The Serious Evidence of Humour in Speech and Language Therapy

A 2024 peer-reviewed study published in Revista Romaneasca pentru Educatie Multidimensionala offered the first systematic look at humour use in speech and language therapy, surveying 210 SLT professionals across Romania. The findings are striking — and largely confirm what experienced clinicians have long known in practice.

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What the Research Found

Of the 210 SLTs surveyed, only 12 — just 5.7% — said they do not use humour in their professional practice. That means 94.3% actively use humour as part of their therapeutic approach with clients who have language disorders. More telling still: 39% use it in every single session, and over 68% use verbal humour specifically.

These are not therapists occasionally cracking a joke to lighten the mood. The data describe a profession that has broadly, and largely informally, adopted humour as an intrinsic part of how it works.

What makes this significant is that the pattern held regardless of the therapist’s age, gender, or years of experience. Humour in speech therapy, it appears, is not a generational quirk or a stylistic preference — it reflects something more fundamental about how therapy actually functions.

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Why Humour Works: The Mechanisms Behind the Method

The therapeutic value of humour is not intuitive to everyone, so it is worth unpacking what it actually does — physiologically, psychologically, and socially.

Physiologically, laughter produces measurable changes in the body. Research going back to the 1980s and 90s has documented that mirthful laughter modulates neuroendocrine stress hormones and immune parameters. In a therapeutic context, a client who is anxious or self-conscious about their speech is already carrying a physiological load that can interfere with learning and motor practice. Humour can reduce that load.

Psychologically, humour shapes the therapeutic alliance — the quality of the relationship between therapist and client. A strong alliance is one of the most reliable predictors of therapeutic outcomes across virtually all health disciplines. When humour is used well, it signals safety, mutual respect, and shared humanity. For a child who has struggled to be understood, or an adult relearning communication after a stroke, that signal matters enormously.

Socially, language disorders are, at their core, disorders of connection — with other people, with meaning, and with the world. Humour, which is among the most social of all human behaviours, creates micro-moments of genuine connection during sessions. This is not incidental. It is therapeutic in its own right.

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The Role of Verbal Humour Specifically

More than 68% of the SLTs in the study reported using verbal humour during sessions — which is worth pausing on. Verbal humour is not slapstick or visual comedy. It is wordplay, incongruity, timing, and the manipulation of meaning. For clients working on language, this is also precisely the territory of the therapy itself.

Jokes require understanding of syntax and semantics. Wordplay demands phonological awareness. Comic timing involves pragmatic competence — knowing what to say, and when. Incorporating humour into sessions does not pull clients away from the task; for many, it puts them directly inside it. In this sense, verbal humour is not merely a vehicle for engagement — it can be the medium through which language skills are practised and stretched.

Research on humour comprehension in children with language impairment has documented that humour tasks can reveal and target specific deficit areas, including syntactic understanding, theory of mind, and perspective-taking. The same applies to adults with acquired communication disorders such as aphasia or the pragmatic impairments that can follow traumatic brain injury.

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What This Means for Clients and Families

For families navigating a therapy journey — whether for a child with a developmental language disorder or an older parent recovering from stroke — the relevance of all this is straightforward: a session that involves laughter is not a session that has gone off-track.

Engagement matters. Motivation matters. A child who looks forward to their therapy sessions attends more consistently and practises more willingly at home. An adult who feels at ease with their therapist is more likely to take the communicative risks that recovery demands. Humour, used thoughtfully, supports all of this.

It is also worth noting that humour comprehension itself can be a meaningful marker of progress. If a client who previously struggled to follow jokes begins to find them funny — or to generate them — that is a clinically observable shift in language and social cognition. Families who pay attention to a loved one’s sense of humour throughout a recovery journey may be tracking something more significant than they realise.

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The Missing Piece: A Humour Assessment Tool

One of the most important signals to emerge from the Romanian study is the gap between humour’s prevalence in practice and the tools available to support its systematic use. 68% of participants agreed or strongly agreed that a dedicated humour assessment tool is needed for effective therapeutic application.

Currently, most SLTs use humour intuitively — guided by clinical experience, client cues, and professional judgement. This works, clearly, given how widely the practice is adopted. But without formalised assessment tools, it is difficult to document humour-based interventions in case notes, to measure their impact, or to train newer clinicians in their deliberate use.

The study’s findings make a clear case that the field is ready for this development. Humour in speech therapy has moved well beyond anecdote. It now has quantitative evidence of prevalence and professional consensus on its importance. Formalised tools would allow it to be studied, refined, and taught with the same rigour applied to other therapeutic modalities.

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From Evidence to Practice

The research from Romania is geographically specific, but its implications are not. Speech-language therapy is practised within cultural contexts, and what makes something genuinely funny is always culturally inflected. The form of humour that works best in a session will vary — by age, background, relationship, and individual personality. What the evidence confirms is that the principle is sound and broadly applicable.

For SLTs, the practical takeaway is permission and encouragement to trust their instincts. The humour they are already bringing into their sessions is not a professional indulgence — it is a clinically coherent choice with a growing evidence base. Developing a more conscious vocabulary around how and why humour functions therapeutically can only sharpen that practice further.

For clients and families, the message is simpler: if your therapist makes you laugh, that is probably a very good sign.

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Frequently Asked Questions

Is humour actually part of formal speech therapy? Yes. Research shows that the vast majority of speech-language therapists — over 94%, according to one peer-reviewed study — use humour deliberately in their sessions. It is not peripheral to the therapeutic process; for many SLTs, it is integral to it.

How does humour help with language disorders? Humour supports therapy through several overlapping mechanisms. Physiologically, laughter reduces stress hormones that can inhibit learning. Psychologically, it strengthens the therapeutic alliance between clinician and client. And in the specific context of language therapy, verbal humour — wordplay, jokes, comic timing — actively exercises the very skills being targeted: syntax, semantics, phonological awareness, and pragmatic competence.

Can humour be used with adults who have had a stroke? Yes. Research on acquired communication disorders, including aphasia and traumatic brain injury, supports the use of humour-based approaches. Humour comprehension and production are also useful markers of pragmatic recovery, and changes in a client’s ability to engage with humour can reflect clinically meaningful progress.

What about children with developmental language disorders? Humour is particularly well-suited to working with children, given its role in engagement and motivation. Studies specifically examining humour comprehension in children with language impairment have found that humour tasks can both reveal and target specific deficit areas, including syntactic processing and theory of mind.

Is there a formal way to assess humour in speech therapy? Not yet — and this is an identified gap in the field. 68% of SLTs in one recent study agreed that a formal humour assessment tool is needed to support more systematic clinical application. As the evidence base grows, the expectation is that such tools will be developed and validated.

How do I know if my therapist is using humour well? Therapeutic humour should feel inclusive and warm, never pressured or dismissive. It arises naturally from the relationship and the session content, rather than being imposed. If you or your child enjoys sessions and finds them engaging — including moments of genuine laughter — that is generally a positive clinical indicator, not a distraction.