Manon SpruitAbout the Author:

Manon Spruit, MSc, is a Dutch speech-language therapist and stuttering specialist working in Germany. Stuttering has been one of the main areas of her clinical work for more than 30 years, working with children, adolescents and adults. She has a particular interest in looking beyond speech itself and in finding an approach that fits the individual person and their everyday life. Manon is actively involved in the international stuttering community, presents regularly at conferences, and is a global partner for the Camp Dream. Speak. Live. initiative. In addition to her work in stuttering, she specialises in FASD and communication and is an author of books and professional publications in both fields.

When I was ten years old, I needed glasses. I hated them. At the time, wearing glasses made you different enough to be noticed and bullied. I was called names, laughed at and made fun of. Four-eyes, snake-eyes; children can be remarkably creative when someone stands out. Fortunately, I only needed my glasses at school to see the blackboard and at home to watch television. The rest of the time, I could take them off.

Over time, my eyesight got worse. By fourteen, I would have to wear glasses all day. To me, that was a disaster. My ophthalmologist must have understood how much this bothered me. Although I was rather young for them at the time, he asked whether I would prefer contact lenses. I don’t think I had ever said “yes” so quickly. The lenses regularly caused eye infections and were certainly not ideal. But none of that seemed as bad to me as wearing glasses.

About twenty years later, after much hesitation, I had laser eye surgery. Before the operation, I could not wear my contact lenses for two weeks, allowing my corneas to return to their natural shape. Those two weeks became a little longer. I still remember how uncomfortable I felt. I avoided going out whenever I could. Rationally, I knew there was nothing wrong with wearing glasses. Emotionally, that ten-year-old girl who had been laughed at was apparently still somewhere inside me. I am still very happy that I had the surgery.

Now I have the age when reading glasses are slowly appearing on the horizon, and I postpone them for as long as possible. The dislike is still there. Strangely enough, I love sunglasses and I hardly ever leave home without them. Apparently, it was never really about having something on my face. It was about what wearing glasses had once meant.

When my own children needed glasses, I immediately worried. Would they be bullied? Would they hate their glasses as I had? But something had changed. Not my children. Not glasses. Society.

Glasses have become normal. People chose frames they like: colourful, fashionable, cool, serious, quirky or almost invisible. Some people even wore frames without prescription lenses simply because they liked them. And there wasn’t just one kind of glasses anymore. There were big and small, round and square, brightly coloured and almost invisible frames. Some wanted their glasses to stand out; others chose a pair that hardly showed. And then there were sunglasses, ironically the one kind I had always loved wearing. Different glasses. Different purposes. Different preferences. Different shades.

Nobody expects everyone to choose the same frame. Nobody says colourful glasses were more valid than almost invisible ones. Nobody told someone who preferred contact lenses that they first needed to accept their glasses, or someone with an extravagant frame to make it less noticeable. They simply chose what suited them.

If Glasses Can Have Different Shades, Why Not Stuttering? 

People who stutter are still laughed at, imitated, bullied and underestimated. They sometimes make decisions about education, careers, relationships and everyday situations based not on what they want, but on what they believe their stuttering allows them to do. In more than thirty years of working with people who stutter, I have learned that there is no single way to stutter. But, equally importantly, there is no single right way to live with stuttering.

I think that is where the theme Shades of Stuttering becomes especially meaningful. Those shades are not only the repetitions, prolongations, blocks, tension or secondary behaviours we can observe. They are also all the different ways in which stuttering can be part of a person’s life.

I remember a young man who had become a carpenter.

He enjoyed his work, but it had not been his first choice. He had wanted to become a teacher and had decided that this was impossible. Teachers have to talk. And he stuttered……

Years later, something was still missing. Eventually, he decided to do what he had once believed he could not: train to become a teacher. He contacted me before an important oral examination he desperately wanted to pass. In a small number of sessions, we worked on acceptance and techniques that could help when he wanted or needed them. We were making sure that stuttering did not get to decide whether he could become a teacher.

He passed the exam. And that was the end of therapy. Not because he had stopped stuttering. He hadn’t. He simply had what he needed. He became a teacher and later a vice-principal. At the beginning of each school year, he tells new students and their parents that he stutters and welcomes their questions.

He stutters. He teaches. He leads a school. And he is happy with the life he chose.

That is one shade of stuttering.

Another man contacted me during the COVID pandemic.

He was going through a divorce and, during the pandemic, almost all contact with the outside world disappeared. He could no longer practise his hobby and had lost contact with many friends. Stuttering became increasingly difficult. He wanted to know what to do when he blocked: to modify his stutters and feel more in control. We worked on modification techniques, because he did not want to accept his stutter, but the more desperately he wanted control, the more tension there was, making the techniques harder to use. His journey became about more than technique. Eventually, he became more able to allow the stutter to be there. He did not learn to like stuttering; even today, he finds it difficult, and that is allowed too.

Acceptance does not have to mean liking something. Success in stuttering therapy does not have to end with someone saying, “I am completely fine with my stuttering.” He continues to speak. He lets people hear his stutters. He does not allow them to silence him.

That is another shade.

Then there was an eight-year-old boy at a camp for children and adolescents who stutter.

At first, he was hiding not just his stutter, but himself as well. He did not want to speak or participate and resisted almost everything we suggested. Underneath was shame. His solution was painfully logical: if speaking revealed what he was ashamed of, silence was safer. We did not spend the week teaching him to become fluent. He experienced other children who stuttered. He talked, played, struggled, laughed and communicated, alongside a few individual therapy sessions.

And something shifted. By the end of the week, the boy who had hidden from people was approaching people he did not know. He was talking about stuttering. He was speaking for himself. He still stuttered, but he was no longer hiding.

Another shade.

And then I think of a teenage girl who taught me something different again.

She was not interested in techniques or in making every conversation an opportunity to work on her speech. What bothered her most was not the stuttering itself, but everybody else’s reaction to it. People finished her sentences. Teachers avoided asking questions because they thought they were helping. Others told her to slow down, breathe or relax. She wanted none of that. What she wanted was time: to finish her own sentence, answer a question in class, or order something without somebody jumping in.

Her therapy looked very different. We talked about self-advocacy, telling people what she needed and responding to unwanted help: “Please don’t finish my sentence. I know what I want to say.” Her goal was not to change the way she spoke. Her goal was to change what happened around her when she spoke.

That, too, is a shade of stuttering.

Perhaps therapy should have shades too

As therapists, it can be tempting to define success.

Less stuttering.
Less struggle.
More acceptance.
More openness.
More confidence.

But the longer I work with people who stutter, the less interested I become in deciding what success should look like for somebody else. 

Our job as therapists is not to decide which shade is best. Our job is to help people discover which way of speaking, communicating and living gives them the greatest freedom.

Looking back at that ten-year-old girl, I wonder how different things might have been if glasses had been viewed then as they are today. The glasses were never really the problem. The reactions were. Decades later, those reactions still left a trace.

So for International Stuttering Awareness Day, and every other day, this is my wish:

  • to create a world in which a person who stutters feels free to speak and knows that their voice is worth hearing.
  • a world in which a young person chooses a dream career based on their talents, interests and ambitions, regardless of how they speak.
  • a world in which an adult is given the time they need to finish their sentence, naturally and without question.
  • a world in which therapy offers possibilities and helps people discover their own way of stuttering, speaking and communicating.

Some will stutter openly.
Some will use techniques
Some will modify their stutters.
Some will work toward greater fluency.
Some will choose not to work on their speech at all.
Some will embrace their stuttering.
Some will never like it.

And all of them should have the same right to speak, to participate, to choose their profession, to take the floor, to tell a joke, to order coffee, to teach a classroom, to lead a school and to be heard.

And perhaps there is one final parallel with my glasses: over the years, society’s view of glasses has changed, and so has my view of stuttering therapy.

When I started as a clinician, I was more focused on changing speech, reducing stuttering and struggle, and teaching techniques. Over more than thirty years, my perspective has changed. Techniques absolutely have a place, but I have learned there is no single destination therapy should lead to. My role is to show clients the possibilities, share what I think might suit them, and explore together what works for them. My goal is simple: that they can say what they want to say, in the way they want to say it.

That, to me, is what the different shades of stuttering are about.

Just as society learned that glasses do not have to look one particular way, I have learned that stuttering therapy does not have to look one particular way either.

Perhaps, as clinicians, we need different shades too.

There are many shades of stuttering.
They do not all need to become the same colour.
They just need room to exist.

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Comments

Shades of Stuttering: Through The Lens Of A Clinician – Manon Spruit — 9 Comments

  1. Hi Manon,

    I really enjoyed reading about your perspective on stuttering as a speech language pathologist. I am currently in graduate school to become a speech language pathologist and am working with my first stuttering client. After reading your article, stuttering therapy has been put into a different perspective for me. When working with this client, it is important to not only consider what I define success as, but to recognize what he views success as. As a future SLP, I need to work with clients that stutter to decide which way of speaking provides them with the most freedom. I love how you stated that there are many shades of stuttering and provided different examples in your essay. Each individual that stutters will have different goals and outlooks relating to their stutter. It is important to listen and tailor therapy to target their personal goals. As an SLP, what are some ways that you work on building confidence relating to stuttering?

    • Hi Aadrey,

      Thank you for your interest in this topic. I love it when students are already interested in stuttering. You have a great question! When it comes to confidence in stuttering I think it is the most important to build the confidence in communicating. What makes a good communicator? What can you do to be a great communicator? What are you already doing that contributes to good communication? (This could be eye contact or a pace of speaking that fits the situation or using your body to show that you are open to communication…..) And I share experiences from my other clients, from myself and from my friends who stutter, to show how they can live with stuttering. One of the first things I tell my clients straight away that I cannot promise them that they will speakk fluently at the end of therapy, because I cannot and do not want to promise it. What I do promise is that they can talk the way they want to talk and when they want to talk and stuttering will not bother them (as much).
      I hope that answers your question. I wish you all the luck in this great profession!

  2. Hi Manon

    Thank you for this wonderful paper. I appreciate how you used your experience as a young child having to wear glasses to explain public stigma. I really like how you explained different shades of stuttering through your lens as a therapist. The way that you work is so important, to see the person sitting across from you, to understand their world, and to help them in the ways that they need.

    We often have the discussion regarding what the SLT should do when the client comes to them and says that they want fluency. It is natural, because of the stigma and the struggle, to want fluency. However, the therapist cannot give the client what they want without the client understanding and being prepared to “pay the price” for that fluency. In the extreme, that price means continually exercising tight control over our speech, practicing for an hour or more every day, and continuing to live with the fear that stutters will pop up (and they most certainly will).

    I wonder, therefore, about those case where the client “will work toward greater fluency”. I am very interested to read your experience and approach to this type of case. What does that entail? How sustainable is it? Does it, in fact, come at a price of increased fear and shame? In my specific case, my self-therapy consisted of letting go of struggle, of embracing my stutter, of recognizing, accepting, and investigating my fear and shame when they come up (which they often do). I try to avoid the fluency trap, of getting attached to those times when I do not stutter.

    Thank you, Manon, for a wonderful paper. I hope that SLTs and students study it.

    Hanan

  3. Dear Hanan,

    Thank you for your views. I never promise (greater) fluency. It can happen, but it is not my goal for therapy. If someone really really just wants to become fluent I will explain to them that that can be very hard, because it means that they will have to think about their speech and how they use it from the moment they get up until the moment they go to sleep. And that is hard. So in my opinion it is always important to reduce the struggle. And if the struggle can be (somewhat) reduced, there is more openness to allow some more stuttering. Most people experience it as positive to struggle less and allow themselves to stutter more openly. And if they still want to be more fluent in certain situations we will use those situations to see if they want to use techniques.
    In the cases that just wanted fluent speech, they reached fleunt speech pretty fast. That is not that hard. But…… in the world out there, it can be so hard to use the techniques, that in almost all of the cases it is not sustainable if there is no acceptance. One dislfluency can result in renewed fear. shame, frustration and so on. Tension increases and so does the tension in speech and the feelings.
    And that is why some sort of accpetance and struggle reduction is important. Instead of: “Oh no, I stuttered again. Now I am a loser or a failure!” “oh, that was a hard one/ I stutter a bit more today. That’s okay. It is just the way it sometimes is.” So more resiliency, more openness is precious.

    I think you walked the right way for you in reducing the struggle, embracing your stutter and working on the fear and shame.

    Manon

  4. Hi Manon,

    This is great. I can so relate to your conclusions: perhaps it wasn’t ever the glasses but the experiences you had wearing them. And perhaps it was never the stuttering, but the choices made that revolve around stuttering.

    How do we get more SLPs to understand and value this? Probably less than .000001 % of SLPs in the world will read this. So what do we do?

    I have stuttered for almost 60 years now, and intentionally chose to try and hide it for more than 35 of those years. Why? How do we get SLPs to want to know why, and not just focus on trying to eliminate moments of stuttering?

    When I fist needed glasses, I tried everything to make it as much of a palatable experience as possible. I looked for stylish frames, and spent a lot of money on no-line bifocals. But my vision changed every year and I was spending hundreds each year on new frames.

    Like you, I had LASIK eye surgery 7 years ago, correcting my distance vision but necessitating reading glasses. I have been more than happy buying cheap, plastic colorful frames from my local dollar stores. I have a pair in every room of my home, in my purse and in my car.

    I can’t wait until the shades of stuttering is seen as just as acceptable and normal as variations of eyesight and eyeglasses.

    Thanks again for sharing this and more so “getting” the complexity of the stuttering experience.

    Pam

  5. Dear Pam,

    That’s a challenge, isn’t it. I would love to get all SLPs to understand, but unfortunately it is hard. I invite as many students to my practice as I can and try to share my passion and views. I invite a few students to every Camp Dream Speak LIve we do, so they can see how much of a difference it makes when there is this view behind it. It opens eyes and that is the first step. I advocate in my private life as well. But until the world of the SLP does not see it as the glasses: no one cares anymore if you wear the or not and how your glasses look, we have to keep on advocating until the world doesn’t care if you stutter and how you stutter. So, let’s keep on advocating until these shades of stuttering are seen as “they are just there”.

    Thanks for your great comment!
    Manon

  6. I really enjoyed reading your paper about how differently stuttering impacts each individual and how therapy should reflect that same diverse. The statement that “acceptance does not have to mean liking stuttering” was especially impactful. As a graduate school student, we learn a great deal about different techniques and approaches that can reduce the tension and struggle that often occur in moments of stuttering, but we do not go into great depth about specific ways to promote self-acceptance (and how differently acceptance can look), target self advocacy, and help people discover their own way of stuttering. I would love to hear any advice you might have for incorporating these areas into clinical practice. You also mentioned that an SLP’s “role is to show clients the possibilities”. I would be interested to hear more about what that conversation looks like in practice and how you help clients explore the options available to them. Thank you so much for sharing your insights and for encouraging readers self-reflect and remain open to other perspectives!

  7. I think acceptance can mean liking/welcoming/embracing – all aspects of stammering pride or open stammering. Acceptance can also be defined as acknowledgement or recognition, which would fit better with not liking. Acceptance does have these different meanings, which can be contradictory and which causes confusion. An example of this would be a begrudging acceptance or resignation. It would be clearer if the word was just used in the first sense and not in the second sense.

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