Abstract
The replacement of stuttering with normal speech requires more than achievement of fluency. Additional components that appear necessary and sufficient to shape normal speech flow include rate, breathstream management, prosody, and self-confidence. These components are described and the rationale for their clinical management is discussed. The merits and limits of this behavioral approach are considered. Recognition is accorded the probability that different facets of stuttering can be treated effectively within different conceptual frameworks, but that no single framework can cope adequately with all aspects of the problem. The ideal program for adult stutterers is not likely to fit exclusively within operant concepts, motor-linguistic concepts, or psychotherapeutic concepts. More likely it involves all three if normal speech is to be shaped, generalized to everyday situations, and made permanent.

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