We could probably add one or two or delete one or two and it wouldn't affect the therapy approach too much. Simply stated, the five parameters are things one must have, or be doing, in order for speech to flow smoothly. An interruption in one or more of the parameters will lead to a disruption in fluency. I'll discuss each one separately. Most basically, we have to have air flowing in order to speak.
Respiration provides the energy or driving source for speech.
The client has to be aware of events occurring at the level of the rib cage, and develop awareness of how much air is in the lungs. Movement occurs at a number of levels. We typically think of movement of the speech structures, but we also have movement of the rib cage to consider, as well. It is obvious that without movement, we can't speak. A basic example of this is voice onset time.