411 on Pull-outs

7/31/2013

A pull-out is a speech tool I use with clients as they gain the ability to monitor and change their stuttering. Once a client demonstrates the ability to use cancellations, I will introduce the idea of pull-outs. It is important to note that a person does not "graduate" from using cancellations to pull-outs, but will rather integrate the two strategies. A person will call upon one tool over the other depending on how quickly they "catch" a particular disfluency.

WHAT IS A PULL-OUT?

A speech tool used in the moment of a disfluency
This strategy is considered a "stuttering modification" tool.
It requires you to catch a word that you are stuttering on and slide/stretch out of it (AKA “get on the sound”).

WHY DO PULL-OUTS WORK?

Increases airflow (as often there is a stoppage, especially during a block)
Changes the articulatory posture (the shape that your lips, tongue, jaw, etc. are in) to a posture that is less tense and allows for sound to escape in a more forward-moving way.
Cancellations work in much the same manner, but pull-outs do not require a pause to "regroup" and release the tension.

WHAT DOES A PULL-OUT SOUND LIKE?

Puh-puh-puh-plllllease pass the salt.
This is an example of a person with quick and tense part word repetitions. Listen to the audio sample above to hear what a pull-out sounds like in comparison to a cancellation.

If you have any questions/comments about pull-outs or the difference between pull-outs and other stuttering modification tools, please post below!

13 Comments

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DISCLAIMER: The purpose of this website is to act as an educational aid and address common topics associated with stuttering. It is not intended to replace the need for services provided by a licensed speech pathologist who can tailor treatment to an individual's needs.

Matthew Delanoy

7/26/2014 01:07:29 pm

Hey, I met you at the NSA conference this year :) ...pretty cool to stumble across your blog post online... This is good stuff by the way :)

Brooke Leiman

8/8/2017 11:14:23 pm

3 years later but I literally just noticed this comment! How have I not seen you again at NSA!?

Stephanie

12/28/2017 09:31:13 pm

If the client uses prolongations as there main type of dyslfuency. Would you still want them to use the “pull-out” method?

1/2/2018 11:33:17 am

A person who stutters can use a prolongation to release tension by continuing to extend the sound while playing around with the tension (wherever that may be). Another option would be to play around with the tension by adjusting the prolongation (the stuttering moment) with easy bounces rather than elongating the sound with a pull out. Hope that makes sense!

Bill

3/16/2018 11:37:45 am

Hello,

Any advice on hard speech blocks? The initial start of sentence, especially with a hard vowel such as O is what I get stuck on. I have anxiety, the anticipation of speaking is something that I need to get better on. Any advice would be helpful
Thank you
Bill

3/21/2018 12:51:26 pm

Bill-

What you're noticing is the downfalls of working solely on speech/stuttering management techniques without attending to the other components of the disorder. Often a person's reactions to the stuttering moment (ex. shame, embarrassment, anxiety, learned habits of avoidance, etc.) make these strategies very difficult to use effectively. For this reason, therapy should focus on ALL aspects of the disorder to include reducing negative reactions. When a person desensitizes to stuttering moment and reduces potential learned avoidances, the person will be better equipped to release tension and manage stuttering moments more effectively (use the strategies that you speak of). Reducing negative reactions to stuttering can be worked on in speech therapy or certainly can be addressed by getting involved in some of the wonderful support groups out there like the National Stuttering Association. There are even some great social media groups like StutterSocial that can help connect you to other people who stutter.

Hope this helps a bit!

Danny

6/29/2018 02:51:12 pm

I'm a writer and editor working with a recently retired prominent stuttering specialist on a book. I don't strictly need to understand every term and technique in the book, but I want to, and this site is the most clear, complete, attractive resource I've found--and elegantly written and edited. Thanks so much!

Danny W.

10/31/2018 02:10:36 pm

I think I understand the idea of a pull-out, and see how it can work with vowels, nasals, fricatives, and liquids, but are pull-outs possible with a consonantal stop? I can't really hear this in my head.

11/6/2018 03:01:10 pm

Hi Danny-

The idea of a pull out (or any other stuttering modification strategy) is to see if you can find a way to move forward with a more comfortable way of stuttering, with less tension/struggle. You can do this by easing into the word with a slight elongation of the sound/syllable or you can move forward with an easy bounce or repetition of the sound. Sometimes with "stop" sounds it's easier to move forward by using an easy bounce/repetition. However, if you use the elongation you can play around with lightening up the contact between the articulators. If it's a 'B' it would be using a light contact with your lips, almost leaving a little bit of air between them. This might have the "side effect" of slightly distorting the sound though. It's really more about releasing the tension with lighter contact rather than about elongating the sound. Hope this makes sense.

Laura Dostilio

2/8/2019 01:47:40 pm

Is "pull out" the same stuttering modification technique as "easing out"?

2/8/2019 02:08:26 pm

Yes- easing out is another way to describe this modification!

Julia

4/8/2019 01:24:53 am

Do you have any suggestions for introducing this strategy to individuals with cognitive disabilities? Right now, we are simply trying to build an awareness of "bumpy" versus "smooth" speech as I pseudostutter. She is able to describe bumpy speech and identify it when I pseudostutter in structured activities. She even demonstrated pseudostuttering herself, but as we then transition to engaging in conversational speech, she no longer reports an awareness of her disfluencies. Her disfluencies greatly impact her intelligibility so we are working toward continuing to build an awareness and explore strategies that might help her stutter more easily.

4/15/2019 01:26:25 pm

I think providing visuals can be helpful when working with kids with co-existing speech/language or developmental disorders. Maybe having a picture of something that depicts bumpy to act as a reminder to what she is looking for or to point to when catching her stuttering moments. One thing I would make sure of is that she does not feel like she is catching "mistakes." Often kids may have a negative reaction to monitoring stuttering because it's something that is shameful to them. I find that the child has a much more positive experience and much better outcomes if they are not monitoring stuttering moments (which they may perceive as monitoring something they are doing "wrong") but rather monitoring times that they are choosing to not give up (I call that free talking or open stuttering).

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411 on Pull-outs

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