Group Therapy in the School System
Hello, my name is Kirsten and I am currently a second year student in a master’s program for speech language pathology. My current externship site is at a school system, and, unfortunately, they are currently low on SLP’s, therefore, large groups of kids are seen at once. I only have one child who presents with a stutter and therefore he is grouped with 3 or 4 other children who are not being seen for a stutter. The group is all early elementary, so, the other children in the group have a difficult time understanding why it is the one child stutters and the rest do not. Every once in a while, a hurtful comment is made. The comments don’t seem to affect the child with a stutter, but, I do feel as though I need to address the situation and am not sure how to do so. I would love any advice on how to address the differences in the needs for speech therapy in each child, especially when only one child with a stutter is present.
Hi Kirsten, I appreciate your question and the fact you are sensing that this grouping is not optimal. I would first recommend that you speak to your clinical supervisor about the situation, sharing your observations on why this group setting may not be the best fit for your student who stutters. If you are addressing the impacts the child is experiencing due to his stutter, it is likely that you won’t be able to work on those in a group setting if the other children don’t stutter. The affective (feelings/emotions) and cognitive (thoughts) aspects of stuttering which are beneath the surface (i.e., stuttering iceberg) generally require more than what could be accomplished in a group setting with children who are probably “drilling” or practicing “discrete skills” related to articulation, for example. Again, it may be important for you to chat with your clinical supervisor and brainstorm alternative options for this student. Hope this helps!
Hi Kirsten,
I believe your small group of three-four children will give you a chance to apply your skills and knowledge successfully. At the start, it is advisable to explain stuttering in a simple age-appropriate manner. Help the other children understand that stuttering is not the child’s fault; it’s okay to be different, and they can be supportive friends. However, in my experience, initially discussing your ideas with the child who stutters will create a trusting relationship. Ideally, your educational activities should be developed together with this child, so that he or she can act as an expert. For this purpose, you can refer to the InteACT – Attitude Change and Tolerance Program (created by Dr. Mary Weidner). By using puppet videos and coloring activity books that feature characters stuttering, you will be able to generate a discussion about the characters’ experiences and feelings, reinforcing acceptance and understanding. It will allow you to create a safe space for the group for openly discussing differences and similarities. Encourage them to share their thoughts, questions, and concerns; guide the discussion towards empathy and respect. Let the children know that it’s okay to ask questions if they’re curious about stuttering. Assure them that their questions help everyone learn and understand each other better. I would strongly suggest to arrange regular check-ins with the child who stutters to monitor feelings and concerns.
In any case, the difficult situations you have faced can bring positive consequences.
I am keeping my fingers crossed for you.
Kasia
PS. You can read more about the InterACT program in the article:
Weidner, M. E., St Louis, K. O., & Glover, H. L. (2018). Changing nonstuttering preschool children’s stuttering attitudes. American Journal of Speech-Language Pathology, 27(4), 1445–1457. https://doi.org/10.1044/2018_AJSLP-18-0019