Clinicians often prescribe direct treatments to manage speech dysfluencies in children who stutter. Such treatments employ fluency strategies that help to decrease tension when speaking, modify a child’s speaking rate and improve her emotional relationship with stuttering. In addition, indirect therapy has been shown to be crucial in the overall treatment program. (Guitar, 2025). What is indirect therapy for stuttering?
An indirect therapy program asks parents and other caregivers to help create an environment that facilitates speech fluency. When examining the home environment, we try to identify potential stressors that may be impacting a child’s speech. A child with siblings in a highly energetic family may feel pressure to speak quickly, especially if brothers and sisters tend to interrupt or speak for her. Maybe the pace of family life is hectic, and there isn’t much time for relaxed conversation. In any case, the parent and clinician can work together to carve out time and space for the child to communicate with reduced pressure.
Positive Comments
For many parents, particularly those who are highly anxious about their child’s stuttering, it can be difficult to know how to respond to a child’s dysfluencies. Correcting or criticizing a child’s stuttering is counterproductive, as it teaches the child to minimize communication attempts in an effort to reduce their stuttering overall. As a parent, it’s best to try to find space and time each day to listen to and engage with your child in a calm environment, preferably one on one. Parents who make positive and accepting comments about their child’s communication will help children feel accepted for who they are. As a result, children will be more open to self-expression and to using fluency strategies successfully.
Slowing the Rate of Speech
There is some evidence that mothers of children who stutter have a faster than average speaking rate (Guitar, 2025). When exposed to a fast speaking rate, children may try to imitate this style, which can increase stuttering as the child tries to speak faster than their speech system permits. We know that when children slow their rate of speech, they often speak more fluently. However, speaking slowly is more easily said than done. Instead of slowing and stretching the individual sounds in words, it’s easier and more natural to insert pauses into one’s speech. “Mister Rogers” provides a good model for slow speech with frequent pausing.
A key component of indirect therapy is teaching parents how to slow their own speech in order to provide a good model for speech fluency. Clinicians can model this style of speech during therapy sessions while parents observe. For those who are used to speaking quickly, slowing the rate of speech can feel effortful. However, especially at the preschool age, providing these good speech models can significantly reduce dysfluencies.
Reducing Interruptions and Asking Fewer Questions
Another environmental factor that may increase children’s dysfluencies is the frequency with which parents interrupt their children. Parents may be more likely to interrupt their children when they are stuttering. This may lead to a faster speaking rate or an increase in tension, or it may train the child to use counterproductive compensatory strategies, such as eliminating dysfluencies by restricting how much she speaks. Interruptions from siblings or other family members can also be stressful. If family members take turns and refrain from talking over each other, children will find it easier to communicate.
Often parents ask a child many questions in order to help her learn new information and allow her to demonstrate her knowledge. However, some children may feel pressured when asked to speak on command, and that can exacerbate dysfluencies. Parents can cultivate a new style of engagement in which they decrease demanding questions and teach by making positive comments and observations.
The use of indirect treatment in stuttering is often the primary strategy for children who are beginning therapy. If their home environments can be modified, they benefit from a more relaxed communication setting. Positive comments improve self-esteem and help diffuse the frustration that often accompanies stuttering. When parents slow their rates of speech, reduce interruptions and ask fewer questions, children will find it easier to communicate.