Courses at the MPC

Working directly on stammering – why, when, what and how @thepalincentre via Zoom

October 3, 2024 9:00 am - October 4, 2024 5:00 pm Zoom

Please note: this training is online via Zoom.

Course Aims

This course was previously called ‘Integrated stammering management approaches’.

This two-day training course is designed for speech and language therapists (SLTs) who wish to explore the integration of direct stammering management/techniques in working with children and young people who stammer (CWS).

It is recommended that participants who attend this course have attended one of our core courses run by the Michael Palin Centre in the general management of stammering (i.e. a Palin PCI, or Primary, or Secondary course) in order to ensure that the direct approaches are set in the wider therapy context.

Hand-outs will be sent to participants in advance. The course will be supported by video material and case discussion.

Learning Outcomes

At the end of this course participants will:

  • be able to set goals for therapy in collaboration with their clients;
  • be able to discuss a rationale for clinical decision making about indirect and direct therapy;
  • to be aware of some of the current thinking about stammering as difference within the social model of disability discourse;
  • be familiar with direct stammering management strategies for CWS under 7 years old which are part of the direct component of Palin Parent Child Interaction therapy;
  • be familiar with toolbox talking, fluency shaping, block modification and integrated approaches to stammering management for older CWS; and
  • be familiar with strategies to promote transfer of skills and to manage relapse.

Course Content


Setting the scene

  • Introduction, scene setting, context;
  • Influencing factors in clinical decision making; and
  • Advantages and disadvantages of direct and indirect approaches

Principles for working directly with clients who stammer

  • Drawing on the client’s skills and expertise;
  • Involvement of parents;
  • Keeping a balance (stammering focus / confidence);
  • Helping the client to become their own clinician; and
  • How to structure and plan a session.

Techniques across the ages (with video, practical demonstration and practice)

Under 7s: Tortoise talking and Bus talking

Case discussion one (under 7)


Techniques across the ages (cont.)

  • 7 to 14s: Toolbox talking; and
  • Speak more fluently, stutter more fluently and integrated approaches:

– Identification: e.g. how speech is made, iceberg, tallying;

– Desensitisation e.g. voluntary stammering, freezing;

– Modification e.g. tick box sheets, soft contacts, continuous voice.

Managing thoughts and feelings

  • Managing feelings, fears and avoidance; and
  • Building confidence, coping and resilience.

Transfer, generalisation and maintenance 

  • Assignments, home practice;
  • Behavioural experiments; and
  • Speaking circles.

Managing relapse

Client experience

  • What constitutes success?
  • How do clients experience direct therapy?
  • Strengths and limitations of different approaches.

Case discussion Two (7 – 14)

Action planning

What Others have said:

“I’ve gained a greater understanding of rationale for direct versus indirect input”

“It really helped me to focus on thinking about what the child needs.”

“I’ve learned lots of different approaches, not just one.”

“I’m much less scared about direct work now I have seen and practised the techniques.”

“I’m confident in going forward.”


Please read our booking terms and conditions before booking.


If you would like to pay for your course by invoice an administration fee of £20 per person will be added to the course fee. Please add this additional £20 onto your form when you select to pay by invoice e.g. cost of course: £290. 

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Standard Integrating Fluency Approaches £270
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Standard Integrating Fluency Approaches (invoice payment) £290 Pay by invoice




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