Advice to SLPs
Hello My name is Annabelle, I am a SLP graduate student! I want to know what do you want to tell SLPs is the most important thing when it comes to speech therapy for PWS? What can professionals do to make sure your getting something out of speech therapy? Thanks!
Hi, Annabelle!
Throughout my life, dealing with my stuttering, I’ve consulted no less than six or seven different speech therapists, each with their unique approach. Some predominantly emphasized techniques aimed at enhancing my fluency. While the intention was kind, I found these methods to be of limited benefit since my primary requirement was to work on self-acceptance.
The current speech therapist I’m working with is focusing more on strategies for long-term improvement. He has prepared me for the reality that my stutter may never completely disappear through techniques alone. Instead, I’m learning to live a better life by embracing and befriending my stutter in a meaningful way. I’ve also experienced the challenges of being a covert stutterer, making the process of learning to cope with it of utmost significance for my own well-being.
In my view, the most critical aspect for speech-language pathologists is to truly listen to the desires of individuals who stutter and delve deeper into understanding their therapy needs. From my perspective, if someone who stutters seeks assistance and conveys that their stuttering significantly impacts their life, it’s important to recognize the profound connection between stuttering and mental well-being. At least in my case, I had to explore various underlying issues to discover that stuttering was at the root of many of my emotional struggles, including anger and sadness. I believe that everything is interconnected.
This is the type of support I wish I had encountered earlier. However, as you’re aware of, experiences with stuttering can vary greatly from person to person, and not every individual who stutters may seek or desire this approach. Techniques alone can also in some cases be enough for the stutterer to be happy.
Warm regards,
Ylva
Thank you for these important questions!
I would emphasize these points for speech-language pathologists when doing therapy with clients who stutter:
– Become familiar with many different therapeutic approaches – fluency shaping techniques, stuttering modification techniques, and psychological approaches (building self-confidence, reducing avoidances, etc.).
– Design a therapy protocol for each client individually that would best meet their needs; resist the urge to use a “one-size-fits-all” therapy program.
– Listen to the clients, learn from them, and respect their needs and wishes in designing this protocol – which should be based on an evaluation PLUS what the client has to say about their own perceived needs.
– Expect that there WILL be relapses now and then. Stuttering differs from many other speech/language disorders in that one cannot expect clients to show relatively steady progress upwards, even with excellent therapeutic skills and knowledge. Relapses are an entirely normal part of the process in stuttering therapy.
– Most importantly, the client CANNOT be blamed in any way for relapses. Too often, frustrated SLP’s tell their relapsed clients that what happened was the clients’ own fault, that they didn’t work hard enough, that they didn’t follow instructions properly, etc., etc. These types of comments from SLP’s are all too common, and it is the main reason why many people who stutter develop negative attitudes about SLP’s.
– Instead, the competent and caring SLP needs to have a deep understanding about relapses, and needs to know how to gently guide a PWS back on a track towards good progress.
– It is also important for an SLP to get to know people who stutter on a personal level. I would advise SLP’s and SLP students to attend national and international conferences of people who stutter, talk to people attending, and learn about their life experiences.
– I would also recommend joining online stuttering forums, to learn about what people who stutter are thinking, what they are feeling, and what their therapeutic experiences have been like.
Personally I have had a great deal of therapy for stuttering, with a variety of approaches. The best therapists were caring and compassionate, listened to my concerns, and were able to adjust their therapeutic approaches to meet my personal needs, taking my personal experiences into account. The worst therapists were quick to make facile excuses for relapses – that I wasn’t monitoring techniques correctly, that I wasn’t putting in enough practice time, etc., etc.
Remember – never blame the client for a relapse. Relapses are a part of a natural part of the therapeutic process – improvement will not be a straight line, but would be more similar to a zig-zag graph. Please be patient with clients!
Hi Annabelle
There are some things I wish SLPs would do.
1. Listen and ask questions. Don’t just listen to the stuttered syllables, but listen to the story. The background. The goals. The culture, religion, anything that makes the person the way s/he is. As stuttering is so much more than what comes out of the mouth. Also listen to the parents and maybe even a friend, a partner. If a PWS doesn’t feel heard or safe, s/he will not give you the information you need.
2. Think out of the book, or box. One size does NOT fit all. One client (or the parent) might want to be fluent. Tell them fluency might not be for all. That climbing the Mount Everest is too hard for most people. So to set up reachable goals. Maybe tools to get out of a block. Maybe working on acceptance and self-worth. Maybe by giving them the knowledge to learn more about stuttering and explain to others. Maybe by suggesting something else but speech therapy. F ex presentation techniques, yoga, a choir. Or all of the above!
By listening, asking questions and providing a smörgåsbord of things to try, TOGETHER you might find something that fits that very client to reach acchievable goals.
3. Show the way to meet others who stutter, like camps, meetings, chat groups (check out Penny’s paper on playing video games with other kids who stutter). But also group therapy to proof they are not alone and can support each other. Let him/meet other adults who stutter. Bring a friend into the therapy room and let them do homework together. But… add fun!! When it’s fun, it’s more likely to continue, and to open up. And when giving assignments, do them yourself too. Don’t give assignments you’re not willing to do. Also offer help to speak to the classroom, you or your client, or maybe someone from a local support group. To talk to the class and/or the teachers (but decide that together).
I recently was at a weekend where a group of PWS who stutter practice public speaking together. With the funniest assignments, that made us ROFL! I had a social studies teacher in school who literally jumped on the table to make a point. Don’t just be the therapist. Be the friend. 🙂
Keep them talking
Anita