This paper will focus on three components of speech production for children who stutter:

1. Awareness of articulatory placements and movements.
2. Gently initiating sounds and words.
3. Moving through or "pulling out" of moments of stuttering.

Charles Van Riper, Dean Williams and others have discussed the importance of speech production awareness, easy initiations and modifying stuttering behaviors. Knowledge of the physical aspects of sound and word production is an important component in understanding how one can easily initiate speech and physically move through moments of stuttering without having to rely upon secondary behaviors. The goal is to get the client in the stuttering moment so he can get out of the stuttering moment.

For young children, you can make a game out of this activity by announcing, "Sometimes I forget how to make sounds and words so you are going to teach me how to speak today." Begin by asking the child, "What parts of your body do you use to say words and letters?" Many students will be able to list the "tongue, lips, jaw, palate (roof of mouth) and vocal folds (voice box)." You may wish to draw a diagram of these "speech helpers" with the child for later reference.

After discussing the articulators, begin having the student teach you how to make sounds and words. Ask the child, "Teach me how to say the letter m." If the child is confused or unsure what to do, explain, "Make the m sound; what did your mouth do?" It helps to use mirrors so the student can observe not only the clinician's speech production, but his own as well. Ask the child to put his hand on his neck so he can feel that the m sound is voiced. The child is then able to explain that to make the m sound, "Put your lips together." It is fun if the clinician follows the directions exactly and sits silently with her lips together until the child says, "Oh, and turn on your voice box too."

Then ask the child, "Teach me how to say the vowel o like in the word mom." The child says, "Open your mouth and turn on your vocal cords." Once the child has learned the steps in producing m and o, you may say, "Now I want you to teach me to say an entire word. Teach me how to say the letters m, o, and m so that I can say the word mom."

Work through the alphabet with the child so that he is able to identify and explain how all sounds are produced. Focus on articulating sounds with easy or light contacts. This knowledge will build a foundation that will aid the child in easily initiating sounds and words, and provide the child with knowledge that will help him move forward through stuttered movements. After working through the alphabet, move on to blends and words.

Have some fun with stuttering and use these new skills to practice moving through stuttered words. Explain to the student, "I am going to stutter. When I do, I will need your help to get unstuck. You will have to tell me what to do to get unstuck and to get through that stutter." Then, stutter on the first sound of a word and hold it until the student explains to you what you need to do to say the next sound (to get unstuck). For example, stutter on the s sound in "sun" and hold the stutter until the student explains that to move forward off the s, you have to "open your mouth" or "drop your jaw" to say the u vowel. Be sure and have fun with this exercise. The student may take his time directing you because it is fun to keep the clinician in a block. Play along and be a good sport.

After the clinician stutters on several words, reverse roles and ask the student to get stuck on a word and to hold the stutter until you explain what he needs to do to move onto the next sound. This type of practice will aid the student with both working through a moment of stuttering and with initiating speech. During this exercise, be sure and work on vowel onset words as well, because words that begin with vowels are particularly difficult for some people who stutter and may lead the speaker to begin articulation with a tense, open-mouth posture. For example, if the clinician is stuck on the letter a in the word "at," the child needs to say, "Raise your tongue to the roof of your mouth to make the t sound."

Some sounds such as stops and plosives or feared letters may require special attention. Here is an example you may provide a child of how to produce the letter p:

I sometimes get stuck on the letter p and sometimes I just push too hard on it. I have a special way to say p easily and smoothly. Put your lips together gently, as if you were holding a little egg between them. Do not crush the egg. Now put your hand in front of your mouth [the clinician demonstrates while instructing] and let a steady, easy stream of air out and say the p sound. Don't push the air out hard - do it nice and soft. [The clinician gives a mirror to the student.] Now, looking in the mirror, do it again. Now teach me how to do it.

Once the student is able to move easily through the p sound, practice saying words that start with the p sound such as "pumpkin" and "panda." The clinician then says, "Let's pretend to stutter on that p sound in "panda," and then we will smooth out the stutter and finish the word. What do our mouths have to do after saying the p?" The child explains how to produce the p sound and that the speaker then has to open her mouth and initiate voicing ("use the voice box") to make the a sound. Teaching letters and words in this manner is a good way to introduce and practice some of the skills necessary in speaking strategies.

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