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By Lisa Scott, Ph.D., The Florida State University

Many teens and adults who stutter have been to speech therapy for their stuttering at least once in their lives. Some people have been through years of therapy. Just because you may have had treatment for your stuttering in the past does not mean you shouldn't consider it again. It is common for stuttering to change over time or for emotions and attitudes about your speech to change as you have new experiences.

It is important for you to have a clear idea about your motivation for going to therapy because your reasons for seeking treatment will help you decide

• The speech-language pathologist who is right for you;
• The amount, length, and cost of treatment;
• Possible goals for speech therapy; and,
• The amount of success to be expected.

Choosing a Speech-Language Pathologist

The key to success with any kind of treatment is finding someone who is knowledgeable about that particular treatment. This is especially true of stuttering.

How do you find a speech pathologist who is right for you? First, begin thinking about the goals that are most important to you. You may even want to read more about stuttering therapy. Good sources of information can be found in Stuttering, An Integration of Contemporary Therapies [2] (Catalog #0016), or Advice to Those who Stutter [3] (Catalog #0009) or Self-Therapy for the Stutterer [4] (Catalog #0012). (Please see our catalog [5] or Web store [6].)

Then, use a referral source. The Stuttering Foundation's referral list [7] has names of people who specialize in treating stuttering. If none are located near you, contact a local university, hospital, or speech and hearing clinic. Universities that have training programs in speech pathology often have a speech clinic that will provide therapy for stuttering.

Once you've contacted a speech pathologist, interview them. There are many important questions you will want to ask, but a few in particular are very important.

• How comfortable are you with treating stuttering? This is important because some speech pathologists are not comfortable working with stuttering.
• How many teens and adults who stutter have you worked with? This will help you determine whether the speech pathologist has the kind of experience you need.
• What do you think the primary goals of stuttering therapy should be for a teen/adult? This will help you decide whether the speech pathologist's ideas about goals match your own.
• What approaches do you use in speech therapy? How often is therapy scheduled? These questions are important because some types of therapy work best when you can go on an intensive schedule (i.e., every day for several hours each day across several weeks). Sometimes the therapy schedule the speech pathologist offers will not work for you because of your job or family commitments. It's important to know this up front.

Therapy Amount, Length, and Cost

The amount of stuttering therapy needed and length of time involved are related to each other and are usually different for each person. The decision about how much therapy is needed and how often it should be scheduled is usually made following a stuttering evaluation.

A thorough evaluation usually ranges from two to four hours and may cost between $300 and $500, depending on your location and the speech pathologist's charges. These charges can vary greatly, so be sure to ask about costs when making the initial call to the speech pathologist. Also, check to see if your health insurance covers the cost of the evaluation.

Once you've completed the evaluation process, the speech pathologist will explain your results to you and then the two of you will begin thinking about the length of time that you can expect to be in therapy and how often it should be scheduled. Therapy length and amount needed depend on your goals, the type of therapy itself, and the severity of the stuttering handicap.

Some therapy programs offer a standard amount of therapy in a set length of time, such as 40 hours across a three-week time period in an intensive program. For many people, however, it takes a longer period of time to overcome the negative feelings about stuttering that build up over the years. In this situation, intensive therapy may not be the right approach to treat the stuttering. Keep in mind also that some speech pathologists do not offer intensive therapy.

If any of these factors are true for your situation, you might want to go to therapy one or two times a week for an hour across several months or even a year. In general, many adults who are seeking long-term changes in stuttering will attend twice-weekly therapy anywhere from 6 to 18 months. Hourly therapy charges can range from fifty to eighty-five dollars. Again, these charges will depend on your location and the speech pathologist's hourly charges. Local university speech and hearing clinics often charge less because of their training mission. At many university programs, it is possible to get an evaluation and therapy at lower rates than those listed here.

Contact your insurance company before you get an evaluation or go for therapy to find out whether they cover stuttering therapy. It's important to ask about stuttering therapy in particular because many insurance companies will pay for speech therapy that is restorative (i.e., after a stroke or brain injury), but may not pay for stuttering therapy when it's viewed as a chronic speech disability. (You may want to read SFA's Guide to Obtaining Reimbursement for Stuttering Treatment [8].)

Expectations for Success

We hear from many people who are doubtful that stuttering therapy can help them. They may believe this because they had limited success or a bad experience in therapy years ago, or because their stuttering is worse than it's ever been. If you have stuttered all your life, it is unlikely that the stuttering will ever go away completely. However, a speech pathologist who is knowledgeable about stuttering can almost always help adults and teens who stutter make positive changes in their communication skills.

As you work with your speech pathologist to set your goals, you will also set your criteria for success. Becoming an effective communicator and living successfully with stuttering should be among the most important of these criteria.

Goals for Therapy

Stuttering therapy for teens and adults usually means changing long-standing speech behaviors, emotions, and attitudes about talking and communication in general. As a result, length and type of therapy can vary greatly depending on your goals. A list of sample therapy goals for teens and adults includes:

• Reducing the frequency of stuttering;
• Decreasing the tension and struggle of stuttering moments;
• Working to decrease word or situation avoidances;
• Learning more about stuttering;
• Using effective communication skills such as eye contact or phrasing; and,
• Determining whether goals relate to long-term change or to meet a specific short-term need, such as a job interview.

Working together with a speech pathologist who is knowledgeable about stuttering will help you identify your personal goals.