In Search of Therapy Strategies
Hello, my name is Amber and I am currently a second year graduate student and full time SLPA. I currently provide services to 8 students who have stutters. I have done multiple activities that target educating my students on stuttering. However, this can only be targeted for so long before they get bored and start getting restless in therapy sessions…
They are all elementary aged boys who get distracted and lose interest quickly. I was just wondering if anyone had any ideas for therapeutic strategies or activities that can target fluency and keep the kiddos engaged as well? I am all about fun and seasonal “themed” activities! I want them to come to speech, have fun, but also learn at the same time. Any advice??
Hi Amber, 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. 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.
Here is where you can access Gerlach-Houck et al.’s 2022 article entitled, “Concealing Stuttering at School: ‘When You Can’t Fix It…the Only Alternative Is to Hide It’” (https://pubmed.ncbi.nlm.nih.gov/36327554/). I would also recommend Sisskin & Goldstein’s 2022 article entitled, “Avoidance Reduction Therapy for School-Age Children Who Stutter” (https://pubmed.ncbi.nlm.nih.gov/35697036/). You should be able to access both of these through your university’s research databases (if not, you can email the authors directly for a copy).
Hello Amber,
I agree once again with what Ana Paula has written. Focusing on fluency in working with a school-aged child rarely yields the desired results. It’s essential to understand what the child wants. By following their expectations and incorporating their ideas into therapy, significant progress can be achieved. However, it’s important for those in the child’s environment to be aware of what we truly aim to achieve. Educating teachers and parents about the goal of having the child speak as much as possible and not withdraw is crucial. Therefore, it’s worth educating children themselves about speaking and stuttering, and then educating others together with them. It’s worth considering whether peers – the child’s friends – also require such education. Pursuing these therapy goals provides much better prospects for the future. Above all, therapy should be enjoyable for the child. Therefore, attentive listening to what they want in therapy and collaborating to determine how to achieve it is crucial. Fluency doesn’t have to be the focus of therapy at all. A child who stutters should not feel broken or in need of fixing. On the contrary, therapy should focus on their strengths – developing communication skills is always an excellent goal.
With this topic in mind, I would suggest one more article written by Hope Gerlach-Houck and Chris Constantino. It is entitled: “Interrupting Ableism in Stuttering Therapy and Research: Practical Suggestions” (https://doi.org/10.1044/2021_PERSP-21-00109). By reading the paper you will also be provided with some suggestions on how to model empowering ways of talking about stuttering with children while avoiding ableism and stigmatization.
I hope I helped.
Warmly, Kasia