New SLPs
Hello, My name is Anna and I am a student in my final year of graduate school for speech therapy. What recommendations, ideas, or concerns do you have for a brand-new SLP just entering the field? These could be ideas that I can keep in mind when working with PWS. We have learned a lot of information, but not as much from the perspective of the PWS. In addition, what is one thing you wish your SLP knew about stuttering when you were in speech therapy?
Thank you for these most important questions!
Here are some general guidelines for speech-language pathologists, based on my many decades of speech therapies. (Only a small minority of these therapies were helpful to me.)
– Know what is possible and feasible, and please don’t overburden a person who stutters. Progress can be made in small steps, and it is unlikely that a great deal of progress can be attained quickly. It is helpful to appropriately praise progress, but progress may not be a rising sharp line.
– Relapses are NORMAL in the treatment of people who stutter. They are to be regarded as natural and expected. (I have studied speech-language pathology myself, and I’m aware that many other speech/language disorders can be treated without expecting occasional major relapses in the client. Stuttering is different.)
It is very normal in therapy for stuttering for clients to have a zigzag line of progress – two steps up, one step back, two steps up, one step back, etc.
When relapses occur – as they almost inevitably will – it is VERY important NOT to blame the client in any way. The relapse did not happen because the client was not following a clinician’s instructions carefully enough. The relapse did not happen because he or she did not practice enough, or was not trying hard enough, or was not committed or dedicated enough to the effort. It is SO essential to understand that occasional relapses are a natural part of the road to progress in stuttering therapy. Clinicians need to empathize and understand the nature of relapses, and skillfully and sensitively help clients to get back on track. Blaming clients for relapses is a quick way to erode trust in the clinician-client relationship. In my experience – and in the experiences of many others who stutter who I have personally known – being blamed by a clinician for a relapse results in very negative views of that clinician. And people who stutter would then often tell others who stutter to avoid that particular clinician. So this is really important!
– It’s important to be patient. A client who stutters may not meet all the goals that a clinician sets, as quickly as a clinician might expect and hope. Patience is needed. It is not the client’s fault if these expectations are not achieved in the time frame hoped for.
– Clients need praise for what they achieve. They need to be encouraged with sensitivity and understanding. If larger goals appear out of reach for the time being, be satisfied with smaller goals. Talk with a client, and fully understand his or her needs, and what his or her therapeutic goals and expectations are. It’s important not to convey disappointment. Always maintain a positive and cheerful tone. It’s important to spontaneously modify planned therapeutic approaches to meet the challenges and circumstances at hand.
These recommendations are based on my own personal experiences with clinicians. If I had to select just one important point, it would be this: Please don’t blame the client for not meeting desired goals, or for relapses. It is not the client’s fault – it is the nature of stuttering itself that therapy can be a slow process, with relapses, and not anything like a straight line of improvement.
Good luck in your future careers!
Hi Anna
There are some things I wish SLPs would do.
1. Listen and ask questions. Don’t just listen to the stuttered syllables, but listen to the story. The background. The goals. The culture, religion, anything that makes the person the way s/he is. As stuttering is so much more than what comes out of the mouth. Also listen to the parents and maybe even a friend, a partner. If a PWS doesn’t feel heard or safe, s/he will not give you the information you need.
2. Think out of the book, or box. One size does NOT fit all. One client (or the parent) might want to be fluent. Tell them fluency might not be for all. That climbing the Mount Everest is too hard for most people. So to set up reachable goals. Maybe tools to get out of a block. Maybe working on acceptance and self-worth. Maybe by giving them the knowledge to learn more about stuttering and explain to others. Maybe by suggesting something else but speech therapy. F ex presentation techniques, yoga, a choir. Or all of the above!
By listening, asking questions and providing a smörgåsbord of things to try, TOGETHER you might find something that fits that very client to reach acchievable goals.
Also Paul has given some good advice on relapse, praise, and being flexible.
Keep them talking!
Anita