Fostering generalization and maintenance in school settings.

One of the most challenging aspects of therapy for school-age children who stutter is generalizing the skills learned in the therapy room to other settings such as the classroom, lunchroom, playground, or home. An additional challenge is seen in maintaining gains over the long term. This article reviews common roadblocks to generalization and maintenance, including the goals of therapy, the nature of the treatment strategies that require generalization, the scheduling and implementation of generalization activities within the overall therapy process, and the child's understanding of the treatment goals. Specific strategies for overcoming these roadblocks include: desensitizing children to both stuttering and treatment strategies designed to improve fluency, using hierarchies as a way of structuring treatment and moving children toward success in their daily activities, integrating the child's real world and clinical settings, and using structured practice activities to help children solidify all of the lessons they learn in treatment. This article highlights the importance of taking a broad-based view of stuttering to help children improve their overall communication across a variety of settings and over time.

Successful communication for children who stutter: finding the balance.

For many school-age children, stuttering consists of more than just speech disfluencies, physical tension, and struggle. Therefore, successful therapy for stuttering should address more than just these observable characteristics. In addition to working on fluency goals, clinicians can help children (as well as the people in the child's environment) reduce negative reactions to stuttering and increase their tolerance and acceptance of their speaking abilities. By treating the entire stuttering disorder in this way, clinicians can help children reduce barriers to successful communication and improve their overall communication skills. When children develop a balance between increased fluency and healthy communication attitudes, they have the greatest opportunity for becoming successful communicators who can speak freely and with confidence in any situation they face.

Stuttering therapy in partnership with support groups: the best of both worlds.

The current challenges facing school-based speech-language pathologist (SLPs) make it increasingly difficult to provide "best practice" services for children who stutter. Traditional modes of therapy alone do not meet many of the needs of children who stutter and their families. Using an interdisciplinary "team" approach to therapy that incorporates support organizations may increase the probability of positive outcomes for children who stutter. By facilitating the introduction of a support organization experience into the direct therapy process, the school-based SLP is uniquely positioned to use this resource to complement an overall treatment strategy. Although there is no substitute for a competent, professional SLP as the primary care provider in the treatment of stuttering, this article outlines some of the many benefits that can be gained by partnering with support organizations when treating children who stutter.