Why I Don’t Count Stammers Anymore

Imagine this. You or your child have come in for a speech and language assessment. You are told you this is a safe space. “It’s okay to stammer here,” I say.

We chat for a bit and then I tell you I’m going to be counting the number of times you stammer in the next task. “Try not to think about it,” I add. Tap, tap, tap, tap.

You see, I was trained to count the stammers, specifically the number of syllables someone stammered on in a word. The reasons for this include:

• To diagnose stammering.
• To identify the severity of a stammer
• To guide clinical decisions about the support a person may need

Over time, my views have changed. Whilst I appreciate some therapists may still count syllables stammered in their work, I’m not here to judge. I am here to share my experiences and invite other therapists to reflect on their practices.

Here’s why I have changed.

1. Assessment doesn’t require counting
I can assess a child or adult’s stammer without tallying every stammered syllable. The best way to do this is by talking to the person who stammers, they are the expert on their speech! I ask how their stammer feels, how it sounds and what it is like in daily life. I will observe any moments of stammering and if it feels right, I’ll make some notes about it (or I’ll do this afterwards). I may decide to complete tasks such as picture description or general conversation to better understand their speech (and to screen language skills too).

2. Counting may not reflect reality
If someone feels they are being tested, they may speak less or try to hide their stammer. Someone scored as having a “mild stammer” may actually be working really hard behind the scenes to change words, use strategies to sound fluent and may have feelings such as shame, fear or embarrassment towards stammering. In contrast, a person described as having a “significant stammer” may feel relaxed and happy when they speak. They say what they want to say and talking feels easy and comfortable for them, even when stammering appears frequently.


3. It doesn’t align with the message that stammering is okay.
For me, it just doesn’t feel right. If stammering is a way of talking, if it’s just a difference and not a defect, why do we need to count how many times someone stammers? In the past, it was used to measure fluency, but fluency isn’t a goal I work towards anymore. I believe we can target what people are hoping for without making fluency the goal.

4. Stammering is variable and strategies are not guaranteed
Even if a person’s stammer changes, it’s not always clear why. If someone used a fluency strategy, did it work when they really needed it, or did they start avoiding words, hiding their stammer or speaking less? Is it worth the time, effort and energy spent? Counting syllables doesn’t answer these questions.


5. Stammering varies over time
A count from one day could look completely different a week, month or even a few hours later. It is not a reliable snapshot of someone’s experience.

What to do instead?

If you choose to remove counting from your practice, you can still assess a person’s stammer:

• Use speaking tasks, questionnaires and rating scales
• Ask detailed questions about how stammering feels and its impact on daily life
• Be flexible and tailor your approach to the individual

Whilst I have questioned whether we need to “assess” a stammer, I think it can be helpful to rule out any other difficulties. Are we definitely hearing stammered speech? Or could it be something else, such as cluttering, word finding difficulties or other dysfluencies (that are not classed as stammering).

Benefits of Removing Counting

Here’s what I hope the gains are from removing the number of syllables stammered:

1. It normalises stammering
It shows that stammering is absolutely okay to do.

2. It creates a relaxed environment
Without the “tap, tap, tap” of counting, speaking feels safer and less pressured.

3. It reduces performance pressure
The person who stammers may stop trying to hide or reduce their stammer. This can make speaking easier.

4. Progress is measured differently
Instead of focusing on fluency, progress can be measured by confidence, comfort and the ability to express yourself authentically. Meaningful, joyful communication becomes our goal.

5. It strengthens the therapeutic relationship
The environment feels safe and supportive, strengthening the trust between the therapist and the person who stammers.

As we come to end of this post, I want to invite speech and language therapists to reflect on their current practice when working with children and adults who stammer.  Lots has changed over the years and we still don’t have all of the answers! However, we can continue to do our best with new information, to listen to people who stammer, to have an open mind and a willingness to change. If we can do that, I believe we can continue to provide the very best care for people who stammer.

I’d love to hear your thoughts. Is this something you agree every therapist should remove from their practice? Are there any benefits from us continuing to count syllables stammered? If you are a person who stammers I would love to hear from you too.

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