Stuttering and young children
Hi there! My name is Jess and I am a second year graduate student studying speech-language pathology. My clinical placement this semester is at a charter school and I am loving it! We have several young kiddos (K and 1st grade) who are exhibiting stutter-like disfluencies and my supervisor and I have been chatting about forming an informal fluency group with them to help start them on a path of awareness and begin establishing positivity and confidence in their ability to communicate. I have chatted with instructors at my university to help get some ideas about how to structure this group, as this is a new topic for me and my supervisor has asked me to step up and organize the group. So far, I am planning to work through exploration of speech by playing with our voices and using puppets to demonstrate how everyone talks differently, and that’s okay! I might model pseudostuttering with them if we get to a point that I think it’s appropriate. I’m not planning on using any labels unless the kids bring it up and start talking about it because I don’t want to assign them an identity and potentially bring on any kind of self-stigma (it sounds like most of these kids aren’t very conscious of their stutters yet). I would love input about some fun activities that anyone has used with this age group, and suggestions for working with these kids. They aren’t on IEPs at this point – this is just supposed to be a fun little group that meets for 15-30 minutes per week to get the ball rolling for them.
Along with all of that, I am considering working on some parent education about what it means to stutter, along with why I am not planning to implement strategies with their kids at this point. Do you have any article recommendations addressing the detrimental effects of fluency-focused treatment? I want this to be a positive experience for both the kids and their parents – any suggestions or feedback is appreciated!
Hi Jess!
Its so wonderful to know you’re enjoying your course and your placement! You have all good ideas here, and I’m sure the kids are going to love it.
Just a few additions:
1. I was wondering if it would help to gradually introduce some speech/ communication activities in mixed groups as well- small groups of some children who stutter and some who don’t- to foster a sense of inclusion and acceptance right at the outset.
2. As you also mentioned Grade 1, I’m assuming some of these children are 6, so you might want to consider some direct therapy as well. Even for the younger children, although you might not want to work on ‘fluency techniques’ as such, good speech habits in general – like slow, well articulated speech with appropriate pauses- could be encouraged through group activities. Having the kids jump over a pattern (similar to the frog on a lillypad analogy), to inculcate the habit of using an overall slow rate of speech, for instance.
Hope these pointers help, and all the best for your fun group!
Regards
Pallavi
Hi Jess-
You ask some really, really great questions here! I’m also glad to hear that you are enjoying your placement working with young children who stutter. This age group is a really fun and interesting one. 🙂
A few thoughts/ideas based on your comments:
I would also encourage you to look into and think about the risk factors that your clients have for persistent stuttering. I bring this up because this age group is sort of in the ‘gray’ area in terms of those who may outgrow stuttering and those who may persist with stuttering. The risk factors don’t give us all of the information; however, they can be very helpful in basing our clinical decisions in evidence.
How involved are the parents in the therapeutic process? Have you talked with them about stuttering – what they know, what they want to know, what questions they have? Parent education can be really, really important at this stage of the game especially. Also, have you talked to the parents about possible stressors that may impact the child’s stuttering (not cause the stuttering in any way – but times that it happens more or less). I ask this because this information gives us a lot of information about possible little changes we can make throughout therapy to lessen the demands on the child/learn more about his/her stuttering.
Another thing that I like to keep in mind at this age is what is the child’s awareness of his/her own stuttering. As we seek to understand this, we also need to think about their stage of cognitive development. Many, many young children may not be aware that they stutter (or have difficulty talking at times) while others may be. This information can be imperative in making clinical decisions moving forward. For children who are not aware, a more indirect/less direct approach with lots and lots of modeling from the clinician might be more appropriate at this time. For children who are more aware, a more direct approach or pieces of a direct approach may be more fitting. It’s definitely not one size fits all.
Also, making changes to one’s speech can be very, very difficult for adults – so we want to keep in mind what a young child is capable of doing. We don’t want to have the same expectations for those children as we might for adults. This is where your understanding of child development can really help you to think about what’s best for the child/most fitting in that moment. Does that make sense?
I think at the end of the day – we want talking to be fun and enjoyable for the child regardless of the approach we take. We also want to include the parents and counsel as often/as much as needed.
I would really encourage you to look more into indirect and direct therapy approaches for preschoolers/young school-age children. I think broadening your understanding of these types of approaches might help you to pick the bits and pieces of each that may best fit a particular client and where he/she is in this moment.
I hope this helps! Please do feel free to ask more questions!
Best of luck,
~Jaime