Should ‘regular’ SLPs be dealing with people who stutter?
I recently listened to a Stutter Talk Podcast that said SLPs have so much to learn that stuttering classes are often the subject that has to give.
My experiences with therapy would suggest this. I would have sooner sought out an acting teacher/ vocal coach/ mindfulness coach when I was young because at least these people would have a definitive approach.
What needs to be done to have better-trained SLPs that agree on best practice?
Kind Regards,
Tim
This is a really good question. Speech and Language Therapy training comes with a heavy workload, and there are lots of areas that a newly qualified practitioner may not feel 100% confident in. However, that doesn’t necessarily mean they should avoid working with clients in that area, just that they need support from an appropriate supervisor or experienced colleague to do so. This allows the new therapist to develop skills, while still ensuring the person who stutters gets a high standard of therapeutic support.
I have many years of experience as a specialist SLT, but I can confirm that I’m still learning, and do so constantly as knowledge about stuttering is always changing as new information comes to light.
Within the UK there are many options that allow SLTs to access additional formal or informal training and professional support networks to learn more about working with people who stutter and their families, and I’m sure the same is true of other countries.
So, to answer your question – yes, ‘regular’ SLTs can still provide support for people who stutter, as long as they recognise the need to seek out support themselves from a colleague with more experience. Through this, we develop the specialist therapists of the future.
I would also add, if someone who stutters is seeking support from a SLT and worried about the level of knowledge and experience working with those who stutter, it’s OK to ask them about it! You can ask your prospective SLT whether they have experience working with those who stutter; if they’ve had additional training in different therapy approaches and if they have access to support from more experienced SLTs. This may help you feel comfortable in your choice of therapist.
Hi Tim,
You raise an important question. Many university programs do not prepare graduate students to work with children and adults who stutter. If there is a class at all, it may be taught by someone who does not even provide therapy for PWS or have a working knowledge of stuttering treatment so the professor may rely on textbook explanations rather than information concerning the dynamic process of treatment. I don’t think that we can rely on graduate programs preparing students, nor can we impact those programs as professionals. Supporting young professionals with an interest in stuttering is our first goal. Through continuing education, internships with stuttering specialists and mentor programs we can improve the quality of services and understanding of stuttering–which is very different from the other areas that SLPs treat. I also believe that families and individuals seeking therapy need to self advocate; interview the SLP (speech language pathologist,)insure that they have experience treating stuttering AND the SLP proposes a direction of therapy applies to the client’s unique experience with stuttering. Thanks for your excellent question.
Tim,
HI! Thank you for taking an active roll of your education and asking great questions.
Being a person who stutters, an SLP, and someone teaches at the graduate level I think there are GREAT teachers that give “Regular SLPs” the skills to help People Who stutter effectively and with kindness, openness and the compassion we need to treat the whole person. Now, just like any field, any job, not everyone is trained the same way and not everyone is taught the same great SKILLS. You will notice, I use the term “skills” and not “Tools.” Skills implies the concept of practice. Tools implies fixing something. I think this is where the training of SLPs can make a major impact. As SLPs we are not “fixing” people, we help them learn “skills.”
Further, I have seen countless graduate students and Regular SLPs who are more effective (in many ways of servicing people) with People Who Stutter at all ages. And, many of them are not people who stutter. However, what they possess is the ability to empathize with the basic concepts of suffering, flexibility, and listening to clients and families to what THEY want.
Keep asking questions!
With compassion and kindness,
Scott
Wonderful question, Tim. In America, there is still a percentage of graduate programs that do not have a course on Stuttering/Cluttering, so there are potentially speech pathologists treating individuals that stutter that have not have the coursework in graduate school. With that being said, there are specialists in stuttering/cluttering and ultimately it is best to find a speech pathologist who is a specialist in this area, or who has experience in treating people who stutter for therapy. As a profession, however, we are getting better. To expand on what Scott was saying, there are so many SLP’s that are educating other SLP’s. It is getting better, and great efforts are being made to try to make it better. It doesn’t excuse every negative experience in speech therapy that a person who stutters has had because of a speech pathologist that didn’t know what he or she was doing, but it hopefully does give some positivity that great progress is being made. I teach a graduate course on stuttering/cluttering and I tell my students, “Now you are taxed with educating other SLP’s, for they just don’t know better. They think they can pick up the ‘fluency therapy in a box kit’ off the shelf and do therapy with any child or adult that stutters, and this is simply not the case and in doing this they are harming people.. but in their defense, they were never taught any differently.” In my opinion, SLP’s that are not properly trained to treat stuttering shouldn’t be working in settings with which they are treating individuals who stutter, but at the heart of the matter, I am not sure the SLP realizes they weren’t properly trained in the first place.
As Scott said, it’s all about what the client and family of the person who stutters wants, not what the clinician wants- so when you go for speech therapy, you are interviewing the clinician just as much as they are interviewing you. 🙂
Hi Tim,
Thank you for such a meaningful question. I fully agree with what all of the colleagues wrote above in response to your question. Since I am from a little different geographical and cultural background, I would like to add that in some places in the world the situation could be even more complicated than in the US and UK. For example, in Poland in the process of teaching speech-language pathologists for decades, a very strong emphasis has been placed on fluency-shaping techniques with the main goal for therapy to eliminate stuttering. As a result of this approach, Polish SLPs are often afraid of stuttering and providing therapy for those who stutter (this was confirmed by the results of a survey that I recently conducted with my colleagues).
Therefore, it is quite hard for an individual (especially for an adult) who stutters to find
a competent specialist. The population of Poland has almost 38 million people and only 4 SLPs have graduated from the European Clinical Specialization in Fluency Disorders. Of course, many Polish SLPs are educating themselves on the subject of fluency disorders by taking various courses or trainings. However, most often the fact that this happens is only the result of their good will and internal motivation. My colleagues, Polish SLPs, often have to make difficult choices concerning which subject they should continue in order to further professional education, typically devoting their private funds and free time to do it (courses and workshops in Poland are mainly organized on Saturdays and Sundays). What I’m trying to say is that finding a competent, well-educated fluency specialist is in many cases like “mission impossible”.
Once again, I am very thankful for your question. It inspired me to invite my SLP students at the university to discuss this topic during my last lecture on fluency disorders. I was amazed by their answers. Among many interesting comments, they were often repeating the statement that a person who stutters cannot be denied help, which meant that every clinician, including a ‘regular’ SLP, should be able to provide ‘first fluency aid’. Moreover, they stressed that it was important an SLP be aware of the complexity of stuttering. They emphasized that it is not enough for a therapist to pose questions on current knowledge, they must also have some special skills. High interpersonal competences and some level of humility were also mentioned. I was amazed how reflective they were. And what I admired the most in their statements was that they appreciated the contacts with individuals who stutter as well as meetings with the parents of children who stutter. They pointed out how much they learned from them and how important these experiences were for them in their opinion. They also highlighted the need to establish cooperation between these ‘regular’ SLPs, who have more direct contact with the client with stuttering (e.g. in school), and fluency specialists.
This discussion generated by your question is likely to help us work on our reflectivity and willingness to learn from each other. This can be the key to success in the SLP education. Once again thank you for this question.
Katarzyna Węsieska
Hi! my name is Destiny Shavers and my question is Have your stutter became more challenging for you growing up or has it become more fluent?
Hi, Destiny. Somehow your question got in with responses to another question. I have a neurogenic (acquired) stutter since the age of 36, but I am the sibling of a person who stutters so I can comment on his experience. My brother has stuttered since the age of 6 years old. I can say that stuttering is a personal journey, and what one person experiences is not what everyone experiences, so this is a questions that you would need to ask of different people who stutter if they are comfortable to answer you. 🙂 My brother stutters now less prominently/overtly than he did when he was a child, but he does avoid more communication now as an adult than he did when he was a child. I hope that answers your question, and take care.