Advice for Helping Fluency Students Feel More Comfortable
My name is Matthew and I am a second-year Speech Pathology graduate student. I am currently working at a local elementary school where I conduct therapy for quite a few PWS daily. Many of the students that I see for fluency have been in therapy for years and know what to expect in terms of breathing and speech exercises we utilize throughout therapy. However, I have witnessed many of the students become frustrated or upset fairly quickly into these exercises and some eventually shut down entirely. Regardless of the activities or events I have planned throughout sessions, a few students appear to never be willing to do certain exercises at all. Are there any ways I can better myself as a therapist and help students feel more comfortable throughout these sessions without making them feel overwhelmed?
Matthew, I’ll share what I shared with another student who asked a similar question. I believe that motivation and interest come when students feel that the treatment they are engaging in is making a real and tangible difference in their everyday lives, so I would start by asking each of those boys what is important to them? How is stuttering impacting them negatively or in a way that is bothersome? What are their concerns or fears? What are the speaking situations they fear or avoid because of their stutter? If we can help equip children to tackle the areas of concern to them and find confidence to speak, participate, take risks, etc. WITH their stutter, I believe you’ll see the increase of internal motivation and interest.
I am making an assumption here, but generally “breathing and speech exercises” are geared toward targeting “fluency.” Targeting fluency is a slippery slope because if often leads to self-stigma (believing that stuttering is “bad” or “wrong” or should be hidden), concealment of stuttering at all costs (see Gerlach-Houck’s work on concealment), less talking, less participating, etc. so I would encourage you to consider treatment activities that will help them become confident communicators WITH stuttering.
In relation to breathing exercises, I would recommend two resources: a video by Tim Mackesey (stuttering specialist and SLP who stutters) related to myth-busting breathing work in stuttering treatment (https://youtu.be/2lxYvaTGVGM?si=CaQLcOxMTuIqa7Mk) and a Stuttering Therapy Resources blog article entitled, “It’s (almost) NEVER breathing in stuttering therapy!” (https://stutteringtherapyresources.com/blogs/blog/its-almost-never-breathing). I hope you find these helpful!
Hi Matthew!
Like Ana I would recommend to change the focus from achieving fluency, and rather focus more on the flow in relations and communication settings. Of course there might be people who want to experience to talk and stutter more effortlessly, in which I understand very much. However, when combining work related to both physcial and psychological aspects, there are several ways to collaborate which keep the person’s motivation. Instead of teaching technically about the voice and/or breathing mechanism, I would approach such issues by inviting the person to be increase awareness of for example the body tension or the breathing patterns without any other instructions. Usually it is not necessary because when the person is increasing awareness of the body tension and breathing mechanism in general, the muscle tension is decreasing. Then you can just explore this together with the person, if you see that the person is responsing positively to this awareness-based excercise.
How to deal with severe stuttering blocks, is often seen as relevant for many persons who stutter too, and who are searching for stuttering therapy. Here as well, the joint explorative and awareness-based work mey be of relevance too.
Best wishes from Hilda