Recently a father of a young girl who stuttered mentioned (with what I perceived was a hint of pride) that if she thought she was going to stutter on a specific word, she would just find a new word. At first blush, there probably isn’t a parent in the world who wouldn’t think the same thing. Isn’t concealing your child’s stuttering the intention of speech therapy?
Hope Gerlach-Houck and her colleagues have been studying stuttering concealment for the last four years, including large scale survey studies and in-depth interviews with 30 adults who stutter about their current and past concealment experiences. Their intent was to understand the why, how, and the impact of concealment on quality of life. (2021, 2023, 2025) One key finding was that :
“Concealment was the strongest predictor of the adverse impact of stuttering on quality of life.” (Gerlach et.al.2021)
When participants were asked to think back about their experiences as children, some reported that they learned concealment strategies in speech therapy. (Gerlach et. al., 2021) When a speech therapist introduces strategies with the intention of stuttering less, stuttering more easily, or not stuttering at all, are they inadvertently teaching children to conceal?
Throughout much of our son’s speech therapy we enthusiastically praised his successful use of speech strategies. It only happened in the clinic setting. By the time he was nine, he decided it was easier to not talk than to disappoint us. From my perspective, the strategies, whether under the umbrella of fluency shaping or stuttering modification, all had the same impact.
Do children have the developmental capacity to differentiate between the intention to make things easier and the intention to produce more fluent speech? Frankly, in our six years of traditional therapy, I wasn’t able to distinguish between the two. There was no counseling for me or for our son, and speech strategies focused on changing the moment of stutter.
This was often the case with the 60 adults/parents of older children that I interviewed for my last book, VoiceS Unearthed: The Impact of Childhood Intervention on Those Who Continue to Stutter. The message they received was that they didn’t talk right, we didn’t like the way they talked, and they needed to use speech tools in order to not stutter or stutter less. Many of them reported feelings of shame, embarrassment, and increased communication anxiety. This resulted in their making conscious decisions to engage less in educational and social opportunities. This withdrawal affected relationships with family members, friends, and school personnel. One participant in the Gerloch-Houck research felt that “speech therapy itself can reinforce concealment,” stating,
“as long as speech therapists are continuing to work on things like easy onsets and light contacts, slower rates and fluency counts – that is concealment.”
In the Fall 2025 Stuttering Foundation of America magazine (SFA), 59 children submitted letters and 34 of them referred to strategies that risk reinforcing efforts to conceal.
“I am working hard on my smooth speech in speech therapy at school.” 8 yr old
“I take deep breaths once I stutter.” 10 yr old
“I also like easy onset and stretchy speech.” 9 yr old
“I can fix it by going back and saying it again.” 7 yr old
Additional strategies as stated by the children included:
- turtle talk
- talk like a robot
- stretchy speech
- slow speech
- pausing
- thinking about what I want to say before I say it
While the SFA is a great information resource for adults and families, these types of comments from children are a consistent feature in their publications and have been for many years. In our experience, we never saw the intention of these strategies as anything but an effort to conceal. It’s disheartening that a widely respected organization would inadvertently support concealment to such an extent.
Where does that leave us as parents? Parents must have a conversation with the SLP as to the intention of speech tools in their practice. They need to understand the risks of strategies that conceal stuttering and the potential negative impact on quality of life. We must focus on minimizing negative emotions, shame, fear, and disconnect that occur when these strategies fail as they often do. It is these internal experiences that contribute to negative life quality, not the stutter itself.
Children quickly learn that concealment pleases the adults in their lives and they just want to please. That’s how it worked when our son was young. When he successfully used his speech tools, we would applaud and give him stickers. We didn’t know any better. Now we do.
Keep them talking and keep talking fun!
Best,
Doreen (Dori) Lenz Holte
Parent Advocate, Mom, and Author:
Voice Unearthed: Hope, Help, and a Wake-Up Call for the Parents of Children Who Stutter (2011)
VoiceS Unearthed: The Impact of Childhood Intervention on Those Who Continue to Stutter (2023)
References:
Journal of Communication Disorders, Volume 118, November–December 2025, 106588, Hide and survive: A conceptual model of stuttering concealment, Hope Gerlach-Houck, Eilidh Cage b
ASHA Research Article: Concealing Stuttering at School: When You Can’t Fix It…the Only Alternative is to Hide It, Authors: Hope Gerlach-Houck, Kristel Kubart,b and Eilidh Cagec February 22, 2022, https://doi.org/10.1044/2022_LSHSS-22-00029
Journal of Fluency Disorders, Volume 70, December 2021, 105842, Relationships between stigma-identity constructs and psychological health outcomes among adults who stutter, Hope Gerlach a 1, Stephenie R. Chaudoir b, Patricia M. Zebrowski a
The Stuttering Foundation, Fall 2025, Kids’ Letters To the Stuttering Foundation