Matthew O’Malley’s “The O’Malley Stuttering Self-Treatment Guide” is not meant for children, but I do believe it holds a perspective that can be helpful to parents.  Below is a chart he shares that reveals a lot about the reality of speech therapy:

Pie Chart - Stuttering Treatment Effectiveness

(Zebrowski, 2008)

Matthew states that

“The pie chart represents different factors that contribute to an effective treatment experience across numerous treatment fields and the percentages represent how important each factor is to treatment effectiveness…Based on the chart,

  • 85% of treatment effectiveness has nothing to do with speaking or mastering a technique.
  • The other 15% cannot tell the difference between techniques.

Within the 85% of what is attributed to treatment effectiveness are elements such as readiness to change, knowledge base, hopes, beliefs, expectations of success, motivation, emotional bonds, shared outlook (between client and clinician) etc.” Matthew goes on to say, “An extremely helpful element in making changes in your stutter is believing strongly and deeply that what you are doing is working.”

Even though Matthew’s Guide is not meant for children, I still wanted his perspective on why this doesn’t apply to children. When children successfully use speech tools and techniques in the clinic setting, you would think that could result in a strong belief that what they’re doing is working, and support the transference of that ability into the real world. Why isn’t that how it plays out?  Here’s Matthew’s response when I asked that question:

“Young children are not properly equipped to engage in most types of direct therapy. The cognitive demands are just too high. Children are in the moment and trying to enjoy that moment.

I am a fan of altering their environment and not the child. Therapy should be geared towards the family and should alter the environment  (people included) to make it more conducive to speech flow and utter acceptance. Children deeply desire pleasing the adults in their lives. We also know children are keen observers and pick up on even the most subtle disapproval. Children succeeding with techniques in therapy can create high belief and expectation of success outside of the clinic. So why doesn’t it work this way for children and what is the impact of it not working?

In the clinic, the child unconsciously knows that the adults around them will celebrate the use of the technique and the child will be completely accepted when they use it. They are even likely to unconsciously link the therapy room with this.  However, when the child goes to use the technique with a peer or sibling, this assurance of approval is no longer implied to the child. The use of techniques in different environments results in different reward outcomes. Once it fails, one’s belief in the technique drops significantly and this sense of failure can also be linked to that environment.”

You can link to Matthew’s Guide at  Thank you, Matthew, for taking the time to respond to my question in such a thoughtful manner!