Persistent stuttering is characterized by stuttering that continues after seven years of age, when the rate of achieving normal fluency slows significantly.  At this point, the primary goal of therapy shifts from achieving fluency to developing effective compensatory techniques and eliminating ineffective secondary behaviors.  While many therapies have been developed for persistent stuttering, the variability in neurological causes and individual reactions to stuttering necessitates an individualized approach.  Therapy focuses on helping the patient accept stuttering, control their communication, and reduce or eliminate dysfunctional secondary behaviors, such as word avoidance and mannerisms.