 About the author: My name is Derek Taylor at 32 years of age I am a father of an eight year old son and a person who stutters. I graduated from Western Carolina University in 2013 as a speech-language pathologist. I live in Asheville North Carolina and have a passion for helping people who stutter. This story is about people who stutter helping each other and how it has led me to where I am.Email: drtaylor4@catamount.wcu.edu |
Stuttering is a mystery. Throughout history, many people have stuttered and many people have attempted to explain what it is and fix it. Speech therapy is a young profession, arising in the early 20th century. Since then, speech therapists have studied stuttering and developed various methods to treat it. Many of the pioneers in stuttering were themselves, people who stuttered.
What works well for one individual, might not work for another. Today, there are a few schools of thought in stuttering treatment: fluency shaping, stuttering modification, integrated treatment and individualized treatment. Fluency shaping focuses solely on the behaviors of stuttering and uses conditioning to improve speech. Stuttering modification focuses on the behaviors of stuttering and the psychological aspects associated with it. There is integrated treatment that uses fluency shaping and stuttering modification, and treatment individualized to each client’s strengths and needs. Professionals in the field of stuttering continue to disagree about which approach to treatment is better for clients depending on their age, severity, level of awareness and other factors.
Maybe you are asking yourself, how this relates to people who stutter helping each other. Well, I am a person who stutters (PWS) and a speech therapist. I became a speech therapist to help people who stutter. Many children who stutter receive speech therapy in school. The majority of speech therapists in schools do not stutter nor have ever stuttered. Stuttering is not a prerequisite for a speech therapist to treat a PWS; but I am biased and believe people who stutter may be some of the best speech therapists to help a PWS. Let me tell you part of the story that has led me to where I am.
I suddenly began stuttering in the third grade. Prior to this, I never had any difficulties with my speech. I began speech therapy in a public school. For three years, I went to speech therapy to work on things like “turtle talk” (slow speech) and was told to think about what I wanted to say before I said it; practicing predominantly fluency shaping techniques. My speech may have slightly improved in the therapy room, but I could not answer questions aloud in class, nor talk to my friends or my family. I became frustrated and quit going to speech therapy. Later in middle and high school, I went to speech therapy off and on. When my speech was horrible, I went to speech therapy, then later, I would stop going and deal with the stuttering on my own. This cycle repeated, until I was in the eleventh grade.
I especially remember one occasion. My US history class began with public speaking assignments. Students were required to speak aloud, taking turns according to seating arrangements. The first assignment was to say the Pledge of Allegiance and I practiced saying it aloud all night before. (It was not as if I had to memorize it; I had said it every day at school for years.) I remember sitting in class waiting for my turn, feeling like there were snakes in my stomach. When my time came, I stood and blocked, mouth open, then finally I uttered “I…I…I…p… p…p…ple…pledge…al..allegiance.. t…t..to… the …the..fl…fl..flag…of…of..the..the..uni…uni..ted…states of..of…of America”. By this time, most students in the class were staring at me and I was sweating. Someone laughed and I ran out of the room, and slammed the door. I cannot remember exactly where I went, I guess to the office, because that was where I expected they were going to send me anyway. I was used to being sent to the office after being in a fight, explaining to the principal that I only punched the person because he was making fun of me.
In high school, I played football and I remember waiting for practice all day so I could knock the shit out of someone on the field. I relieved my daily aggressions on the field and I excelled in football. I started on the varsity team as a sophomore; but regardless of my athletic ability, I could not talk when I wanted to. So, as a result of walking out of history class and not going back for the next few days, my teacher pulled test scores and arranged a meeting with my parents and me. My teacher did not understand how a person with good test scores was thinking about dropping out of high school. This was when I decided to try speech therapy again.
It turns out the speech therapist was nice, and became my friend. She let me talk about whatever I wanted to during therapy. This was the first time that a speech therapist was interested in how stuttering affected me. It seemed that she was trying to learn more about stuttering. She helped me figure out ways to address my stuttering so it would not affect my grades. She introduced me to two other guys in high school who stuttered. We had group therapy during which we talked about all types of things and practiced techniques to improve our speech and she had a man who stuttered come and talk to us. I was enjoying speech therapy for the first time ever. However, stuttering was persistent. I felt better about my stuttering, but was unable to speak freely. Then one day during our session, she said told me that she did not think there was anything else she could do for me and recommended that I should go to Western Carolina University (WCU) to meet her fluency professor. She told me that her professor was a PWS and he might be able to help me further.
My parents drove me to WCU to meet this professor. This meeting was monumental. I met a PWS who learned how to speak freely. I remember thinking, “there was a way to tame the beast”. Hope, inspiration and faith found their way into my vision. Stuttering appeared to me to be conquerable for the first time. The graduate student I was working with was pretty and sweet. The professor was truly empathic, compassionate, wise and willing to listen. I drove for an hour and went to WCU for weekly therapy during the summer. I remember practicing fluency shaping and stuttering modification techniques in therapy. I cannot recall the details of treatment precisely. The professor had just published the first edition of his text on stuttering intervention that year. He gave me a copy of the book when our therapy sessions came to an end. I believed that within this book, there was the answer to my riddle and the mystery of stuttering. I thought that, if he learned to speak freely, I could too, and this book would teach me how. It was not an overnight miracle, but it was magic! As I learned about stuttering, I became empowered to fight for my freedom to speak.
Over the next years, my speech drastically improved. I made it through six years of college, graduated with a degree in English, minoring in philosophy and religion, and fell in love with poetry. I would read poetry at open mics. I was in relationships with girls. I saw the birth of my son. I worked hard doing everything from waiting tables, running a printing press and plumbing, to surveying. When laid off from surveying, I reconsidered my life’s path. I chose to go to school to become a speech therapist. I called on the professor I had met many years earlier to discuss the idea. He encouraged me to pursue this path and he has supported me the entire way. A PWS, helping a PWS, that is what this professor has done for me: first as a human being, then as a clinician, then as a professor/mentor, and now as a colleague and friend.
We people who stutter are one in a tribe who owe it to each other to help one another. I am humbled to dedicate my life’s work to helping people who stutter. I have seen firsthand the accomplishments that are possible with dedication, determination and hard work. I have read numerous books written by professionals in the field of stuttering, who are themselves people who stutter and believe that for these people there is more to speech therapy than having a job to pay the bills. Stuttering can become a passion and reason for living.
I went on to graduate from WCU with an undergraduate degree in communication sciences and disorders and began their graduate school program the next year. My fluency class at WCU was the first class to use this professor’s 2nd edition of that stuttering intervention book, I had seen some ten years prior. I presented a poster on individualizing stuttering intervention with a school-age child at the American Speech and Hearing Association (ASHA) conference in 2012 with my clinician/professor/mentor/colleague/friend. Today my speech is mostly fluent, thankfully I still sometimes involuntary stutter. I was working with a middle school student this past year and told her, “I stutter” and she did not believe me. I faked stuttered during our sessions and by the end of the session and for the rest of the day, I found myself really stuttering.
Sometimes people need to learn to quiet fighting themselves and each other. My fellow people who stutter, sisters and brothers, no one is alone. There are people searching for you as hard as you are searching for them and the key is that we all can learn from each other. Wisdom, sympathy, experience, creativity and compassion are some of the qualities of people who stutter. So, be proud, talk freely (loud), know thyself, and be heard so others will get to know you and what you have to say. I hope one day as a PWS that I can help other PWS the way one PWS has helped me. If I can be of any help to you please let me know! I wish each of you the best of success on your journeys.
Ask yourself the following questions. If you’re comfortable to do so, share them in the discussion for this paper:
- Have you ever worked with a speech therapist that has or does stutter?
- Do you think that speech therapist who do or have stutter can offer something in therapy that other speech therapist cannot, if so, what?
- How do you feel about the different types of stuttering treatment (fluency shaping, stuttering modification, integrated treatment and individualized treatment); what types of treatment you have you received?
- What do you think about speech therapy in the schools?
Derek: sincere thanks for openly sharing your story and passion. You’re helping just by sharing!
Dan,
Thank you for reading. I know you may be one of the exceptions (someone who does not stutter, but has the capability to understand where a client is coming from and has the compassion to really want to help). I know you will help your clients who stutter- they are lucky to have you as a therapist. I hope we have the opportunity to work together n the future.
Derek
I hope we can too!!
Hello Derek,
My name is Melissa and I’m currently a first year graduate student at Western Carolina University in Cullowhee, North Carolina, USA. (Go CATS!)
I thoroughly enjoyed reading your story and have some questions regarding your biased belief that “people who stutter may be some of the best speech therapists to help a PWS.” I would agree that having personally experienced disfluency would aid in assisting those who currently stutter due to the ability for the clinician to relate to the client, however I do not agree that that particular quality of a therapist would necessarily make them a better speech language pathologist with a focus in fluency disorders and stuttering. Because our field is becoming so heavily influenced by evidence-based practice, I was interested in knowing if there is any research that facilitates your view?
Thank you for your time. I look forward to hearing from you soon.
Respectfully,
Melissa Blackstone
Melissa,
Thank you for reading my paper. You should currently be in your fluency disorders class at WCU I suppose. Maybe you have not got to the point in the course where the client-clinician relationship is emphasized as being a critical part of successful therapy. Yes, I am biased but I believe and no conundrum of evidence based practice will change my mind. Live it, then talk about it, then you can tell me what you know. Otherwise, you only offer what you have been told. Let me give you some EBP literature that supports what I am saying (not that you really need it- you are using on of the best text in your field in your class): but here is part of what another reader of my paper suggest: “I do think a clinicians’ competence is most important, since this has been found to correlate with clients’ satisfaction with treatment (Cooper, 1998). I think that an SLP who is also a PWS could provide better counseling because people confide more easily about sensitive experiences to those who have had similar ones. Plexico, et al. (2005) describes that in their case study, each participant discussed a variety of support groups that “provided them with the chance to connect with others who stuttered” and some also described mentors who knew about “the nature of stuttering”. This said, I believe that stuttering modification therapy from an experienced SLP (who is not a PWS) along with concurrent support groups (with people who are PWS) could possibly be just as successful in assisting a PWS in successfully managing their stuttering. This is echoed by Yaruss, et al. (2002), in a survey of 71 NSA members, many respondents reported fluency shaping was beneficial, but more indicated they achieved benefit from stuttering modification techniques and from “meeting other people who stutter.” Overall, both SLPs and meeting PWS appear to me both vital in successful stuttering management, and one would be twice as fortunate (if not more) to have both combined in one”. I encourage you to look back to the pioneers of stuttering treatment: Wendell Johnson, Malcolm Fraser, Joseph Sheehan, Charles Van Riper etc. to thoroughly understand where stuttering treatment has came from in relation to where it is at today. If you are in the fluency class at WCU, have you ever had a more passionate professor?
Derek
Hello Derek!
Enjoyed reading your paper!
Your questions at the end of your article were thought provoking to me as a person who stutters. I appreciate the opportunity to share that you provide!
As a person who stutters, here is my personal take on each question:
1. Nope – Never did I have therapy with a professional who was a person who stuttered.
2. Yup – I do. That being said, here is a quote offered by Walt Manning re: choosing a clinician: “If I had to select only one quality of a good clinician it would be the thorough understanding of the stuttering experience by the clinician. Two people who have taken a similar journey are more likely to be connected because of a shared understanding of the experience. Whether or not the clinician has a history of stuttering, he or she should understand the breadth and depth of the experience of stuttering.” I believe this is a truth.
3. All of the therapy I received as a child from the age of 4 through the age of 17 (Domain Delacato, Fluency Shaping/Training,Stuttering Modification, Hybrid of FT/SM, DAF therapy, Drug therapy) increased the severity of my stuttering to the point where the ultimate stuttering behavior – CHOSEN SILENCE – was what I did. All of these therapies severely hurt my development as a human being mentally, emotionally and physically. All of the therapies led to extreme levels of the fear of stuttering, the fear of talking and the fear of interacting with others. On a scale of 1 – 10, the suck levels of these therapies for me was about 100+!
4. This is a loaded question you ask, and here is my response: ASHA does not require even one course or one practicum experience in the area of fluency disorders for a CCC’d person to be allowed to give “therapy” to a child who stutters. Because of the current state of ASHA — to me – chances of finding effective therapy in the public schools is, ah, well, um, well, ah — kinda slim to none. I urge all parents to search for a BRS-FD professional in regards to hopefully finding effective therapy for a school-age child who stutters.
Derek – Thanks! I appreciate the opportunity you have given me to respond.
Enjoy the journey you have undertaken!
Retz
Retz,
Thank you for reading my paper! I’m glad to hear we agree about many things related to stuttering therapy as a PWS. I have really enjoyed the book you have sent me. I have been very busy this past week. I have worked a notice a Neo Burrito and started a SLP job at Carolina Ped Therapy here in Asheville. I can hear the passion and enthusiasm in your writing. I hope after many years practicing speech therapy I feel the same way. I would like to Skype again in the future. I will be in touch.
Derek
Hi Derek – thank you for sharing your story. I am the mother of a 17-year old who stutters and author of “Voice Unearthed: Hope, Help, and a Wake-Up Call for the Parents of Children Who Stutter.” I also authored “The Right Time to Break Out the Stickers” for this conference. I will answer your questions to the best of my ability…
Have you ever worked with a speech therapist that has or does stutter?
yes.
Do you think that speech therapist who do or have stutter can offer something in therapy that other speech therapist cannot, if so, what?
I think every speech therapist brings something unique to the table – my guess is that both therapists who stutter and those who don’t can be effective and not be effective. How’s that for vague?
How do you feel about the different types of stuttering treatment (fluency shaping, stuttering modification, integrated treatment and individualized treatment); what types of treatment you have you received?
My book is all about this question as it relates to school-aged children. Our son received fs and sm and integrated therapy and he went from mild to moderate to severe to mostly silent by the time he was nine. After six years of research and reflection I came to the conclusion that asking a child to change the way they talk in order to not stutter or stutter less is developmentally inappropriate and comes with great risks — withdrawal and silence. For our son, the withdrawal and silence was a far greater handicap than the stuttering behavior. I believe that parents and speech therapists have the right to fully understand the risks and to be able to access more appropriate and less risky options.
What do you think about speech therapy in the schools?
School-based speech therapists are in a tough place. I have heard from at least 50 since my book was published in 2011, and many feel at a loss when it comes to supporting these kids. I have talked to teachers, school psychologists, and school-based therapists and come to realize that the school-setting is so dependent on the exact environment that can be the most difficult for a child who stutters. A great deal of the assessment is dependent on verbal response. The child is in an environment daily (hourly!)where they are expected to talk under pressure and in front of groups, while continually being judged. wowser…
I frequently hear that children who saw school-based therapists felt most supported by a therapist who encouraged them to talk about whatever interested them and was a great listener and friend. Kudos to those therapists!!
I hope this is helpful- thanks again for sharing your story and posting these great questions.
best,
Dori Lenz Holte
Dori,
Thank you for the response to my paper. I was sent your book “Voice Unearthed: Hope, Help, and a Wake-Up Call for the Parents of Children Who Stutter” by a fellow SLP and PWS. I have not had the chance to read it yet, but am looking forward to hearing what you have to say. In no way should speech therapy for PWS lead to a child’s silence. I agree that allowing a child who stutters to talk is more important that working on decreasing stuttering. The school environment is tough, I remember. In time I feel each PWS comes to his/her own realization about how to effectively communicate. If you would maybe send me an email drtaylor4@catamount.wcu.edu and we can discuss your book at some time. I wish your son the best!
I would love to connect to discuss “Voice Unearthed.” Hopefully you’ll find a parent’s perspective useful in your work. I’ll pass your good wishes on to Eli…
Best,
Dori Lenz Holte
Hello Derek,
I am a graduate student at San Jose State University in California, and I am intrigued by your paper. I am not a PWS, but I did go to speech therapy as a child for articulation and have a son of my own, who is six years old, and so I can relate in several ways. I would like to share my thoughts on your second question: Do you think that SLPs that are also PWS can offer something in therapy that other SLPs cannot, if so, what? I want to first share my opinion, relate it with some literature I’ve researched, and then ask you a few questions.
I do think that an SLP who is also a PWS can offer more than a regular SLP. I think an SLP that is also a PWS would be able to relate to their client more, which could allow them to provide more appropriate counseling and treatment. However, I do think a clinicians’ competence is most important, since this has been found to correlate with clients’ satisfaction with treatment (Cooper, 1998). I think that an SLP who is also a PWS could provide better counseling because people confide more easily about sensitive experiences to those who have had similar ones. Plexico, et al. (2005) describes that in their case study, each participant discussed a variety of support groups that “provided them with the chance to connect with others who stuttered” and some also described mentors who knew about “the nature of stuttering”. This said, I believe that stuttering modification therapy from an experienced SLP (who is not a PWS) along with concurrent support groups (with people who are PWS) could possibly be just as successful in assisting a PWS in successfully managing their stuttering. This is echoed by Yaruss, et al. (2002), in a survey of 71 NSA members, many respondents reported fluency shaping was beneficial, but more indicated they achieved benefit from stuttering modification techniques and from “meeting other people who stutter.” Overall, both SLPs and meeting PWS appear to me both vital in successful stuttering management, and one would be twice as fortunate (if not more) to have both combined in one.
Considering what I have presented, do you think there is additional benefit that an SLP who is also an PWS can offer, that can’t be gained through receiving services from an SLP combined with a support group? I am also curious if you would consider the professor you mentioned as your mentor, or if you had a mentor? I am inspired after reading your paper, and doing this research, to wonder what the correlation may exist between individuals managing their stuttering and their interactions with others who already successfully manage their stuttering. I want to lastly thank you for writing your paper and sharing with everyone your experiences, and for further inviting this discussion.
Best regards,
Scott Erickson
Scott, Thank you for the thoughtful comments. It is interesting that you do not think an SLP who is a PWS can offer better treatment that an SLP who does not stutter; but then you do say that a SLP who is a PWS may be able to offer better counseling than an other SLP. PWS for many years often develop psychological and emotional reactions to their stuttering, therefore counseling is a critical part of successful treatment with these clients. In additional it is odd that you support stuttering modification and neglect to mention any SLP who is also a PWS that pioneered or supports stuttering modification: people like Charles Van Riper and Berry Guitar. I support stuttering modification techniques with some clients and feel like it is necessary to understand the origin of such methodology before practicing it. You say it is important for a client to have an SLP and meet with people who stutter in treatment. Well, I agree I just feel that those strengths can be held by the same person- a SLP who is a PWS. I do think it is important to the client to meet all different types of PWS if possible, no two PWS will share the same experiences. Where I grew up (rural mountains) I was lucky to know one other person who stuttered. So realistically speaking why not have the best of both worlds available to you a SLP who is also a PWS. Yes the professor I mention in the paper I do consider my mentor. Thank you again for your comments. I encourage you to dig a little deeper into the history of stuttering treatment and stuttering modification to better understand it’s origins.
Derek
Great paper Derek and story. I also do not think that a PWS SLP would be any better than a SLP who does not stutter. They of course would have more understanding though about the emotions, fears and feelings revolving around stuttering. I once had an arguement with a PWS at a conference who was very anti-open stuttering, or not working on it. He was dead against an SLP openly stuttering or showing any degree of acceptance. His comparison was “Would you get your car fixed by a mechanic who cannot fix his own car?” What is your opinion on this?
Grant,
Thanks of reading the paper. We each are entitled to an opinion. I assume you are not a PWS, so may take defense to my beliefs. I thinks that the person you mention how did not want to stutter openly or work on his stuttering was in a horrible situation. I can remember feeling the same way as a child, but the suffering of that circumstance inspired me to move on and face my fear. After years of unsuccessful treatment it can be very hard to a PWS to accept stuttering and have faith in stuttering treatment. If SLP who do not stutter are as successful treating stuttering as SLP who are PWS, why then do so many school-age children who stutter continue to do so into adulthood and end up not able to accept their stuttering or want to continue therapy and choose silence instead of being able to effectively communicate? If my car needed repair I would rather take it to a mechanic who learned how to fix his car himself from trial and error that a mechanic who was trained at a fancy school an never really got his hands dirty because he always had someone looking over his shoulder telling him what exactly to do. PWS are like cars: all are different. A self taught mechanic knows the parts of a car and the different ways they can be built and put together. A trained mechanic looks to a manual to understand the complexity of what he is working on. In stuttering therapy we have yet to create manuals for all the different type of people who stutter. However, I feel that like the self taught mechanic: a SLP who is a PWS has a better understanding to all the parts and combinations of stuttering treatment and a better chance of individualizing treatment to meets each clients needs.
Derek
Thanks for the reply Derek. Interesting views. No, I am a proud over PWS 🙂 . I am from Australia and we do not have a large culture of acceptance in terms of stuttering openly or not even choosing to work on it at all
Hi Derek,
I am a second year graduate student at LIU Brooklyn, NY for speech pathology and I am currently taking a fluency class which has made me realize the stuttering population is what I would like to work with. My best friend stutters and I have been supporting him for many years hence my interest in stuttering. First off I would like to thank you for being so real and true in your story. You truly have had an awesome experience and I loved the way you expressed yourself. My favorite line from your story was, “So, be proud, talk freely (loud), know thyself, and be heard so others will get to know you and what you have to say”.
Question I have for you is, has stuttering ever affected your relationship with anyone, such as family, friends, girlfriends, etc? You mentioned “Stuttering can become a passion and reason for living” is that what it has became for you ultimately? Also, what was the event that happening to inspire you to become a speech therapist when you started reconsidering your life’s path?
Best,
Elina
Elina,
Thank you for reading the paper. It sounds like your friends is lucky to have someone as yourself offering support. When I was a child my stuttering definitely affected my relationships. I would get in fights on the playground because kids would make fun of me. I never could talk to girls because I was scared of stuttering. I could not talk openly to my family because of stuttering. I learned to keep to myself. I didn’t trust many people. When I did finally start talking to girls and having girl friends, I realize now that I would hold on to them for dear life. When I finally found a girl who accepted my stuttering I felt safe and would keep them as long as possible and believe it was “true love”. I regret this behavior now, as I have spent the majority of my life living in a fairy tail world that never truly existed- except in my mind. I am now 32 and just now realizing what I should have known in high school. I do feel that being a PWS has made me more sensitive to other peoples hardships and suffering. I am grateful for this. That may the element that inspired me to become a SLP. I really want to try to help improve other peoples quality of life, especially related to communicating. I remember as a child in school going to speech therapy (where I was supposed to get help) and feeling like no one knew what I was going through or much less how to help me. I want to give kids today a different option, other than what I had growing up.
Derek
Hi Derek,
Thanks for sharing your experiences, and congratulations on your achievements! As a former special education teacher for emotionally disturbed young people and an SLP grad student, I am curious about a couple points you bring up.
First, as you pursued your education did you feel supported in your program? What do you think schools should be doing to attract more PWS into this field?
Also, when you said you are just now beginning to realize things you should have known in high school about relationships, do you feel this is common for many PWS? If we, as therapists are seeing poor social development in our students as a result of their diagnosis, what are some ways we can help our kiddos?
Hi Derek,
Thanks for sharing your experiences, and congratulations on your achievements! As a former special education teacher for emotionally disturbed young people and an SLP grad student, I am curious about a couple points you bring up.
First, as you pursued your education did you feel supported in your program? What do you think schools should be doing to attract more PWS into this field?
Also, when you said you are just now beginning to realize things you should have known in high school about relationships, do you feel this is common for many PWS? If we, as therapists are seeing poor social development in our students as a result of their diagnosis, what are some ways we can help our kiddos?
Thanks! Kim
Hi Derek,
Here are my responses.
1) Have you ever worked with a speech therapist who has or does stutters?
I have met one speech therapist who stutters.
2) Do you think speech therapists who do or have stuttered can offer something in therapy that other speech therapists cannot, if so, what? I had a stroke at birth. I decided to become a speech pathologist to help people who have experienced neurological damage. Although natural skills (such as flexibility, creativity, etc.) are essential, I feel I can provide my clients with support and understanding because I have been through a similar situation. However, the “common factors” in treatment responsiveness indicate that only 30% is attributed to the therapeutic relationship (e.g. the clinician’s and client’s characteristics that result in progress). These characteristics involve shared goals/expectations, agreeing on therapy techniques that are utilized, and the emotional connection between the clinician and client) (Bordin, 1979). Therapy techniques account for 15%, extratherapeutic change (e.g. client and his environment) accounts for 40% and expectancy (hope that treatment will be successful) accounts for 15%. (Asay & Lambert, 1999; Bernstein Ratner, 2005; Bordin, 1979; Franken, Kielstra-Van der Schalk & Boelens, 2005; Lambert & Bergin, 1994). In other words, I believe personal experience is helpful but may not always result in a better clinician. One question I have is how many speech therapists enter the profession because they have a speech or language disorder?
3) How do you feel about the different types of stuttering treatment? I am glad there are various treatment options to meet the specific needs of each person. Both fluency shaping and stuttering modification have yielded improvements in PWS and are evidence-based therapies. However, both treatments have different ways to approach stuttering (e.g. stuttering modification helps people stutter more fluently, whereas fluency shaping aims to decrease or get rid of stuttering moments) (Prins & Ingham, 2009).
4) What do you think about speech therapy in schools? My experiences in the schools are limited; however, my colleagues have explained that there are few speech therapists who feel comfortable treating children with fluency disorders.
Wendy
References:
Asay, T. P. & Lambert, M. J. (1999). The empirical case for the common factors in therapy. In
M. A. Hubble, B. L. Duncan, & S. D. Miller (Eds.), The heart and soul of change: What works in therapy (pp. 23-25). Washington, DC, American Psychological Association.
Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working
alliance. Psychotherapy: Theory, Research, and Practice, 16, 252-260.
Bernstein Ratner, N. (2005). Evidence-based practice in stuttering: Some questions to
consider. Journal of Fluency Disorders, 30, 163-188.
Franken, M., Kielstra-Van der Schalk, C., & Boelens, H. (2005). Experimental treatment of
stuttering: A preliminary study. Journal of Fluency Disorders, 30(3), 189-199.
Lambert, M. J., & Bergin, A. E. (1994). The effectiveness of psychotherapy. In M. J. Lambert
s(Ed.), Handbook of psychotherapy and behavior change, (4th ed., pp. 143-
189). New York, Wiley.
Prins, D., & Ingham, R. J. (2009). Evidence based treatment and stuttering – Historical
perspective. Journal of Speech, Language and Hearing Research, 52, 254-263
Wendy,
Thank you for the technical evidenced based response to the questions. I admire that you have chosen to try to help others that may be where you have been. That is exactly what I am doing. I do not need evidenced based literature to do that, however there are many professionals in the field of stuttering who are PWS who conducted research to support their methodology. People like Malcolm Fraser, Charles Van Riper, Berry Guitar, Walter Manning, etc. I encourage you to remember why you are doing what you are doing and to learn everything you can to best treat your clients. why do you think SLP in the schools feel uncomfortable treating children who stutter?
Derek
Some of the comments/responses to your question regarding treatment and how they ultimately reacted to an array of treatments are giving me anxiety. Silence, withdrawal, and finally hating speech therapy are sentiments that I also found in a forum for deaf and hard of hearing people. And whenever I reach this point of unease, I like to think back to one of the most profound stories I’ve heard from one of my undergraduate professors. She was not a PWS but she told her students about one person who did not see his stutter as a disorder or anything remotely negative, it was just apart of him. He didn’t have a problem with it, WE did, it was everyone else’s problem and not his.
Of course, this is not everyone’s view but what I liked most about it is that it made my professor take a step back as a clinician. I learned that the therapist does not always hold the solution.
Tangina,
Yes- stuttering is first defined by the ears a critical listeners, then as the child/person begins to believe that she/he is hearing from these people she/he begins to believe that she/he is actually stuttering. It is a type if manifest destiny to become a PWS. Our society is not open to accepting what is unordinary. Last year on the ISAD online conference I interacted with a PWS who moved to Norway with his new wife and he said that once in Norway his stuttering declined to a point that it did not bother him, because the people he was around in Norway did not treat him different because of his stuttering. My fluency professor emphasizes “seeing through the eye’s of each client”. I think that is what you professor is getting at. It is not always in the best interest of our client’s to “fix” her/his stuttering, sometimes it may be more important just to listen and let her/him talk. Thank you for attempting to see stuttering on a deeper level!!!
Derek
Simply a great positive paper.
Everything in your paper I agree with and I feel that it is indeed such an important issue that we come together and can show empathy, support and positivity for others that may not have gotten to the ‘good place’ that we may be in.
Support groups, group therapy and conferences are a good place to start.
I am sure you will continue to help many people in your role as an SLP but also as a person who stammers.
Mandy Taylor
Mandy,
Thank you dearly for the kind words. I am guessing you are in the U.K.? This conference is supposed to be about people who stutter helping each other and I think we agree on this topic. I have been criticized by many student SLPs who are people who do not stutter for saying that SLP who are PWS are better equipped to treat stuttering than SLPs who do not stutter. I am afraid I have put many of these types of people on defense. I am not saying that all SLPs who are not PWS can not offer successful treatment. Are you a PWS and what are you thoughts on this topic?
Derek
Hello Derek,
I greatly enjoyed reading your paper and your journey to becoming an SLP. It sounds like your SLP in high school was an excellent clinician. She understood that there was more to stuttering than was just on the surface and formed a mini-support group for other students who stuttered.
In response to your questions:
1. I am currently a in my first year of grad school to become an SLP and am currently taking a fluency class. On the first night of class the professor had two guest speakers who stutter come in and talk to the class. One was an SLP and the other was a teenage boy. It was great to be able to hear their experiences. Before that night it hadn’t occurred to me that there were SLPs who stutter and that they would be the best to work with a PWS.
2. I do think SLPs who stutter have more to offer to PWS, than those who don’t. Yes, I understand that clinicians can form excellent relationships with their clients, but I think that the common issue of stuttering provides so much more to the relationship. You always feel better getting help and advice from someone who has been in your shoes.
3. I’m still in the process of learning about the different types of stuttering treatment.
4. I don’t have much experience with speech therapy in schools, but I have observed a few sessions and understand how it is run. I think speech therapy in schools can be tricky at times because some kids who are having difficulties don’t always qualify for services in the schools. I also think think that some kids need more help than what can be offered in the schools. But, at the same time, it is just what many kids need.
-Jamie
Graduate Student
Jamie,
Thank you for responding to my paper! I wish you the best of luck in grad school. Sometimes seeing is believing, I’m glad you had the chance to meet a SLP who is a PWS and and PWS in your class. I learned in graduate school that the most important part of stuttering therapy is to individualize Tx based on each client’s strengths and needs. Too often therapy focuses on the disfluencies and negative aspects of stuttering. I encourage to to focus on your client’s strengths (point out the fluency that already exist and build on that. I have often thought of stuttering therapy as a “snowball effect”, if you focus on the negative more negativity accumulates, if you focus on the positive more positivity accumulates. Once PWS develop secondary behaviors related to stuttering and have stuttered for years, there may be many psychological and emotional aspects related to stuttering that need to be addressed in therapy. Good Luck!
I really enjoyed this paper; it put things in perspective for me an I glad that you became an SLP and enjoy it.
1 and 2. I am a person who stutters and have worked with and SLP who stutters for about 2 years and they can provide everything I need to be successful plus more. They have a stronger connection on the emotional mindset side of things. They aren’t just a speech therapist, but more of a person I can look up to and go to for help.
3. I do not have anything against the variety of ways of treating stuttering, given that I am not ad SLP and do not have the knowledge to answer this to the level that I would like to. I have worked with a few of these techniques and have found more success in some than in others. My bias is purely based off of what I have been taught and what has worked well.
4. I have not had the best experience with school speech therapy, and I know that some of my peers who stutter can say the same. I feel that private therapy is much more effective since it is more personalized. I recently started working with Daniel Bower (I heard you know him from WCU) and it has been much more worthwhile than past school therapy. He and my private SLP have been communicating, unlike in the past, and everything is going very well.
I can relate to your story and I learned a new insight on the topic. Thanks for sharing!
-David Roney
David,
Thank you for reading my paper! It is nice to hear from you. It sounds like you are find the right people to help you. I wish you the best of luck, you WILL succeed!!! I know Dan, he is a great guy! Him and I worked together at WCU on a couple different stuttering research project. One thing he was interested in was emotional intelligence (EI), this is way of thinking that really allows one to connect with other on many levels, even if they have not been in there shoes. You are lucky to have Dan has your school therapist. If you ever want to talk to me about therapy or anything at all, ask Dan for my number- he has it. Give Dan a hard time for me, push him as hard or harder than he pushes you. It really takes two (maybe in your case three) to make the most of therapy. Never let stuttering stop you from pursuing your dreams! People who stutter are one in a tribe of those who understand how to have compassion for the things in life. Best of luck!
Derek
Derek,
Thank you so much for sharing your honest and poignant, but still uplifting story. I am not a PWS but somewhat like yourself, I am a graduate SLP student who has entered the field after spending some time trying to find a career I have a real passion for. After college I spent 4 years serving in the Army and completed two combat deployments to Iraq. I entered this field because I hope to one day work with Veterans with Traumatic Brain Injuries. Like you, I 100% believe that Veterans are as you described PWS to be, “a tribe who owe it to each other to help one another.” I also believe that with our passion for people just like ourselves, we can accomplish anything with hard work and determination. This is what I truly believe makes our field so terrific; TBI and Stuttering are on opposite ends of the speech spectrum and yet as therapists, we’re not all that different at all. We want to help people who remind us of ourselves and that is how we become experts in our our chosen specialty. I am so glad that in the face of adversity you were able to find a purpose and a passion in your life.
Additionally, I was so happy to hear that your personal speech therapy breakthrough occurred because your high school therapist focused therapy on how stuttering affected you. With the large caseloads we have and the demands for progress placed on us by various parties, it is easy to see how the feelings of a person who stutters, or any patient can be ignored. As with any disorder in our field, we have to be vigilant about putting the needs of our clients first. Their fears, concerns, strengths, and goals. I believe, as was evident in your story, that is where the breakthroughs will occur.
I do wonder, Derek, would you be able to say that your breakthrough as a young adult occurred as a result of your relationship with your stuttering mentor, self-acceptance of your own stuttering, finally being “heard” by your high school therapist, or would you attribute it to something else?
Thank you again for sharing your story!
Theresa
Derek – great contribution to the conference. Thanks for sharing. I understand why some non-stuttering SLPs and students would be a bit defensive when someone concludes that a person who stutters is better equipped to help a stutterer. It definitely brings up some controversy!
I have stuttered since around age 5 and I’m in my late 40’s now, and still stutter, probably more now than I ever did, because I’m no loner trying to hide the fact that I stutter, which I did for many years (out of shame.)
It sounds like you’re embarking on a great journey with your chosen career.
As for your questions:
1.Have you ever worked with a speech therapist that has or does stutter?
Yes, briefly – while I was attending a college clinic for therapy. I attended for 2 years, about 6 years ago. The person who stutters was the clinical supervisor, and sometimes would come into my sessions with the grad student clinician.
2.Do you think that speech therapist who do or have stutter can offer something in therapy that other speech therapist cannot, if so, what?
I think the therapist who stutters can relate on the emotional, feelings aspect of therapy. Not sure if they would be any more competent than a well trained, experienced clinician who has actually worked with people who stutter.
3.How do you feel about the different types of stuttering treatment (fluency shaping, stuttering modification, integrated treatment and individualized treatment); what types of treatment you have you received?
The treatment I received was largely fluency shaping and it did not work for me. I felt like the approach was I was broken and needed to be fixed and I didn’t agree with that approach. I felt there was not enough emphasis on counseling in my therapy.
4.What do you think about speech therapy in the schools?
I only experienced school based therapy in the schools for 6 months in the third grade – then my dad pulled me out of public school and placed me in catholic school, where therapy was not available. He refused to allow me to go to therapy somewhere else. I don’t remember anything significant about the therapy I had in third grade, except that the therapist was nice and had the same name as me! 🙂
Question: do you think gender differences should be considered in therapy for stuttering?
-Pam
Hi Derek,
Congratulations to you for submitting an excellent paper – one that is both thoughtfully presented and thought-provoking. I think you can see by the number and diversity of responses that you have an important message that resonates with people who genuinely want to understand stuttering and stuttering intervention. Your title summarizes your essential message beautifully – that with the right help, one can discover passion, purpose, and potential. This is true for stuttering and myriad other challenges faced by the human experience. I am thrilled that you are accomplishing much and discovering your three Ps. This field needs you. Keep up the good work.
Kind regards always,
DAS
Derek,
Congrats on this paper! I really enjoyed reading your story after being in classes with you for the past couple years. Your clients are truly lucky to have such a passionate clinician to work with. After reading your paper, I had a couple questions…
1. In class we have been discussing school age children who stutter and the involvement of their families. What was your family’s approach to dealing with your stuttering? Were they supportive? Did they understand?
2. Secondly, do you lean more towards a stuttering modification approach? Or would your approach lie somewhere in the middle of fluency shaping and stuttering modification?
3. Last question I promise: What would your advice be to SLPs that are not PWS but may have a client that is a PWS? Obviously if you had to drive an hour to get to the college for therapy, there are not many clinicians that stutter so what would your best advice be to accommodate our fluency clients?
Thanks and look forward to hearing from you!
Maralee
Hi,
Thank you for sharing your story. I am a graduate student studying Speech Language Pathology, and am in my final semester. I am not a stutterer or PWS, and may perhaps have stuttering clients in the future, and am curious on your perspective. Should the only therapists that work with clients be people who they themselves suffer from a dysfluency or disorder? Should I not treat particular clients because I do not stutter, do not have CP, Autism, etc.? I know you touched on this theme in some comments above, but I believe this is a slightly different angle. Knowing the likelihood that I will one day treat a stutterer, what advice could you give me then, when encountering fluency clients?
Thank you so much,
Victoria T., B.A, M.A.
Long Island University-Brooklyn
Derek,
I am also a first year graduate student at WCU and in the fluency class. I am writing to say that I can definitely relate to the speech pathologist you spoke of that you liked but couldn’t help you in the end. I spent a year after undergraduate school working as a speech pathology assistant and I had at least two middle school students on my caseload who stuttered. Having never taken a fluency class in undergrad or observed a fluency session even I struggled to be helpful to those kids, especially initially. I found that my greatest achievement was building their confidence and getting them so that they were not afraid to open up and talk, despite the fact that I did little to drastically change their fluency in the course of time I saw them. What would your advice be now to a student clinician or SLP-A in a similar position? Would you say referral is the best option in that case, or are there simple techniques that can be easily picked up when you have very little knowledge base? Also, would you say that building confidence and being able to be comfortable with your speech, at least in a therapy setting, was beneficial to you despite the fact that your therapist at the time could not help you any further?
Thanks so much for writing such an insightful paper! I look forward to hearing from you.
Sincerely,
Amelia Loewer
Sometimes referral may not be in option, in that case I feel it is important to address the psychological aspects related to stuttering, if they are of age that the stuttering effects emotions. You can introduce the client to someone who stutters, if not in person then there are stuttering blogs, where people who stutter can interact. It is nice to know you are not only. The greatest thing anyone ever told me is that it is OK to stutter, learning how to do it with ease is the difficulty. Confidence is key to successful on the part of the client and the clinician!!
I really enjoyed your perspective and insight. I am not a PWS, but I fully agree and appreciate that a PWS as an SLP would be highly effective. I think there is a special bond and trust between people who stutter and it would be a hugh benefit and motivator for therapy.
As a graduate student SLP, I hope to become an effective clinician, and would like to be able to best help people who stutter. What advice or recommendations do you have for a non-PWS clinician to use during therapy? I would love insight, tips, and suggestions to add to my tool bag. What therapies have you found to be the most effective for yourself and/or your clients?
Thanks,
Angie
Idaho State University
The type of therapy depends on age and severity. I think parent education is key for kids under 5 or so, fluency shaping can help young kids in school learn tools to improve speech, and stuttering modification is most successful with older kids and adults. However no one Tx approach will work them same on different people. So learn about the client, take into consideration what they want to do in Tx and as I have been told “attempt to see through their eyes”. Often I’m afraid that Tx focuses too much on the disorder and not the person. I wish you the bets of luck!
Hi Derek!
It was really great reading about your perspective on stuttering and how you felt about it as you grew older. I’m really glad that you found an SLP who you could connect with, even though she could not necessarily relate as well, because she was not a person who stuttered.
I’m actually a first year at the University of Redlands and am currently in a fluency class. We recently did a pseudostuttering activity where we picked a public location and stuttered during a conversation with someone we didn’t know. It was definitely a difficult experience and I am glad our professor assigned it as a part of our curriculum. It widened my eyes to some of the anxiety that can be felt during stuttered speech.
The consensus is that, while we may have felt some of the emotions that a person who stutters may feel, we cannot truly replicate those feelings. As an SLP and a person who stutters, do you think that sharing what happened during this pseudostuttering activity with an older client who stutters help gain rapport and help move therapy forward? Would it even help?
I’d really appreciate your feedback considering your position as both an SLP and a previous receiver of therapy!
Hi Derek. I truly enjoyed your paper. I agree that therapists can relate better to their clients, and possibly do a better job, if they themselves have experienced what it feels like. However my ‘it’ is not stuttering. I wrote this opinion in my answer to Dr. S’s first essay question What is my definition of stuttering?…I kind of went off on a tangent. Nevertheless he liked the answer. I can relate to a person who stutters in many ways. I was really heavy at times in my life. This drew unwanted attention to me. I was made fun of in school and I so wanted to find a ‘cure’ for what I call my ‘affliction’. Many would argue that I had control of this myself because I could lose weight any time. However I disagree with this…I don’t think anyone can understand this need for food and inability to control it unless they’ve lived it. I conquered it later in life (for the most part)…and this is why I feel that I could provide speech therapy to a person who stutters…because I gained compassion and feel empathy. Many people don’t have this unless they’ve experienced something truly painful and gained that insight from the experience. There are so many experiences that can provide this compassion and empathy. My friends wife suffers from mental illness and even though she takes medication she is judged and suffers humiliation…My daughter, as you know, has speech intelligibility issues and it kills me to see her pain when she senses that someone can’t understand her or is pretending to. I think maybe I get what you are saying…I certainly wouldn’t want to be counseled for weight loss from someone who hasn’t felt the pain of obesity themselves, but if they’ve gained the compassion for my situation from some kind of situation that is personal to them, I think I would get past that and give them the chance to help me. I would know pretty quickly if they could. What do you think? Jamey Freeman
Hi Derek,
I am a first year graduate student at WCU, and I am currently taking Fluency. I think your argument that clinicians who are also PWS are the best therapists to PWS is interesting. I am not a PWS, so I cannot say that I have that personal experience to relate to, and I think that this is true for most SLP’s. Since the majority of clinicians are not PWS but all face the possibility of working with that population at some point in their career, what advice as both a clinician and a PWS do you have for those of us who do not have experience in both of those realms?
Hi, Derek!
I am also a first year CSD grad student at WCU. Thank you for sharing your story! I can definitely understand your sentiment about PWS clinicians being better equipped to help fluency clients; I think, based on my studies so far, it gives a unique insight into the client’s personal construct, etc. As I believe several here have already pointed out, though, many SLP are not also PWS. In class, we’ve spoken about how one of the signs of being an effective clinician is realizing when a case is beyond your own ability to handle as a clinician. If a clincian who is a non-PWS is not seeing any progress in therapy with a PWS, do you think it would be a good idea for the clinician to refer the client to an SLP that is also a PWS? I know not all clients have the ability to switch SLPs because on finances, distance, etc., but I would very much like to hear your input on this sort of situation.
Again, thank you very much!
One key to effective Tx is the client-clinician relationship. If a therapist does not feel comfortable working with a PWS, then the PWS is not doing to feel comfortable working with that therapist. In that case a referral would be a good idea, it made a world of difference in my life! If that is not an option then consider working with a counselor if the client has psychological issues related to the stuttering. Sometimes it just helps a PWS to have a non judgmental listener.
Hello, Derek,
Thank you so much for sharing your story- as (yet another) graduate student in the CSD program at WCU, I feel like we clinicians-in-training are too often removed from the social human interaction aspect of therapy, especially for those of us who have never experienced speech/language/fluency/voice disorders from a first-person standpoint. There’s such a treacherous pitfall of no longer thinking of our patients as people, and merely as a collection of behaviors we seek to alter in some way or another. Sharing your story reminds all of us clinicians who have never had experiences such as yours (ie, who do not stutter) that we, in fact, DON’T know where exactly you’re coming from, and that we need to respect our clients and empathize as fully as possible in order to be effective clinicians. We who do not stutter have never felt what you have described in your article, and for allowing us to get a glimpse of how you have developed and changed through your life, and how your stuttering has evolved with you, I thank you.
My question to you is: as clinicians who haven’t experienced extreme cases of disfluency, is there anything we clinicians can do in therapy to improve the quality of our treatment? I recognize that we will never be able to fully relate to our clients in such an intimate and almost familial way, but if I do ever get assigned a client who stutters, I want to make sure that my time with said client is as effective and impactful as possible.
Thank you for your time, and for your excellent paper,
Kevin Dorman
That was a wonderful story. Thank you for sharing it with us. It seems clear that you feel that being a person that stutters has brought a special benefit and perspective to your work with fluency clients. How do you feel it has affected your interventions with other clients?
Dear Derek,
My name is Sarah and I am a speech-language pathology student in the 2nd year of graduate school. I really enjoyed reading your paper and found it very inspirational. As a student and someone who is not constantly in contact with PWS, I feel like I do not understand the feeling a PWS experiences. Can you give me a few tips that a therapist who doesn’t stutter should know about the feeling of PWS in order to help treat the client better?
Derek,
Your paper provided an excellent insight into the struggles and “aha” moments for you as a PWS. It appears you benefited tremendously from seeing the success of a PWS, and from receiving encouragement to pursue your goals from a PWS. For people who are not in areas where they have the opportunity to work with a specialist who stutter’s, what do you recommend SLPs do in order to provide that motivation, and offer that incredible insight to our clients.
Thanks.
focus more on the fluency than disfluency, reward moments of fluency do not punish disfluency. Create an environment where your client can succeed in the treatment room than slowly transfer this to the real world. You must be positive about the opportunity to create change- clients can see this.
Derek,
I can see how a therapist that is a PWS could have better insight and perhaps be better equipped to treat a patient who stutters. There is going to be a special bond between therapist and client, and there would probably be many thoughts and feelings that the client won’t have to explain to the therapist. You imply that switching to a therapist who was a PWS made all the difference. You saw the fluency that he had achieved and said this was your inspiration. Would you say this was what made the difference, seeing his success? Did he exhibit an empathy you had not experienced from past therapists? How has being a PWS specifically influenced your methodology in treatment? Do you think you gravitate towards techniques that specifically worked for you? Do you think being a PWS might actually bias a therapist towards what techniques they choose to use?
Thanks,
O
My name is Emily McCormick and I am a first graduate student studying Speech Language Pathology. I am very new to learning about stuttering, therapy, and connecting and discussing emotional pieces related to this. Your writing, thoughts, and experiences are so engaging and it was great to learn from you. This was wonderful to read and I thank you for sharing some emotional pieces as well as your experiences from your childhood. It is amazing that you met an SLP that you were able to truly connect with and then led you to meet her fluency professor. I am wondering what stuttering treatments or techniques helped you during high school and also what do you find most helpful today to implement into therapy sessions. Also, do you have any advice about ways to discuss emotional aspects of stuttering? Thank you very much and I learned a lot from your paper!
Sincerely,
Emily McCormick
Derek,
Thank you for sharing your background. I see that Dori, who also has a paper on this site, has made some comments for you. In her paper she talks about the therapist’s and the parents’ goals getting in the way of what the child who stutters really needs or blinding them from what the child is capable of at any given time. After reading your story, I think it may be a possibility that a therapist who stutters would be better equipped to assess a child’s communication needs are as they would have had the experiences of feeling like they were being pushed to do be “perfect” when perfect wasn’t an option. That being said, forums like this are a great tool to educate therapists who do not stutter themselves on what these children are going though. Thank you again for sharing your story and for giving us all some things to think about.
-AH