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What strategies do you recommend in speech therapy if there was a patient who stutters?

International Stuttering Awareness Day Posted on by

I was wondering what are the reccomended strategies for patients who stutter since not one single strategy will help and there some strategies some people may not like. I am a student who wants to become an SLP one day and I am here to learn.

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What strategies do you recommend in speech therapy if there was a patient who stutters? — 10 Comments

  1. Hello, Amber. Thank you so much for asking a question to the professional panel. When I read your question it automatically populated an “About Amber” section at the bottom and it says you are a student at Cal State Fullerton; I have been there for a conference before and that is a beautiful campus! Congrats on your studies and I must say- you are entering the most amazing field ever (although I am a bit bias).

    You ask a good question, Amber, albeit a very broad one making it a little tough to answer. I will say this, however- when it comes to “strategies” in the therapy room, SLPs can use many different strategies in the therapy room, beyond the traditional strategies you may think of (those for actual speech production/pattern and doing something with that speech pattern), there are also strategies for communication confidence- we counsel (yes, counseling is within our scope of practice when it comes to working with communication and swallowing- isn’t that super cool?), teach people things like mindfulness techniques, all sorts of cool stuff.

    I will say, however, when you say “what are the recommended strategies for patients who stutter” my answer to that specifically is: stuttering strategies, no matter what type you are doing in the therapy room, are a one-size fits all and in general can never just be recommended for all people who stutter like a blanket statement. Stuttering is an individualized experience, and every person that walks into our therapy room comes there for a reason. That reason may be because their best friend duped them into going to speech therapy again and they really don’t want to be there, or that reason may be that they are so excited to be there because they can finally afford the time, funds and mental headspace to do speech therapy again after years of off-time from services. No matter what- that moment… the moment when that person walks into your clinic room for the first time… that means something, and if you miss it- you’ll miss so much. That person comes with a story (just like we all do, right?). A story of when their stuttering began, what it has been like, life experiences with their stuttering and how that stuttering has made them feel. That is all so much a part of what we do in the therapy room, and the strategies- or what we do with that person we are serving- highly depend on that lived experience and actually varies from person to person that we serve.

    So now, best practice is for us as SLPs to listen to the person we are serving that stutters (because I always say to the graduate students that I have the honor to teach, that I truly believe the best thing that you can do for a person who stutters is to listen) and within that listening, gear the therapy goals and activities in therapy towards the person’s goals within their own personalized stuttering journey. In recent years, I had a person who stutters tell me that his goal was to ask any question that he had freely in class, in front of his classmates, without being afraid or hesitating because of his stuttering (this person was a college student, and oftentimes went with content misunderstandings but never asked questions during class in front of classmates because of his stuttering and therefore, was really beginning to run behind in course content because of that). So- one of my therapy goals for him was literally for him to ask a given question (or questions) as needed in class; we did various techniques and things to help encourage him and help him to have the communication to do this- regardless of his fluency skills. And guess what- he did it. So I didn’t really all what I did “strategies” per se, but therapy was specifically made to be what he needed to be- and that’s what we do…. we use our knowledge and skills to make therapy exactly what the person who stutters needs it to be in their life.

    I hope that this help in answering your question, and thanks again for asking a great question to the professional panel. Enjoy your studies!

    Thanks,
    Steff

    • And typographically, my response should have said, “stuttering strategies are NOT a one size fits all”. 🙂 It’s a bit late, and I decided since I can’t sleep to answer questions- and that is showing through in my typing skills.

      • Hey, Steff!

        Sorry, I just saw your second post that explains another question that I asked in my other post. I appreciate the great advice and I am glad that also ways of building a person’s confidence can be used. I will make sure to use these types of strategies when it seems fit since everyone is different and not one size fits all, like you mentioned. Thank you so much! My brother wants to be a teacher. Is there any advice that I can let my brother know when he is a teacher? He wants to teach English.

        -Amber Yado

          • Hey, Steff!

            Thank you so much! I will show this to my brother. Since he lives in an apartment I can just send him the link. Thank you so much for the great advice! Is it okay if I use this conversation for a project that I have? One of the things that my professor wants us to do is screenshot 3 conversations in this conference (from clinicians, people who stutter, or people who is a family member of someone who stutters) and have us talk about it in our project.

            -Amber Yado

  2. Amber,

    HI! This is a great question. Than you, Amber for being a part of this conference and engaging to help us all learn. Growing up as person who stutters, and now a professional SLP who still can stutter, I now use the word “Skills” to describe ways to help anyone adjust anything about themselves.

    The first skills we can teach and model (you will hear this often) is being aware of what the person who stutters wants. This comes with active/mindful listening skills. These skills are things for everyone to learn to be more conscious of their our thoughts and behaviors.

    Another skills is to practice willingness to step outside of comfort zones with thoughts and behaviors. If we can challenge ourselves a little (not big steps, just enough little steps) we can make adjustments in our lives we hope for over time). However, we first have to be “Willing” to do so. So, we can practice willingness by being kind to ourselves and creating language that helps us with willing thoughts.

    Building off the skills of willingnes and awareness we can then address fears, anxiety, and building up self-worth, self-confidence, and self-care which all involve practice which means these are skills. From here we can address the physical nature of stuttering, again listening to the person who stutters, and teach them any relaxed or speech modification SKILLS!

    The reason I keep using the word “skill” is that everything we learn takes practice, so that is a skills. The word “tool” implies “Fixing” something. We are not trying to FIX people. We encourage people to learn skills to make any adjustments they wish to make.

    So we model and teach awareness, active/mindfluness listening, willingness, confidence, counseling, and behavior skills and so much more. All in the effort to help a person be the person they wish to be for themselves and their future.

    Does that all make sense?
    Let me know!
    Thanks again for asking questions. It helps us all learn!
    With compassion and kindness,
    Scott

    • Hey, Scott!

      Thank you so much for letting me know that I should use the word “skills” because I did not know that. I appreciate learning more and more as I continue being in this conference. I am glad that I can use strategies to help build people’s confidence. And I agree that it is best to start off of what they want to accomplish so that I can base the skills to teach them based off of what they want to accomplish. Are there any other words that are commonly used that should be changed to be more inclusive?

      -Amber Yado

      • Hey, Scott!

        Thank you so much for the wonderful advice! Is it okay if I use this conversation for a project that I have? One of the things that my professor wants us to do is screenshot 3 conversations in this conference (from clinicians, people who stutter, or people who is a family member of someone who stutters) and have us talk about it in our project.

        -Amber Yado

  3. Hey, Scott!

    Thank you so much for the great advice! Is it okay if I use this conversation for a project that I have in one of my classes? One of the things that my professor wants us to do is screenshot 3 conversations in this conference (from clinicians, people who stutter, or people who is a family member of someone who stutters) and have us talk about it in our project.

    -Amber Yado

  4. Hi Amber

    Techniques that I remember from my youth were not very helpful, as they only focused on breathing. F ex I was asked to say the days of the week and repeat as many times as possible in one breath. Well, I played the saxophone ? With another one we drank a lot of tea where she was listening to my stories. Nice, but when I felt I wasn’t going anywhere after a year, I wanted to stop. And she replied by throwing it all back in my face. That everyone was right, it was my fault, I was a quitter, etc. Another one let me talk and read with a hand on my tummy. And everytime I stuttered, she interrupted me, which had me focus on what I was doing “wrong” even more. I tried hypnosis, but couldn’t get in the hypnosis state. I even tried a pyrit stone in my pocket. A healer got rid of my shame.

    But things got better. Today I have learned techniques that help me stutter less.

    The techniques that helped me are
    1. selfesteem. The better I feel about myself, the better I speak. Fluency is one thing, but if I don’t love and accept myself, I’m building a tower in the swamp, and risk to fall so hard, it can make me silent, or be afraid of every word, as fluency might become the only “right” thing. NLP and Mindfullness have helped me to no longer feel bad about myself for stuttering, and to move on and stop altering.
    2. public speaking. Good speakers use body language, voice, pausing, etc. By studying speakers I like to watch and listen to, and learning from them, my speech has increased. It is, and will always be a roller coaster, but I can use the techniques when I feel I need to use them. And the acceptance to feel ok when I decide to not use techniques and just stutter on. I also feel good by relaxation techniques. And of course peers who cheer for me on good days and who pull me up when I’m not feeling good. My “Stamily” has been crucial to get me back on my feet and to stand with me on my journey.

    The hard part, but also the part that makes your job so exiting and interesting is that we PWS are all different, and that we come to your for different reaons. Some want fluency, some want a toolbox to simply get out of a block or get a slightly smoother speech, others might want to get help to educate a family member to get him/her off their back. 😉 So start by creating a relation with your client by listening what s/he wants, have an open mind and think out of the box, and offer a mix of tools to give it a try and see what fits this very client. And don’t hesitate to ask. As you’re the expert on treatment, but your client is the expert on his/her stutter, so together you can make the perfect match. 🙂

    Happy ISAD and keep them talking

    Anita

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