John Doe is an 8 year old boy who was referred for a speech evaluation by his neurologist. His mother reported that he has stuttered since he began speaking but the behavior has increased recently. There is no significant family history of stuttering.He was diagnosed with Tourette’s syndrome and ADHD at 6 years of age by his neurologist. They began medications, 5 mg of dispersal daily to control his tic behaviors. His tics began at the age of 5 with throat clearing, teeth clenching, eye blinking and facial grimacing. His parents described him as inquisitive, energetic, sensitive and interesting. They believe that his speech patterns is beginning to prevent him from participating in activities and the recent changes may lead to increased teasing, reduced self esteem and problems with peers. It was suggested that John’s interventions should take place with peers who demonstrated similar characteristics, to reduce anxiety and promote more fluent speech.