About the Author: James Hayden is a son, brother, friend, and person who stutters from the New Orleans area. He is the author of Dear World, I Stutter: A Series of Open Letters from a Person Who Stutters. His work has been published by numerous outlets and organizations. He’s also presented at numerous universities and conferences. Outside of stuttering advocacy, he enjoys reading, spending time with loved ones, and consuming way too much Survivor related content.

“One size fits all!” It’s something we’ve heard to describe wristwatches, The Comfy, life jackets, bike helmets, and more. Yet, it seems the field of speech therapy tries this approach when treating individuals who stutter. When in fact one size does not fit all. Before we go further, I am not a speech language pathologist, nor do I want to be one. I’m just a person who stutters and is an expert in his stutter. 

I first attended speech therapy in the late 90s and early 2000s. During that time, it felt very by the book. These were the assessments I needed to take, these were the exercises I needed to do, and if all goes well fluency should be the result. Yes, my speech therapist did incorporate my interest into my therapy exercises, so in that way it wasn’t 100% the “one size fits all” mentality. However, it still felt by the book. As if I was another member of the “Five Steps to Fluency” club. That the “problem” would be fixed if I did these things. Spoiler alert: it wasn’t and I still stutter.

Looking back, I don’t blame anyone for this approach. Everyone was doing what they believed was best because that was the standard at the time. Unfortunately, for some, this is still the standard. 

My second round of speech therapy was in the mid 2010s. At this time, I was a junior in college, in my early 20s, and would rather be anywhere but the therapy room. This time my therapy was personalized. Yes, my therapist and I worked on techniques to reduce my stutter. But, that wasn’t the main focus. Rather, we focused on my goals and what I wanted to get out of this process. Those goals were: speak on the phone without a script, order through a drive through, and become a more confident public speaker. These aren’t the goals everyone has. These were my goals and my speech therapists ensured I did my best to achieve those goals. 

The second round of speech therapy was an individualized approach because I was more involved in setting my goals. Once I set my goals, my therapists conformed their plan to my goals and not my goals to their plan. Unfortunately, the same can’t be said for anyone. I know many who had therapy experiences like my initial round of therapy. And as a result, they have a negative view towards speech therapy and speech therapists.

I’ve been out of speech therapy for eight years; however, I’m still very active in the stuttering community. I’ve seen what happens when we try to fit therapy into a one size fits all box. This was evident to me over the past year. In fact, this realization was in the unlikeliest of places: conventions for speech language pathologists.

Within the last year, I’ve had the opportunity to attend two such conventions. In both instances, I was representing a national stuttering organization. And both times I was glad my facial expressions didn’t have a voice because they would’ve gotten me in trouble. I know the questions I was asked and conversations I had came from a good place. But they both showed the danger in having a “one size fits all” mentality toward speech therapy. When I suggested different ideas that worked for me and might work for their client, they were stunned. As if going a bit outside of the box was a crime. The few days I spent at the conferences demonstrated to me how dangerous having a “one size fits all” mentality is for the field, the speech therapist, and most importantly the patient. 

So, how do we ensure that speech therapy is no longer viewed through the lens of “one size fits all”? Fortunately, some speech therapists have started moving away from this approach. However, many still need to jump on the train. 

The first way starts at the ground level. How are future clinicians being taught about stuttering if they are at all? The textbook works, but that doesn’t represent the lived experience of every person who stutters. Instead elevate different voices to show that no two stutters are alike. This would also highlight that no two journeys of people who stutter are alike. What works for one person might not work for someone else. And that’s ok! That each journey is good, beautiful, and valid. That no one size fits all when it comes to speech therapy. This can be done by using outside resources such as books, podcasts, and/or guest speakers. 

For current speech therapists, how do you define successful therapy?  Is it equating fluency to success? That mentality is not doing anyone any good. From my perspective, successful speech therapy is someone choosing to be a person who stutters more than they are choosing to be a person who is silent. This is done by introducing outside resources such as books and podcasts by other people who stutter into your sessions. What also helped me was talking about what laid beneath the stuttering iceberg. Having those conversations helped me start to accept my stutter. Looking back, those conversations did more good than learning a technique to reduce my stuttering moments.

Another question is who is setting the client’s goals? If it’s not the client, then everyone’s time is being wasted. A client may not seek fluency and that’s ok. Rather, their goals could be to develop confidence to perform in the school play or order through a drive thru or anything else. 

Redefining success and allowing your client to set their goals allows for speech therapy to not be a one size fits all approach. Rather, it celebrates the uniqueness of each person, their voice, and their journey. A goal which should be strived for by all.