What is the ICF Model?
Many parents, teachers, and others that we have worked with have found value in knowing more about the ICF Model (International Classification of Functioning, Disability, and Health) as it relates to stuttering. This framework highlights the speaker's experience of stuttering, including how it can impact a child’s quality of life.
Why Understanding the ICF Matters
The ICF model helps parents, caregivers, and SLPs understand that the experience of stuttering is more than how a child speaks. Using this “wider lens” can help you understand that the experience of stuttering also includes how your child feels, functions, and participates in the world.
If listeners focus only on fluency of speech (or what they can see and hear), they miss the heart of what truly matters in the long term – a child’s connection, confidence, and comfort in communication. This is why comprehensive, affirming speech therapy can help your child and family see that they do not need to “fix” their speech. The greatest value of communication is not fluency; it is your child’s messages that are most important.
Looking Beyond Speech: What the ICF model teaches us about communication
To help you understand stuttering at a deeper level, the ICF model outlines 4 key areas. Let’s go through each area one at a time.
1. Body Functions and Structures – The Speech System
Listeners can notice moments when a child gets “stuck,” repeats sounds, or stretches words. For children who stutter, these are natural variations in how the brain and body coordinate speech. It is important to remember that stuttering is not caused by physical damage or something “wrong.” It’s simply a difference in how speech is produced by those who stutter.
Another core characteristic of stuttering is that it is variable in nature. You have probably already noticed that your child does not stutter all the time, and that their stutter fluctuates from moment to moment and situation to situation. This is normal, and highlights that the body functions of the speech system are highly complex and cannot be “managed” into consistently fluent speech.
2. Activities and Participation – Everyday Life
This part of the ICF model explains how stuttering can impact your child’s daily experiences. Some examples include talking with friends, reading aloud or answering questions in class, and engaging in conversation during family events.
Some children might begin avoiding certain speaking situations, not because they can’t talk but because they feel worried, rushed, or uncomfortable talking. This is one reason why goals in therapy include supporting children to become confident and comfortable with their communication. Together with your speech therapist, you can help your child gain acceptance of stuttering as a form of verbal diversity - simply another way of talking.
3. Environmental Factors – The World Around Your Child
Your child’s experience with stuttering will be shaped by their environment and the responses of listeners.
Environments that include time pressure, unhelpful advice, or expecting your child to speak fluently can make communication more stressful.
Supportive environments that include patient listeners and acceptance of stuttering can help your child thrive.
4. Personal Factors and Reactions - Your Child's Internal World
How your child thinks and feels about themself and their stuttering also plays a role in their experience. Some children may feel frustration, embarrassment, or fear about communicating. Others may feel proud of their differences and strong in their resilience. Every child (and indeed every person who stutters) has a unique experience.
Stutter-Affirming Support: What You Can Do
You don’t have to be an expert to help your child who stutters feel understood and supported. Here are a few ways to use what you are learning about the ICF model to set up supportive environments for your child:
- Focus on what your child says, not how they say it. Listen to their ideas and stories without correcting, finishing sentences, or giving advice.
- Give time and space for communication. Model patience and relaxed turn-taking that minimize interruptions.
- Encourage participation. Let your child know their voice matters in class, at home, and with friends.
- Talk openly about stuttering in a matter-of-fact ways. Normalize it. Let your child know - by what you say and do – that everyone speaks in their own unique way. Stuttering is one form of verbal diversity, and it is nothing they need to hide.
- Partner with your SLP. Together, you can create plans that fit your child’s needs, both in therapy and in daily life.
In Summary
The ICF framework helps you and others in your child’s environment understand stuttering at a deeper level, and this can help you help your child. By moving away from outdated ides that fluency is the only way for communication to be successful, you will be guiding and supporting your child in their abilities to navigate their stuttering with confidence.
Learn More
For additional resources about stuttering and how to help your child, check out the links below:
What Caregivers of Children and Teens Who Stutter Can Do
Five Key Facts About Stuttering
Booklet for caregivers of school-age children who stutter
Booklet for teachers of school-age children who stutter
Booklet for caregivers of preschool children who stutter
What children and teens who stutter want caregivers to know
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For your speech therapist
Information for this blog came from the following professional articles that your SLT can access:
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Tichenor, S. E., Herring, C., & Yaruss, J. S. (2022). Understanding the speaker’s experience of stuttering can improve stuttering therapy. Topics in Language Disorders, 42(1), 57–75. https://doi.org/10.1097/TLD.0000000000000272
- Yaruss, J. S., & Quesal, R. W. (2004). Stuttering and the International Classification of Functioning, Disability, and Health: An update. Journal of Communication Disorders, 37(1), 35–52. https://doi.org/10.1016/S0021-9924(03)00052-2
- Tichenor, S. E., & Yaruss, J. S. (2019). Stuttering as defined by adults who stutter. Journal of Speech, Language, and Hearing Research, 62(12), 4356–4369. https://doi.org/10.1044/2019_JSLHR-19-00137
