It is sometimes a little unnerving to look back into the not-so-recent past and consider how little has really changed with regard to our stuttering treatment protocols. It might be argued that over the 10 years that have intervened since the first edition of Stuttering and Cluttering, rather little has changed regarding the essential components of the behavioural/mechanical approach to fluency therapy. But perhaps that shouldn’t be surprising; after all, there are only so many practical adjustments to the way in which speech musculature can be manipulated to help facilitate fluent speech. Features such as soft consonantal and glottal onsets, slide starts, smooth airflow, relaxed speech and such like are regurgitated under various different working names across a wide range of programmes. As we saw in Chapter 13, whether employed continuously within a prolonged speech or fluency-shaping format or more on an as-needs basis according to a stuttering modification approach, the underlying fluency-enhancing tools are remarkably similar.