Valsalva Stuttering Therapy: A Brief Introduction

by William D. Parry, Esq., CCC-SLP

Copyright © 2016 by William D. Parry

Valsalva Stuttering Therapy is a comprehensive new approach for treating the most common form of stuttering, often referred to as “persistent developmental stuttering.”  Valsalva Stuttering Therapy is based on the realization that most stuttering is caused not by a lack of ability to speak, but rather by an interference with that ability. Furthermore, it recognizes that the interference with speech does not begin in the mouth, but rather in brain - even before the person tries to say the word being blocked. This interference may involve a freeze response, which inhibits phonation of the vowel sound - the loudest part of a word or syllable. It is usually accompanied by a strong impulse to exert effort through activation of the body’s Valsalva mechanism (named after Italian anatomist Antonio Maria Valsalva who lived from 1666 to 1723).

Valsalva Stuttering Therapy addresses the neurological and physiological core of stuttering blocks - the brain's substitution of motor programs for effort instead of phonation of vowel sounds, in response to anxiety or the anticipation of difficulty in speaking.  Consequently, the larynx is not prepared to phonate the word's vowel sound, causing speech to get stuck on the consonant or glottal stop preceding the vowel sound.  Because of this, speakers often feel that an upcoming word contains an obstacle, or "brick wall," even before they try to say the word.

Stuttering behaviors then occur as maladaptive struggles to overcome these internal blocks. The block is usually accompanied by a strong impulse to exert physical effort in the lips, tongue, or larynx, often involving the build-up of air pressure by the body's Valsalva mechanism in a self-defeating attempt to "force out" the word, as if it were a physical object

Because the larynx isn't ready to phonate the vowel sound, the speech mechanism hesitates or gets stuck on the consonant preceding the vowel - repeating, prolonging, or forcing on it.  In words that begin with vowels, the repetitions or forcing may focus on the "glottal stop" - the brief closure of the larynx to build up air pressure to accentuate the beginning of the vowel sound. These are the behaviors called "stuttering."  The harder the speaker tries to force out the word, the stronger the block becomes.

Consequently, it may be said that stuttering is best understood and treated as a specific kind of voice problem, and not as a "fluency" problem or an "articulation" problem.  Once the voice problem is fixed, the stuttering behaviors will disappear on their own.

By understanding the "voice problem," Valsalva Stuttering Therapy is able to address more effectively the physiological, neurological, and psychological aspects of stuttering, teaching effective new ways to:


Dissolve blocks by means of a revolutionary new procedure that diverts the effort impulse away from the mouth and larynx to a part of the Valsalva mechanism that does not interfere with speech, while neurologically preparing the larynx to phonate the vowel sounds, and


Reduce the occurrence of stuttering blocks by promoting self-expression through easy, resonant, Valsalva-relaxed speech.

Rather than focusing on "controlling" one's speech, Valsalva Stuttering Therapy promotes easy, natural speech by:


Relaxing the Valsalva mechanism,


Reducing the urge to exert effort,


Diverting effort impulses to a part of the Valsalva mechanism that does not interfere with speech,


Treating words as a continuous flow of movement and phonation, rather than as physical objects, and


Promoting the voicing of vowel sounds and self-expression through the music of your voice, so as to free your own natural speaking ability. 

Valsalva Stuttering Therapy intentionally does not emphasize "fluency" per se, because efforts to “stop stuttering” are usually self-defeating.  Natural fluency cannot be forced. Instead, the goal is to free you to express yourself in an easy, effortless, and natural way, thereby allowing natural fluency to follow on its own.

Valsalva Stuttering Therapy, in its current form, has been developed through actual clinical  experience, experimentation, and practice-based evidence, involving the participation of more than two hundred persons who stutter from all over the world. Individualized counseling also helps you transfer Valsalva-relaxed speech to everyday speaking situations.

Valsalva Stuttering Therapy has been very effective in promoting easier, less effortful, natural-sounding speech in everyday speaking situations.

The Standard Therapy Program includes 15 hours of individual online therapy sessions and daily independent practice over a period of approximately 4 months.

In order to allow the therapy sessions to focus more efficiently on your own specific needs, both programs are supplemented by the following Materials Package, which can be downloaded:


Extensive written exercise modules, totaling more than 200 pages.


A PDF version of my book, Understanding & Controlling Stuttering (3rd Edition).

The time required to obtain optimal results will vary depending on each individual. However, the insights and skills learned from Valsalva Stuttering Therapy may enable you to achieve further progress on your own, while reducing the possibility of relapse.  You can also arrange additional therapy on an hourly basis, as needed.

Basic Elements of Therapy

Valsalva Stuttering Therapy has three basic elements – education, practice, and transfer:


Education. Changing false and harmful beliefs, expectations, and intentions by understanding the nature of stuttering blocks, the Valsalva mechanism, and the essential ease of speech.


Practice.  Establishing easy, effortless speech through exercises that promote Valsalva-relaxed breathing, phonation, self-expression through vowel sounds, changed intentions in speaking, effort reduction, and revolutionary new ways to dissolve blocks and divert effort away from your speech mechanism. In addition to the therapy sessions, you will also do 30 minutes of practice routines every morning, plus an additional 30 minutes later in the day.


Transfer.  Carrying over easy, effortless speech into ordinary speaking situations through individualized counseling, desensitization, and changed intentions in speaking.

Is Valsalva Stuttering Therapy Appropriate for You?

Valsalva Stuttering Therapy is intended for treatment of what is often referred to as persistent developmental stuttering.  These are some of its characteristics:


“Developmental stuttering” usually begins in childhood and is not associated with brain damage.  It is “persistent” if it continues into adulthood.


It is basically a speech problem rather than a language problem.  You knows exactly what you wants to say, but you are sometimes blocked when trying to say the words.


You are able to talk fluently some of the time, and stuttering severity may vary depending on the speaking situation. 


You are usually able to sing, mouth words silently, whisper, speak in unison with other people, and make isolated vowel sounds without blocking.

Valsalva Stuttering Therapy may be especially appropriate if, in addition to the above, you also experience the following:


Sometimes you feel as if an upcoming word contains a “brick wall” that will require force to break through.


You often get stuck on the beginning consonants of words or syllables, or on the laryngeal closure at the beginning of words that start with a vowels, and are unable to vocalize the vowel sound that follows.  You find yourself repeating, prolonging, or blocking on these initial sounds.


Sometimes you find your words being blocked by tightness in your mouth or larynx (throat), accompanied by tension in your chest or abdomen and a build-up of air pressure in your lungs. 


There also may be times when your voice doesn’t respond when you want it to.

Advantages of Valsalva Stuttering Therapy

Valsalva Stuttering Therapy should be seriously considered as an approach to stuttering therapy because it is:


The only approach that directly addresses the Valsalva mechanism's involvement in stuttering behavior;


Comprehensive in that it addresses the psychological, neurological, and physiological aspects of stuttering;


Consistent with natural-sounding speech;


Harmless, non-invasive, and without adverse side effects; and


Not dependent on drugs or devices.

Therapeutic Exercises

The exercises in Valsalva Stuttering Therapy are designed to promote easy, effortless speech by rooting out the effort impulses that lead to stuttering blocks. Rather than teaching superficial “fluency” tricks, which tend to be ineffective in actual speaking situations, the exercises seek to permanently resolve the principle cause of stuttering: the substitution of excessive physical effort (as in a Valsalva maneuver) in place of the normal phonation of vowel sounds. The exercises accomplish these objectives in various ways, including the following:

Relaxation of the body’s Valsalva mechanism through Valsalva-relaxed breathing. The purpose of these exercises is to prevent the occurrence of Valsalva maneuvers, in which the exhaled breath is blocked in the larynx or mouth for the purpose of building up air pressure in an attempt to “force out” words.  Because the muscles of the Valsalva mechanism are neurologically coordinated to act as a “team,” the relaxation of one part of the mechanism tends to relax the others. Among other things, participants are taught to relax the puborectalis and abdominal muscles while exhaling, as a way to relax the Valsalva mechanism and prevent forceful blockage of airflow. Valsalva-relaxed breathing is incorporated into all the other exercises. The puborectalis muscle, which is part of the Valsalva mechanism, can also be used to discharge “effort impulses” that result in blocks.

Reprogramming your speech mechanism. One of the therapy’s principle exercises is aimed at eliminating the tendency of phonation and articulation to interfere with one another, resulting in blocks. You are taught how to perform continuous phonation through your nose while silently articulating the words in your mouth. In this way, the articulation of consonants cannot build up air pressure and trigger Valsalva maneuvers, while the larynx is always ready to phonate the vowel sounds. This frees articulation from phonation and vice-versa and frees you from your habitual pattern of effortful speech. You then gradually allow more air through your mouth, while maintaining the same Valsalva-relaxed breathing, phonation, and articulation. Phonation and articulation are thereby gradually re-integrated in an effortless, Valsalva-relaxed way.

Valsalva-relaxed production of phonation and vowel sounds. Participants practice bringing together and adjusting the pitch of the vocal folds while exhaling Valsalva-relaxed breaths. They practice shaping the airflow in the mouth to produce the various vowel sounds, instead of pressing on the consonants (or the glottal stop, in words starting with vowels). Participants are taught to anticipate and prepare for shaping and voicing the “key vowel sound” in a word or phrase, instead of fixating on the consonants.

Valsalva-relaxed articulation. Various exercises reduce your urge to force on consonants by teaching you to view and process words as melody and movement, rather than as physical objects to be forced out of the body.

Resonant, Valsalva-relaxed speech. The final result of the therapy is easy, effortless, natural-sounding speech. But before this can be achieved, the participant must practice and master each step along the way. Each aspect of the therapy must be diligently practiced so that it becomes habitual and provides the foundation on which to build the next step. The purpose of Valsalva Stuttering Therapy is to make lasting changes in underlying speaking behavior as well as attitudes about speech. These changes must be continuously practiced so they will become second nature and hold up even in stressful situations.

Will You Be “Cured”?

Ethically responsible speech-language pathologists avoid using the term “cure” in regard to stuttering in adults.  Currently there is no therapy, drug, or device that totally eliminates stuttering in all stutterers all the time.  The results of any stuttering therapy will vary depending on each individual.  Although clinicians will use their best efforts to help to improve your speech, the results of stuttering therapy cannot be guaranteed and therapy fees are not refundable.

The reason is that long-established nerve pathways for stuttering may be weakened, but they cannot be totally eliminated. Some vestiges of them may remain in your brain indefinitely.  Therefore, don’t be surprised if they continue to cause occasional blocks, particularly when you’re stressed or excited.  Nevertheless, much can be done to reduce the frequency of such blocks, to help you handle them when they occur, and to make speech easier and more enjoyable.

Valsalva Stuttering Therapy has produced significant improvements in both fluency and the overall impact of stuttering in the great majority of participants, while preserving natural-sounding speech.  

As with any kind of therapy, the time needed to achieve the desired results will vary, depending on each individual. In the case of Valsalva Stuttering Therapy, your speech should continue to improve long after formal therapy is completed. Using the skills, insights, and natural way of speaking that you have learned, you will be in a position to make further progress on your own.  The more you go out and talk, the easier and more enjoyable speaking will become.

Contact Information:

William D. Parry, CCC-SLP

A licensed speech-language pathologist, offering Valsalva Stuttering Therapy by video conferencing over the Internet (depending on location and subject to applicable law). 

Mail: P.O. Box 55, Merion Station, PA 19066-0055

Phone: 215-620-6792



Stuttering Therapy and Counseling:

The Valsalva-Stuttering Network:

Valsalva Stuttering Therapy is a new approach to improving fluency by controlling the physiological mechanism that may contribute to stuttering blocks. For further information on Valsalva Stuttering Therapy, visit Stuttering Therapy and Counseling at  If you are interested in therapy, send an e-mail to to inquire about a free consultation. 

The Revised and Expanded Third Edition of Understanding and Controlling Stuttering (2013) may be ordered from the National Stuttering Association or from

For information concerning stuttering self-help and support, please contact:

National Stuttering Association

1460 Broadway, New York, NY 10036

(800) 937-8888


Updated 5/23/2020

Back to Home Page

Back to Valsalva Stuttering Network Home Page

Last revised: 5/23/2020

More information: