To:
X Insurance Company
From:
Date:
Re:
Letter of Support for Speech Therapy Services for X
Parent:
I am a speech-language pathologist (SLP) at X (name of facility). I am writing in regards to X
(client’s name), who has been diagnosed with a X (severity) stuttering disorder that is
characterized by behavioral, affective, and cognitive components. The behavioral components of
the disorder include many instances of speech disfluency including speech repetitions, blockages
or tense pauses before words and phrases, and/or prolongations of sounds. These behaviors are
the result of disruptions in the timing of the systems of respiration, phonation, and articulation. In
addition, X’s (client’s name) parents have reported that X (his/her) reactions to stuttering include
many negative feelings, thoughts, and attitudes toward speech. These negative behavioral,
affective, and cognitive reactions to stuttering may continue to have a profound impact on X’s
(clients name) communicative performance in social and educational settings if they are not
addressed. In my professional opinion, intervention is critical at this point for X (client’s name).
Early intervention is critical in preventing long-term stuttering. While it is true that some
children exhibit a period of developmental disfluency and recover without formal treatment, X
(client’s name) exhibits the following characteristics that have been associated with a higher risk
of long-term stuttering:
_____
_____
_____
_____
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Family history of stuttering
Stuttering that has persisted for more than six months
Physical tension/negative reactions associated with stuttering
Presence of avoidance behaviors
Presence of secondary behaviors (e.g. eye blinking, head nodding, etc.)
A summary of risk factors can be found in: Yairi, Ambrose, Paden, E., & Throneburg R. (1996).
Predictive factors of persistence and recovery: pathways of childhood stuttering. J Commun Disord. 1996 JanFeb;29(1):51-77.
I recommend that X (client’s name) be enrolled in stuttering therapy for X (number) session(s)
per week for X (number) minutes per session. X’s (client’s name) parents are receptive to this
recommendation. The goal of this treatment is to assist X’s (client’s name) parents in facilitating
development of fluent speech for X (client’s name) at home and in other real-world settings.
Specifically, treatment activities will emphasize changing the negative affective (emotional),
behavioral, and cognitive (thoughts) reactions to X (his/her) stuttering. Additionally, X’s
(client’s name) parents and X (client’s name) will be taught to speak more effectively by
modifying X (his/her) stuttering moments into a less severe form of stuttering and by learning
strategies that will allow X (him/her) to speak more fluently. These strategies will permit X
(him/her) to reduce the current handicapping effects that stuttering will have on X (his/her)
social, emotional, and educational opportunities.