Approaching the topic of stuttering.
Hello, I am currently a second year graduate student who is pursing her degree in Speech-Language Pathology. This degree is so wide and you can literally work with anyone who wants and needs speech. When I was a freshmen in undergrad I never thought that being an SLP you could work with all ages and all different disorders, fluency being one of them. I always thought stuttering was just part of the way someone spoke and could not be avoided. I grew up with cousins who stuttered and never did it cross my mind for them to see a speech therapist. Of course I was only 10 years old and all I was worried about was beating them in our little competitions and playing. Come to find out now, they could have therapy and truly benefited from it, and it is never too late however, they are now grown boys and I don’t think they feel the need for therapy.
My question is, I have a little boy who I am seeing in the schools and he stutters. He does not quite understand it because when I asked him why he was in therapy, he said he didn’t know. That his mom told him he had to go because he shouldn’t be saying his name with repetitions for example, he will say “Hi my name is J-J-J-J-Johnny.” He is one happy and energetic little boy who does not seem to notice any problems with his speech. That makes me happy for him, but I feel like I don’t know how to approach the fact that he stutters and some simple techniques that he will generalize. I don’t want to focus on techniques that he will not generalize over in his every day life. Any suggestions?
Hi! This is an excellent question and I am so glad that you brought this off. First of all, congratulations in your studies and welcome to the amazing field of speech-language pathology! This is such a wonderful field and I think you will find it surely so rewarding. With that, you bring up such a valid point when you say he does not “notice any problems with his speech.” This is where it gets sticky with the parent and the child and what the parent wants and the child wants and giving the child a voice for themselves. Even though the child is young, the child still has wants and needs of their of for communication like anyone else. As I am gaining rapport with the parent of a child that I am seeing for speech therapy (whether it is for articulation, language, stuttering, pragmatics) I introduce myself, we talk about what concerns they have regarding speech/language/communication, and I get the opportunity to provide some education regarding the nature of what they are concerned about. I usually do this over the phone when the initial referral comes in (like in the public school setting) before I even meet the parent (IF I get to meet the parent- if the parent is able to come to the therapy placement meetings, etc.) This first phone call that I intentionally make helps the therapeutic alliance with the parent so much- it eases the parents mind, helps the parent to understand the nature of what is going on with their child, but also is the first step in giving the child a voice. So many parents still come to me saying they would like for me to “fix” their child’s stuttering because it is a “problem” and given what we know about the nature of stuttering itself, that isn’t the case and that’s not why we do therapy. Stuttering is not a “problem to be fixed.” So it is our job to gently and kindly tell the parent, guardian or teacher or whomever it may be, otherwise. We can do that with that initial phone call meeting when we first get the kiddo referred. We can establish a relationship with them right then. It doesn’t mean we aren’t going to try to reach their goals: if they want to work on fluency, we can- we know how to, and we know how to teach and shape those strategies with research based methodology. It doesn’t mean the child may or may not grow out of stuttering, show less disfluencies, improve communication confidence- any of that. What this means is we have been raw, honest, and set the stage for success for the child early on: we have given them a voice. We set the parent up to understand the nature of stuttering right off the bat- we don’t want false expectations especially of the child. It’s not about my ego as an SLP…… I don’t want the parent expecting complete fluency from their child! That’s not the nature of stuttering and that’s far too much pressure to put on a young child at a young age for an entity like stuttering that is described in our textbooks as a “loss of control” at times. If it is a “loss of control” at times by nature, then why would a parent or especially an SLP for that matter, expect perfect fluency? None of us are perfectly fluent! Are you following? To more specifically answer your question, in my personal opinion, it is not my job to tell Johnny, “Johnny, you are a person who stutters: because that is something that Johnny or Johnny’s parent needs to handle on their own. In my opinion, just like with other entities in life, there has to be a factor of self discovery there. I have used words like “bumpy speech” or “bumpy voice” with real little guys (like age three) during vocal play while using monster voices and mouse voices during play with toys.. but I don’t like to use the word stutter until the child does first. The reason why is because it is their stutter, not mine. The child decides when they are ready to use that word for their stutter, not me. The child gets to name their own stutter, not me. So until they name their stutter a “stutter”. I don’t. I don’t name it at all, really. I can say what we are working on sure… but I don’t name their stutter.. I let them do it themselves. Does that help? That’s something I also tell the parent/guardian. Now usually the parent has named it for them. But that at times can cause trauma. And that’s a whole new can of worms, dear one (although it doesn’t cause trauma all the time.. just in some cases- the stuttering experience is so individualized.) I hope that this answer helps you. Treating stuttering is my absolute favorite- children and adults. It is such a fun world to be a part of, and I hope you can discover that. Be well!