This study reports on a course of treatment used on a boy aged five years and one month with severe stuttering that began at the age of three years and three months. He had awareness of his speech difficulty. Treatment consisted of direct speech therapy, play therapy, and modification of the home environment through counseling of the subject's mother. The direct speech therapy was performed with an element of play involving his mother. The speech therapies consisted of the following: 1) slow, “stretched” speech using a toy turtle for metaphors and as a pacer; 2) rhythmic speech using tapping with a toy frog; 3) gentle voice onset and speech: after inspiration, the subject performed easy voice onset, followed by slow and stretched speech using a gentle voice with expiration; 4) free conversation between the subject and the therapists. After these speech therapies, the subject was administered child-centered play therapy. His mother was also encouraged through counseling to reduce stress in his daily environment. Through this treatment, the boy's stuttering and attitude improved remarkably. The study suggests that treatments featuring direct speech therapy can be useful for preschool children with fully developed stuttering. The findings also suggest that treatment which combines direct speech therapy and play therapy can be effective.
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