Rationale: The child must develop a positive attitude toward 
himself/herself as a communicator. To approach communicating without
fear and apprehension, and to experience successful speaking 


Andrews and Culter (1974) - noted that change in the person's self-
concept as a speaker is imperative to therapeutic success. 

Bennett, Ramig, and Reveles (1993) - found that children attending a
summer fluency camp exhibited negative communication attitudes which
consisted of both interpersonal and intrapersonal components. 

Bloodstein (1987) - encourages the parent to provide successful 
speaking situations for the child--nursery rhymes, choral speaking,

Daly (1988) - incorporates both mental imagery and positive self-talk
strategies into the treatment paradigm for adolescents and adults who

DeNil and Brutten (1991) - investigated the communication attitudes 
of children and found that children who stuttered exhibited greater
negative communication attitudes when compared with their fluent peers.

Starkweather, et. al. (1990) - states the child's concern about his/her
speech may result from parental reactions toward his/her stuttering. 

Guitar (1976) - found that pre-therapy attitudes may predict therapy
outcomes.  Subjects who exhibited high pre-treatment speech avoidances
exhibited significantly higher post-treatment stuttered speech.

Guitar and Bass (1978) - found that changes in clients' communicative
attitudes seemed to be related to long-term improvements in fluency. 

Ramig and Bennett (in press) - discuss the importance of addressing
attitudes and feelings of the school-age child who stutters.

Van Riper (1973) - stresses the importance of making speech a pleasant


1. "All About Me Book"
   Encourage and reinforce the child's strong areas,
   i.e., singing, coloring, artwork.  Make the child
   feel good about the things he/she does well.

2. Employ hierarchically based therapy activities that
   provide maximum success with fluency.  Make therapy
   fun and enjoyable for the child as well as successful.

3. Always encourage an open line of communication.  The
   child must feel trust and confidence in the clinician's ability
   to help him/her, and the clinician should be supportive 
   throughout the therapy.

4. The clinician is encouraged to talk openly about stuttering and  
   reduce the "conspiracy of silence" which often surrounds the 
   disorder.  Talking about talking and talking about stuttering will
   convey an atmosphere of total acceptance and will enhance the 
   client's self esteem. 

5. Activities about "Ways of Becomming a Good Communicator" will 
   help the client see that communication is more than just "how" 
   one speaks but also includes "what" one has to say.  Talking about 
   turn taking, interruptions, and teaching the client various coping
   mechanisms will enhance the development of "speech assertiveness."

6. Discussing the "global attributions" of the clients is very important
   to the process of attitudinal change.  Catch the client when he/she 
   says a "can't" or "never" comment and spend a few moments talking 
   about how one talks to oneself does affect one's behavior.  Changing 
   "negative self-talk" into "positive self-talk" are viable tasks for 
   the clinician and client to undertake.