Adult Stuttering

Adults often wonder whether they are to old to come for therapy. The answer is no, you are never too old to come for therapy.

There is a difference between stuttering (more appropriate word is Dysfluency) therapy for adults and children. Adults have a wider emotional range and more life experience which can negatively impact on their speech. Therapy for adult dysfluency sometimes takes longer than expected due to the need to manage the emotional aspects, and not just the speech. Therefore, Speech Therapy is often combined with Psychology to assist in the aforementioned.

What is the speech therapist’s role in Adult Stuttering?

For some adults, the therapist may teach the adult either Fluency shaping or Fluency modification techniques.

  • Fluency shaping will encompass assisting the patient with the management of the dysfluency when it happens, but not necessarily changing the dysfluency itself.
  • Fluency modification refers to assisting in the direct management of the dysfluency behaviours. The reason for this is that fluency modification is not always viable in all cases.

In most cases, both techniques are used to some extent, in order to assess the best therapy protocol for each patient. The success of therapy is also up to the patient, as they are required to implement the techniques in order to generalize these skills to other environments outside of the therapy room. Often adults are more successful at this than children, as they are able to implement these techniques themselves and experience feedback on it. Children may, and often will, need help with the facilitation of these from another individual.


Voice difficulties can be caused by a number of conditions. Voice difficulties normally manifest audible symptoms such as high vocal pitch, hoarse or breathy voice quality, intermittent or inconsistent phonation or vocal production, to name but a few. These symptoms may be caused by , but not limited to, the following:

  • Swelling of the vocal cords, such as often happens after head and neck surgery and upper respiratory illnesses.
  • Benign or malignant growths on the vocal cords due to nodules, polyps and/or other tumor-like lesions
  • Paralysis of one and/or both vocal cords due to neurological fall-out such as Stroke, Head Injury, Guilian Barre Syndrome,etc
  • Puberty such as what male patients often go through at a certain age

Symptoms of Voice difficulties:

  • Stridor
  • Throat Clearing
  • Coughing
  • Breathiness
  • Hoarseness
  • Aphonia (no voice production)
  • Roughness
  • Tremor
  • Strained voice quality
  • Monotone
  • Fluctuating pitch breaks
  • Nasal Speech Quality
  • Inappropriate breathing patterns

The speech therapist’s role in Voice:

The role of the Speech Therapist in voice difficulties is:

  • to assess the patient to determine the symptoms and causes of symptoms which will include an interview with the patient and contact with the patient’s ENT should the patient have been referred from a specialist
  • refer to an ENT where necessary. This normally happens in cases where a patient has been presenting with vocal difficulties and has not yet been assessed by an ENT. The ENT will do an internal assessment via scope to assess the status of the vocal tissue.
  • Provide the patient with a vocal hygiene program for vocal protection and sustained vocal production
  • Provide voice therapy where it is indicated

Assist the patient with the necessary changes to their environment to assist with vocal protection and optimal use.