Multidimensional behavioral treatment for child stutterers.

The team tested a three-part package on four children who stuttered. Kids learned regulated breathing and easy speech while parents got coaching to stay calm and praise smooth talking.

Sessions ran 12 to 24 times. The design was a multiple baseline across kids, so treatment started at different times for each child.

Three of the four children dropped stuttered syllables below 3%, a level most listeners cannot hear. The low stutter rate held six months after therapy ended.

The fourth child also improved, but not below the 3% mark.

Lotfizadeh et al. (2020) later showed that doubling ABA hours from about six to eleven per week gives moderate language gains after two years. Their larger quasi-experiment updates the 1989 single-case work by showing dose matters, even though they targeted broader communication skills, not just fluency.

Rojahn et al. (1994) used a similar multi-piece package—modeling, self-monitoring, and reinforcement—to teach social behaviors to deaf teens with language delays. Both studies show that bundling several tactics beats using one alone, and gains stick after training stops.

Semino et al. (2025) extended the idea by adding precision teaching and ankle mobility drills to cut toe-walking. Like the stuttering study, they blended motor work, feedback, and rewards to produce large, quick changes for preschoolers with autism.

If you treat fluency disorders, copy the combo: teach the child a replacement skill, train parents to react warmly, and measure syllables each session. You can finish in under 25 visits and still see six-month maintenance. The same build-a-package rule works for other vocal issues—just swap the target and keep the parent piece.