by Gerald F. Johnson, Ph.D., CCC SLP/A and Maxine M. Johnson, M.S., CCC SLP

Originally presented at ASHA, November 5, 1961: "Environmental Reorganization for Cases of Primary Stuttering" ASHA 3:10 (10-61) 325.

1. Make a list of all the pressure points or demands made upon your child and ways that these can be eliminated.

2. Keep track of how many times a day you say "No" or "Don't" and ways that these can be eliminated.

3. Make a list of things that upset your child such as TV, family quarrels, and how these can be eliminated.

4. Make eating and bedtime pleasant.

5. Give your child much love and attention.

6. Show interest in your child and things that he* does.

7. Enlist other members of your family and neighborhood to help by being patient while your child is talking, and by not interrupting him. Remember: by doing nothing-you are doing something.

8. Do not bring family trouble to your child.

9. Have good family relations--enjoy each other.

10. Bring other siblings into the family group on an equal basis.

11. Try to make your child's life as placid as possible with no extreme peaks or dips.

12. If your child is confused about standards in the home, the home should be restructured so that the child knows his limits without any excessive demands being placed upon him for conformity.

13. If your family is too demanding the child should be relieved of most, if not all, of these pressures.

14. If your child should be punished, forgive him, and yourself, quickly. Do not prolong the anguish.

15. Build up your child's assets and minimize his liabilities.

16. Show your child an adult can accept him and love him in spite of himself.

17. Try to eliminate frustrating experiences for your child such as his trying to do something too difficult or trying to keep up with older children.

18. Change mealtime and nighttime prayers to unison prayers or simple prayers, especially if your child has a great deal of trouble saying them. Example: "Thank you, God, for our food. Amen."

19. Put your child to bed with pleasant memories.

20. Do not make your child feel an urgency for doing something by saying, "Hurry-up" or "Come on, let's go."

21. If there is a baby in your family, find ways to bring the baby easily into some of your child's activities to reduce any sense of competition and to be able to supervise enjoyable play activities between your child and the baby.

22. Do not say to your child, "Stop acting like a baby," or "Grow up."

23. Do not have your child fight for attention.

24. No new toys or games to excite your child.

25. No new experiences or material things should be brought into your child's life to help eliminate excitement.

26. Help your child feel secure at home.

27. No exciting activities, play, games, etc.

28. Company is kept minimal to keep from exciting and possibly demanding too much of the child for correct behavior.

29. Try to build up your barriers for reacting to your child's speech behavior.

30. Find ways for giving your child self-expression through painting, drawing, playing in sand, etc.

31. Good way for your child to express hostility is to buy an inflatable punching bag.

32. Encourage your child's self-play and self-talk. Do not interrupt these activities.

33. Do not talk about your child's speech when he is around or in hearing range.

34. Do not interrupt your child; let him finish without having to compete with anything or anyone.

35. Curtail extraneous noise such as radio, TV, and stereo.

36. Develop a good attitude about speech; make it happy and light and try not to reflect your concern through your own speech pattern with your child.

37. Isolate your child as much as possible from other children and people so that he can be protected from criticisms concerning his speech.

38. Do not make him talk while he is crying or emotionally upset.

39. Do not have him "Go ask" or "Go tell."

40. Do not ask him questions except those that can be answered by "yes" or "no."

41. Do not reward your child for any speech attempts, good or bad.

42. No demands for speech such as: "What did you do?" or "Where did you go?"

43. Do not have him show off or recite for family or friends.

44. Do not say: "Stop and start over. Think about what you want to say." "Take a deep breath." "Relax." Or "slow down. All of the aforementioned make your child focus on what he is saying and it brings to his consciousness the idea that he is not speaking right.

45. Do not read aloud to your child because of the overwhelming fluency pattern; just look at the pictures and talk about them.

46. Unison talking is a good way to build up his fluency pattern. Use nursery rhymes or simple sayings.

47. Simple speech activity when combined with rhythm, marching, tapping with finger, etc., will activate speech rhythm and fluency. Singing might also be used.

48. After your child has had much trouble talking and perhaps has given up the speech attempt, you might rephrase what he tried to say using simple speech. Immediately change his activity to something entirely different so that the speech unpleasantness is forgotten.

49. If your child has a particularly long and difficult stuttered word, you can help your child say the word so that the abnormality doesn't call any more attention to itself than it has already. There is no need to let the abnormality reward and reinforce itself. Naturally, you must be selective with this technique and very sure you know the word that is stuttered upon so your child is not devastated.

50. If your child blurts out, "I can't talk." Or "I can't say that word," he should be reassured that it's okay because some words are hard for everyone to say. Then immediately change your child's attention to something pleasant.

51. Use three or four word sentences. Be sure that the sentences are not connected. This simple speech is easy for your child to copy and gives him an easier adult speech model to imitate.

52. When you are talking to another person and your child is within hearing range, use simple speech.

53. If your child is playing by himself and he is not talking (self-talking) about his play, you can self-talk about his play using simple speech. Be sure to leave lengthy pauses in your self-talk so he can add his self-talk to yours. This will encourage his self-talk.

54. Self-talk about your activities when your child is nearby. Your simple speech self-talk model would be good for him to hear.

55. Be tolerant of your child and give him all the love you have.

56. Be willing to sacrifice your time, patience, and other interests for the sake of your child's future success and happiness.

*For ease in reading, we have only used the male designation. We intend this to be non-preferential or discriminatory.

added with permission, October 16, 1998