Evidence-based strategies
Hello! My name is Emily. I am a second-year graduate student. In the future, my goal is to work in the school setting. I am currently at an internship at a school, and we have two students that stutter. They both have great attitudes, and they’re so fun to work with, but it is challenging to find strategies that are effective for them. That being said, what evidence-based strategies do you find the most effective when working with school-age children who stutter, and how do you determine which to implement in different cases?
Emily,
Hello! Thank you so much for asking a question to the professional panel, and welcome to such an amazing field! This is such a good question, and I first want to encourage you the back-up just a bit- and think of what defines the term “effective” in speech therapy? How are the goals written for each kiddo and are they obtainable with what we know about stuttering? In determining further goals here are some additional thoughts for you- what kind of communication pressure does each kiddo place on themselves in their day-to-day communication exchanges? What does each kiddo think stuttering is, isn’t- and what role does stuttering play in their school life? A kiddo who stutters may think that they have to be completely fluent to be an effective communicator (we know this isn’t true) but that tells you so much about their personal stuttering journey and the pressure the place on themselves (or don’t place on themselves) within their communication exchanges. I think an important step here with both kiddos is to determine the “why” for therapy within the setting you are serving (which in your case is the public school setting, so you have to have an “academic need” for services- see my response to another question in this thread that talks about that some- I also encourage you to read responses to the other questions as that may also be helpful to you). Parents come into play big here because here in the United States they are the legal decision makers in terms of services, plan of care, etc- and what a parent thinks stuttering is and knows about stuttering is very important to a child’s lived experience of stuttering (and even the reactions of staff members, teachers and other communication partners)- so I do a lot of counseling and educational discussion with communication partners in the child’s world as part of the speech therapy experience. As far as methodologies, this is very individualized to the kiddo, family, and personal lived experiences of stuttering so I’d need to know quite a bit more about each kiddo and their stuttering journeys to be able to recommend direction to consider. Dr. Scott Yaruss and Nina Reeves have excellent resources for working with kids who stutter on their website with Stuttering Therapy Resources (https://stutteringtherapyresources.com/), there are also great online CEUs that are reflective of most recent best practices in stuttering therapy with kiddos. So, I think taking a holistic step back to what you are doing in therapy, why you are doing it, and how it can help the kiddo in their academic environment while also weighing heavily on what the child themselves wants and feels like is helpful to them (and collaborating with the parents with those conversations).. all can be helpful to determine potential next steps. In addition to what any of my colleagues on this panel say (I am excited to see how they may chime in), you can also reach out to your supervisor at your school site or your graduate professor. I hope this was helpful to you, and best wishes. Take care!
Hi Emily,
It’s so great to hear that your kids have great attitudes and are fun to work with! And thank you so much for your question.
When I work with young people who stutter, I don’t use ‘strategies’ to promote fluency, rather I work with them to affirm the way they speak, build resilience, help them learn more about stuttering (which can be empowering), connect them with others who stutter, help them learn to advocate for themselves, encourage self compassion. I may also help with reducing tension/struggle. I help them learn that their communication is not limited by stammering and they are free to communicate what they want when they want (regardless of how much they stutter). Hope this helps a little bit. It’ll be great to hear what the others have to say and whether they utilise strategies in their therapy. I believe that focussing on fluency whilst telling a person it is okay to stutter is conflicting.
Enjoy the rest of your course, Nic
Hi Emily!
Thank you for your question!
I am tempted to remind you and all of (!) us that there is a kind of a conflict when we talk about evidence-based practice (EBP) when dealing with persons who stutter. Since we know that stuttering and stuttering therapy can manifest so differently in each person, I would rather focus on the two students who you already are collaborating with, and use them as a resource or advisors. Give them even more space to both define their specific needs, goals, preferences and contexts which matter for them. Then you may use your expertise and creativity to adapt therapy to fit these contexts. This individualized approach is defined as practice-based evidence (PBE), and can lead to even more effective and meaningful outcomes. Furthermore, by involving your students in the decision-making process, you will foster senses of ownership and empowerment, which can increase their motivation. In many ways, you are then developing your own therapy which both is personalized and even more responsive, in which is beyond what evidence-based practice can capture.
Best of luck with your future professional plans in speech-language therapy!
Greetings from Hilda