and what goals to set. This course will address the specific needs of these very early learners.
Risk Factors for Young Children who Stutter
Presented by Craig Coleman, MA, CCC-SLP, BCS-F


Craig Coleman, MA, CCC-SLP, BCS-F
Course: #6170 1 Hour
  'Very practical view of stuttering identification and treatment'   Read Reviews
When working with young children who stutter, it can be difficult to determine which children need treatment and which children will recover without formal intervention. This course will discuss risk factors for young children who stutter that help determine the treatment plan following a comprehensive evaluation.
Creative Treatment for Children Who Stutter: Community-Centered Assessment and Intervention
Presented by Craig Coleman, MA, CCC-SLP, BCS-F


Craig Coleman, MA, CCC-SLP, BCS-F
Course: #6499 1 Hour
  'It provided a variety of case studies that made application of strategies and assessments easier to understand'   Read Reviews
We are moving into an era where family-centered intervention may not be sufficient to serve the needs of children who stutter. As the healthcare and school service delivery models change, it will be critical to provide community-centered assessment and treatment. This course will discuss specific assessment and treatment activities to utilize as part of a community-centered approach to stuttering.
Counseling in Stuttering Treatment
Presented by Craig Coleman, MA, CCC-SLP, BCS-F


Craig Coleman, MA, CCC-SLP, BCS-F
Course: #6557 1 Hour
  'Very easy to follow and gave good strategies to help counsel patients who stutter'   Read Reviews
As defined by ASHA, our scope of practice includes counseling people with communication disorders and their families. However, many speech-language pathologists lack formal training in counseling. Stuttering is an area where significant counseling is needed to help the child/adult work through the affective and cognitive reactions to stuttering. This course will focus on a review of counseling principles and discuss how those principles can be applied to stuttering intervention across the lifespan.
Fluency Disorders in the ASD Population
Presented by Kathleen Scaler Scott, PhD, CCC-SLP


Kathleen Scaler Scott, PhD, CCC-SLP
Course: #6580 1 Hour
  'This course helped guide my search through current literature on ASD and stuttering (particularly WFDs)'   Read Reviews
This course will present the latest information regarding what is known and unknown about the presence, possible causes, and potential effective treatments of fluency disorders in Autism Spectrum Disorders (ASDs). Advanced review of cognitive features of ASDs which may play a role in assessment and treatment of disfluencies will be discussed. Examples of practical application of existing information will be presented.