Bill Murphy (MA, CCC-SLP) and Bob Quesal (Ph.D., CCC-SLP, BRS-FD) use their 80 years of combined professional experience to offer 7 tips for helping SLPs who can lose their confidence when treating pediatric stuttering. These speech therapists believe you will become more comfortable treating this often perplexing population.
Tip # 1: Stuttering is more than surface behavior
One cannot effectively address the mechanics of stuttering without also addressing a child’s avoidance of words, sounds, and situations. By acknowledging and tackling the child’s anxieties and negative thoughts, the therapist will be much more able to keep him or her motivated and fully engaged.
Tip # 2: What a child can do in therapy is not always what he can do outside of therapy
Stuttering clients are often able to speak more fluently in therapy sessions with a disappointing level of carryover into their everyday life. Suggestions to “use your therapy speech” are likely to add to their frustration and guilt. This only makes their stuttering worse.
Tip # 3: “Fluency” speech is often as embarrassing as stuttered speech
Many speech therapists have been taught that the main goal for stuttering therapy is fluent speech. What this goal misses is that for many pediatric patients, “fluent” speech as it is taught in the therapy room may involve speaking in ways that feel and sound abnormal. Asking these students to use “fluency enhancing behaviors” like stretched speech can make them so uncomfortable in public settings, that their stuttering worsens.
Tip # 4: SLPs need to be willing to do what they want their clients to do
Beyond trying to use fluency enhancing techniques, it might be useful to walk up to strangers and stutter to see how they react while your client watches. Following up by discussing these reactions with your client serves two purposes. First, it helps you better understand how your client may feel when a person is hearing their stuttering for the first time. Second, it gives you the opportunity to discuss the fact that first-time listeners react in a variety of ways, most of which are not nearly as negative as expected.
Tip # 5: Desensitization precedes change
Desensitization can play a crucial role in reducing a child’s negatives thoughts and emotions about stuttering. For example, have your child teach his or her parents how to stutter and “grade” the parents’ performance. An important part of desensitization is self-disclosure. As the child becomes more comfortable with these revelations, stuttering is less feared and, as a result, they hide their stuttering less. As they hide their stuttering less, their speech is more likely to become more effortless.
It is important to underscore that getting your client more relaxed about stuttering will not ultimately succeed if parents and other key people don’t become desensitized to stuttering as well. Children can invite parents, friends, and teachers to therapy sessions and do a presentation to the class about stuttering. A child cannot get more relaxed about their stuttering all alone—they need the people in their lives to get more comfortable as well.
Tip # 6: It’s OK to stutter
If a child continues to stutter into third grade, it is likely that she or he will continue to stutter to some degree through adulthood. Because of this, one of the most important messages for the SLP to send is that it’s OK to stutter. When children learn to accept their stuttering and talk about it appropriately, it sets the stage for acquiring the lifelong skills in managing stuttering that can make a substantial difference to their quality of life.
Tip # 7: You are not alone
For children, knowing that they are not the only ones who stutter can help reduce the negative effects of stuttering. Resources for finding children who stutter and their families include The National Association of Young People who Stutter (www.friendswhostutter.org), The National Stuttering Association (www.westutter.org), Stuttering Foundation of America (www.stutteringhelp.org), and the Stuttering Home Page (www.stutteringhomepage.com).
Mr. Murphy is a professor emeritus in the Department of Speech, Language, and Hearing Sciences at Purdue University. Mr. Quesal is a professor of Communications Sciences and Disorders at Western Illinois University. I would like to express my indebtedness to them on behalf of all allied health professionals for their development of these seven succinct yet comprehensive tips for the crucial and rewarding opportunities that SLPs have to change the lives of their child stutterers forever.
Robert Hoyt, Ph.D.
Allied Health Professionals LLC