Hey AB, sorry for the late reply. I can't speak to how spina bifida, kyphosis, or the issues may impact speech. If getting enough air isn't a problem when he is is relaxed and happy, I wouldn't peg it as a core stuttering issue, but again I am just a random dude on the internet. What I can say for speech therapy is it is helpful, but it ***really*** depends on the therapist. Finding one who has a real understanding (and specialization) in stutter, and has experience dealing with some stuttering intersectionality as well is what I would search for high and low. ​ Also I dont know what part of the country you are in, but I would strongly strongly recommend getting involved with amazing organizations like [FRIENDS](https://www.friendswhostutter.org/virtual-kids-groups/) and [SAY](https://www.say.org/for-kids-and-teens/) if you can. They can be lifesavers. Of course these orgs arent in full swing due to Covid, but it is still worth looking and finding out more info.