When Amir Hossein Rasoli Jokar began interviewing speech-language pathologists across the United States, a striking pattern emerged: clinicians treating people who stutter were watching their clients' symptoms shift from appointment to appointment, yet many didn't have the training to respond effectively. Now, their research is quietly reshaping how the next generation of therapists will learn to help them.
A study led by researchers at Charles Darwin University in Australia and Michigan State University in the United States has pinpointed a root cause of inconsistent stuttering care—and more importantly, pointed toward a solution. Among 143 certified American speech-language pathologists observed, the researchers found that generalist practitioners were far more likely to rely on reactive management when a client's stuttering varied between visits. The pattern stemmed from a surprising gap in graduate education: more than half of speech-language pathology students in the United States complete their training without a single clinical placement focused specifically on stuttering assessment and treatment.
"Specialized education grounded in evidence-based practice helps SLPs understand that stuttering extends far beyond visible speech symptoms," said Dr. Hamid Karimi, a lecturer in speech and language therapy at Charles Darwin University. "By encouraging a holistic view—incorporating the emotional, social, and participation aspects—coursework equips clinicians to assess and address variability more comprehensively and effectively."
That holistic view, the researchers found, made a measurable difference. Specialist SLPs in the study were more likely to look beyond what they could observe in the clinic, seeking information from parents, teachers, and the person who stutters themselves about their experiences throughout daily life. Rasoli Jokar, the study's lead author and a doctoral candidate at Michigan State University, argued this broader approach leads to more balanced, effective therapies.
"A holistic approach is essential because stuttering variability is not just about changes in speech that we can hear in a clinic setting—it also involves changes in how people think, feel, and engage in communication across different situations," he said.
The research is already spurring change. Charles Darwin University's own speech pathology program is being updated to reflect the findings, with substantial modifications to student training beginning in 2026. The curriculum will deepen students' exposure to the biopsychosocial model of stuttering, balance evidence-based practice with neurodiversity principles, and strengthen direct input from people who stutter themselves.
"Educating society to view stuttering as a difference rather than a deficit is also essential to support inclusion," Dr. Karimi said.