The fluency shaping therapies teach the person who stutters how to slow down and smooth out all of their words, not just the words on which they stutter. The ultimate goal is to have the fluent speech replace the stuttered speech. One common fluency shaping approach begins with establishing fluent speech in short, one word, utterances, and then gradually increases the length and complexity of the utterances while maintaining fluency. A second common fluency shaping approach requires the stutterer to alter her/his speaking pattern in a dramatic way and then move that altered, fluent speech closer and closer to normal sounding speech. Some clinicians have combined these approaches by having clients alter their speaking pattern in an exaggerated way, for example speaking at 1 syllable per second by stretching out every sound in a word, establish fluency with this method in single syllable words, move up to longer words and sentences, and increase the rate to something more normal, all the while maintaining a high level of fluency. Some fluency shaping thearpy programs have used the delayed auditory feedback device to help clients alter their speech. This device makes the person hear their own voice slightly delayed. In order to overcome the delay, the person who stutters must talk very slowly and smoothly by stretching out the vowels and sliding all of the words together. In print it might look something like this: "Hooowwwaarrreyyoouu?" The stutterer begins at an extremely slow rate, around 50 wpm, and then builds up to something slightly slower than normal, maybe 140 wpm, while maintaining the smoothness and sliding words together.
The Best of Both Worlds
Recently some clinicians have successfully combined elements of stuttering modification and fluency shaping therapies. These therapies usually begin by teaching the person who stutters fluency shaping strategies to slow down and smooth out all of their speech. This eliminates most of the overt stuttering behavior. For the moments of stuttering that remain, the individual learns to manage them with stuttering modification strategies. In addition, the stuttering modification phases of motivation, identification, and desensitization get encorporated into therapy to help the individual manage the negative emotions that have built up around the stuttering.