Broad but Genuine Question from a Future Provider
My name is Candace and I am an SLP graduate student, and I understand that this may be a broad and loaded question, but what are some core concepts that you want future providers to understand while working with individuals who stutter?
Thank you for the question.
I would say that it is helpful to realise that each individual is different. Hence, the stuttering is different, as is the theme of this year’s ISAD – different shades of stuttering.
It is also helpful to know how is the home-environment of your client- espcially if they are kids or teens,as it affects how they perceive and learn from the therapy. If the home environemnt is not supportive, eg- they do not agree with the therapy, or they want their kid to get therapy but hide it in front of everyone (meaning shame is associated with the therpay),or are the parents quite helpful and 100% support the kid at home! It will impact on how the cleint takes the therapy, and if gets benefitted at all.
Hi, Candace. And thank you for this important question!
Here is what I call the Number One Principle in stuttering therapy – Every person who stutters presents a different type of case. No particular type of treatment helps all who stutter. I can summarize this with a statement: NO SIZE FITS ALL.
Too often, clinics and clinicians rely on only one particular method of treatment, and they believe that their particular method is the best, and that it would be effective for anyone who stutters. This is a fallacy.
Such a belief makes things easier on the clinicians – they don’t have to bother learning more than one method of stuttering treatment. But this is not to the advantage of the client. And sadly, too often, the clients are blamed if they don’t “succeed” with that particular method.
There are many different approaches possible in the treatment of stuttering, though none constitutes a “cure”.
Fluency shaping is one such method – training clients in particular techniques to help enhance fluency. These can include relaxed diaphragmatic breathing, gentle onsets of sounds, prolongation of sounds, and slowed rate, to name a few examples. Another approach is often called stuttering modification. This includes teaching ways of stuttering without vocal tension or secondary symptoms, and includes reduction of avoidance (of situations, or of sounds/words if this is a factor).
And then there is the newest movement in stuttering therapy – self-acceptance, sometimes called a stutter-affirming therapy. This approach emphasizes building self-confidence, and the full acceptance of oneself as a person who happens to have a difference of speech. The client is taught methods of coping with life’s challenges, and enjoying one’s life, as a person who just happens to have a difference in speaking (similar to a difference in accent or dialect).
Still other treatment approaches combine aspects from various methods listed above.
An experienced speech clinician needs to be familiar with all these, and together with the client, needs to determine which approach to try in each individual case. And if the chosen method seems not to be too helpful to the client, then another approach needs to be tried. Perhaps a combination of approaches may be best if it is not clear which method would be most suitable in a particular case.
But always, please remember: NO SIZE FITS ALL.
Good luck in your career!
– Paul