The Valsalva Stuttering Network

Diagnosing Valsalva Stuttering: Suggested Criteria

By William D. Parry, J.D., M.A., CCC-SLP

The involvement of the Valsalva mechanism in various types of stuttering behavior cannot be determined without further research. In the meantime, the following criteria are suggested for selecting those individuals who most clearly seem to exhibit Valsalva-type stuttering and who would be most likely to benefit from Valsalva Control.  The following suggestions are not intended to be a substitute for individual diagnosis by a qualified speech-language pathologist or other appropriate health-care professional.

Excluding Complicating Factors

Are you currently free from brain damage or other identifiable neurological defects or deficits? Yes ___  No ___

Are you free from physical defects that affect your speaking or breathing? Yes ___  No ___

Was the onset of your stuttering not related to head trauma or other disease or condition affecting the brain? Yes ___  No ___

Characteristics of Stuttering

Are you able to talk fluently some of the time, or in certain situations? Yes ___  No ___

Are you fluent when you sing? Yes ___  No ___

Are you fluent when you read in unison with someone else? Yes ___  No ___

Does the severity of your stuttering vary depending on the speaking situation or the words being said? Yes ___  No ___

Do you tend to stutter more on the words that are most important? Yes ___  No ___

When you stutter, are any of the following true? Yes ___  No ___

bullet Your words are sometimes blocked by tight closure of your lips, your tongue, or your larynx (your throat)? Yes ___  No ___ 
bullet When you have a block, whether it be sustained or repetitive, you feel tightness in your abdominal and/or chest muscles and increased air pressure in your lungs? Yes ___  No ___ 
bullet You sometimes have difficulty or delays in making voiced sounds (phonation)? Yes ___  No ___ 

Valsalva Maneuver Exercises

Perform the following exercise:

Curl your fingers, and link both hands together in front of your chest. Take a deep breath. Now try to pull your hands apart, as hard as you can, without letting go.  (If you are seated at a desk or heavy table, an alternative would be to put your fingers under the edge of the desk or table and try to lift it.)

(Warning: You shouldn't overdo the Valsalva maneuver, particularly if you have a heart condition. In extreme cases a person might pass out.)

While you are pulling (or lifting):

bullet Do you notice the muscles in your chest and abdomen tightening up? Yes ___  No ___
bullet Do you notice your throat closing up? Yes ___  No ___
bullet Do you notice your throat closing more tightly, the harder you pull (or lift)? Yes ___  No ___
bullet Does your throat feel the same as when you block on initial vowel sounds (as in "apple")? Yes ___  No ___

Now try the same exercise again. This time, start by putting your lips together and pretend you are going to say a p sound. Now pull your hands apart (or lift) as hard as you can. While you are pulling (or lifting):

bullet Do you find your lips pressing tightly together? Yes ___  No ___
bullet Do your lips feel the same as when you block on consonants like b and p? Yes ___  No ___

Now see what happens when you press the tip of your tongue to the ridge behind your upper front teeth, and pretend you are going to say the t sound. Take a deep breath and start pulling (or lifting). While you are pulling (or lifting):

bullet Do you feel the tip of tongue pressing forcefully? Yes ___  No ___
bullet Does this forceful closures feel the same as when you block on consonants like d and t? Yes ___  No ___

(This exercise can be repeated using the articulation positions for other consonants.)

Valsalva Relaxation Exercise

Intentionally do a sustained, forceful block on the p sound, similar to the hardest stuttering blocks you have personally experienced. While you are blocking, notice whether any other parts of your body are tense.

bulletDo you feel tightness in your abdominal muscles? Yes ___  No ___

Now do another forceful block on the p sound.  This time, while you are blocking, relax your abdominal muscles.

bullet Did the force of the block automatically disappear? Yes ___  No ___
bullet Are you unable to make the same kind of forceful block while relaxing your abdominal muscles? Yes ___  No ___

If the answers to all, or nearly all, of the above questions are "Yes," the Valsalva mechanism may be involved in your stuttering behavior, and Valsalva Control should be seriously considered.

Copyright 2002, 2005, 2009 by William D. Parry


Contact Information:


 William D. Parry, Esquire, CCC-SLP

A licensed speech-language pathologist and trial lawyer, offering stuttering therapy and counseling (including Valsalva Control stuttering therapy) in person in Philadelphia and over the Internet via webcam (subject to applicable law). 


Office: 1608 Walnut Street, Suite 900, Philadelphia, PA 19103
Phone: 215-620-6792



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Valsalva Control Stuttering Therapy is a new approach to improving fluency by controlling the physiological mechanism that may be causing stuttering blocks. For further information on Valsalva Control Therapy, visit Stuttering Therapy and Counseling at


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

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

National Stuttering Association
119 West 40th Street, 14th Floor, New York, NY 10018
Telephone: (800) 364-1677 or (800) WE STUTTER
Fax: (212) 944-8244

Researchers and speech-language pathologists seeking further information about the Valsalva Hypothesis may e-mail me at:

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Last revised: 7/17/2011