Hello, Gayle! Thank you so much for asking a question to the professional panel. I love your question so much, because this already shows how much empathy and compassion you have instilled within you for people who stutter. When it comes to fostering an inviting, comfortable and safe environment for people who stutter you want to begin this from the get go with treatment and start trying to establish that therapeutic alliance/trust relationship right away so you are spot on with saying, “within the first few sessions”. I always teach my graduate students, that when someone walks into your office/clinic… that in itself is a moment, and if that moment is missed by the clinician, then the clinician will miss so much. That moment- when a person walks into your office- that moment happens for so many reasons and that person comes with a story and life experience of their own no matter what age they are. The person may have come into your office because they feel that their parent is forcing them to be there. They may be there because they are giving speech therapy another try after years of not going because of a sour experience earlier in their life. Or, the person may be there because they absolutely had a wonderful speech therapy experience in their childhood, and they want to come back and work on some different things in adulthood. Whatever that reason might be, recognizing that moment and being sensitive to that moment as a clinician means so much.

So, my first advice to fostering a safe environment for the person who stutters that you may serve in the future: listen, actively. The best thing you can do for a person who stutters is to listen as you may be the first person ever to do this for them. Listen to what this child or adult has to say, and give them agency (control) over their narrative and the moment as they share. Give them however much space they need to tell their story, however much of that story they decide to share with you.

Second advice: ask this person their preferences within their stuttering journey- even if this person is a child. If an adult: Why is the person in your office for an evaluation? What does this person call stuttering and what is the person’s preferred language regarding stuttering (the person may or may not like it when others tell them to “slow down”, or “be fluent”) and how do those words make this person feel? If a child: This child may or may not know they even stutter, depending on the age. If the child does know they stutter: what do you like to call your speech? (they may call it stuttering or they may not)… let the child name it themselves (also giving them agency), if they wish.

Third advice: Involve the person in the goal writing process. I call this, the ship and the steering wheel. The SLP is the ship- we have the educational background. But the person who stutters (even a child) is the steering wheel- and knows more about their personal stuttering journey than we do. Let the person who stutters themselves name their own goals in therapy (even children), while you use your clinical knowledge and educational expertise to write the goals and create therapeutic activity to achieve those goals (that’s where “skilled therapy” comes in). One question I get asked with this is, “but kids aren’t the legal decision maker.. how do you do this?” I professionally and kindly educate parents on the nature of stuttering and the individualization of the stuttering experience; you can’t put the stuttering experience in a box. One time in my time in this field, I had a parent demand that the child work on fluency strategies to speak “more normal” (those words were like nails on a chalkboard to my ears, as we surely do not want to “fix” stuttering and what is “normal” about anyone’s speech for that matter?). I explained kindly the nature of stuttering, etc as I do, and the parent still insisted. The child, on the other hand, had no desire to work on fluency strategies. Their goals didn’t line up. I told the parent that she could find another clinician who was willing to do exactly what she said against her child’s wishes, but I educated her about the risks that this could have on her child’s life (trauma, the child could stop talking if forced into therapy the child didn’t want, etc.)… I said- I am not that clinician.. but that I was willing to do a mediation between the child and guardian to come up with a plan. So- we did just that. Child, guardian, and myself sat down and we all had a talk- and the goals ended up being what the child wanted. 🙂

So- there are a few pointers for you. Stuttering is oftentimes described as a “loss of control” by the person experiencing it, so any time as clinicians that we can give that person agency, or a sense of control with their stuttering is groundbreaking in the therapy room and will for sure assist with feelings of safety and being welcome in the therapy room. Thanks again for asking a question to the professional panel, and be well!
Thanks,
Steff