Hierarchical simulation: Two case studies of stuttering modification using systematic desensitization

The use of behavior therapy techniques to alleviate stuttering is being extensively applied. Two cases illustrating hierarchical simulation are presented. In the first, a technique incorporating systematic desensitization and reciprocal inhibition was used to reduce the stuttering behavior of a 13-year-old boy while speaking in a classroom situation. The procedure involved the use of color slides to simulate speaking before an actual classroom as an adjunct to systematic desensitization and reciprocal inhibition. Results indicated a reduction in classroom stuttering as reported by the client and his teacher. In the second case, a 5-year-old boy used forceful muscular activity as being reciprocal to anxiety. This procedure involved the use of videotapes to hierarchically simulate anxiety producing classroom situations. Measures of stuttering indicated a mean reduction of 18%. One year after therapy indicated stuttering had been eliminated.