Quick Hits: what the research says about improving fluency

Quick Hits: what the research says about improving fluency Hey everyone, we all read the posts every week from people suffering because of their stutter, unsure what to do about it, if there's anything they can do about it. All of us want to help; I'm no different. I'm significantly more fluent than when I was younger, but more importantly, I've been reading research on stuttering for the past eighteen months. I've condensed the findings about improving fluency in adult stutterers. This post is a shorter version of a [longer post](https://www.reddit.com/r/Stutter/comments/puk7u5/the_gameplan_putting_stuttering_research_into/?utm_source=share&utm_medium=web2x&context=3) a few days ago that goes into more detail and explains the why of each bullet point. (Also has all the sources for these statements.) ​ * **Intensive speech therapy works.** Multiple studies have shown that intensive speech therapy increases fluency and drives neuroplastic change. All but a handful of the \~80 participants would have qualified as a "mild" stutterer by the end of their program; even the ones with a severe stutter. [Here](https://www.reddit.com/r/Stutter/comments/pruw9f/speech_therapy_and_neuroplasticity_how_and_why/?utm_source=share&utm_medium=web2x&context=3) is a much longer explanation of how/why. ​ * **"Intensive" means programs that usually take between 35-55 hours to complete, usually over 2-3 weeks.** I did not find any studies that used weekly sessions, but considering that - with other disorders - intensive programs create more neuroplastic change than weekly-based ones, it's likely that weekly-based speech therapy will not cause as much neuroplastic change; which may explain why people have mixed results with those programs. ​ * Speech therapy can be delivered with a speech therapist, but the research studies also used computer programs. These programs gave the participant a speech exercise, used a microphone to judge whether the participant did it correctly, and to give feedback. One of these studies took place in 1995 and used a computer running on MS-DOS, so you could probably do all of this on a smartphone if such an app existed. (And you have the discipline to do \~40 hours of therapy over 2-3 weeks.) ​ * There is a ceiling effect to speech therapy. Most participants finished the program speaking with about 2% stuttered syllables, even if they started the program much higher. However, these stutterers were not cured. **If you are over eighteen and still stutter, you will likely have a stutter for the rest of your life, even after speech therapy**. ​ * It's important to follow your intensive program with a **maintenance program**. These programs maintain the fluency you gained in the clinic, and help you transfer it to the real world. These can be much more spaced out; in one study, the program started with one visit a week, then gradually slowed down to one visit a month. That program lasted a full year. ​ * **Metronome therapy** is an effective alternative if speech therapy doesn't appeal to you. Metronome therapy also increases fluency and drives neuroplastic change. ​ * One metronome therapy study had participants **read aloud to the beat of a metronome for 15 minutes a day, 5 days a week, for 8 weeks**. You can even practice using metronome assistance in real life, by playing a metronomic beat in your ear. ​ * In one study, participants simply read aloud two-syllable words for multiple hours a day for seven days, and even they had improved fluency and neuroplastic change. (Study wasn't clear, but it was probably >5 hours of speaking a day.) ​ * **Anxiety and avoidance are the greatest threats to fluency gained in speech therapy**. Studies show that if you do not use your new fluency, you will lose it. ​ * Speech therapy may improve your fluency, but that doesn't necessarily mean you will start speaking more. One study showed that participants took on more speaking challenges after improving their fluency - which is good - but not as much as participants who completed a cognitive-behavioral therapy program, even before they started speech therapy. So, **you do not need improved fluency to speak more often**, though it certainly helps. ​ * To that end, **cognitive-behavioral therapy** (CBT) was very effective for improving mental health/quality of life and enabling these participants to speak in situations that used to (or still did) scare them. ​ That's the essence of the research. If you have any questions, or are curious for more, please check out [my other posts](https://www.reddit.com/user/AlsoTomLovett), as they go into much more detail. (But are a lot longer.) Thank you for reading!