Which approach is the most appropriate initial therapy focus for a patient with stuttering?

The most appropriate initial therapy focus for a patient with stuttering involves reinforcing the patient’s attempts to produce words without fillers, pauses, or substitutions. This approach emphasizes fluency and encourages the individual to speak smoothly and confidently, thereby helping to build their self-efficacy and reducing the anxiety often associated with stuttering.

Starting with positive reinforcement of fluent speech can provide the patient with immediate feedback and motivation, which is essential for effective therapy. Establishing a foundation of fluent speech helps to create a more supportive environment, allowing the individual to gradually tackle more complex aspects of their speech difficulties as they become more comfortable with producing fluent speech.

In contrast, options involving improving the naturalness of speech, implementing specific techniques like cancellations, or focusing on pausing would typically be considered more effective after establishing some initial fluency. These strategies may serve as secondary or advanced techniques addressing the nuances of speech but are unlikely to be as beneficial as focusing on creating a smooth, fluent speech pattern at the outset.