Working with Parents
Hi all!
I am currently a post-baccalaureate student within the COMD field and also work in the speech department of a local school. In a current course on fluency, we’ve been discussing the importance of helping clients — school-aged or not — accept their stutter and the adverse effects that can come with focusing exclusively on percentages of fluency met by clients during structured or spontaneous speaking tasks.
I was wondering if anyone has tips or experience working with students or clients on accepting their stutter and combatting shame or negative self-talk, especially when the mindset you promote in therapy is contradicted from input they receive outside. For example, how would you help a student to accept their stutter when parents at home condemn instances of dysfluency or urge their child to make their speech as fluent as possible to the point of embarrassment or withdrawal from speaking situations for fear of later stuttering?
Thank you in advance!
In India, because of a collectivistic culture, even a child’s immediate social circle is very large, comprising of their grandparents and extended family. I personally deal with this in two ways- first, educating as many people in the child’s social circle as possible, directly or indirectly. Second, gradually making the the child resilient enough to cope with possible negative reactions, because it is often impossible to change deep rooted beliefs of everyone in the family. Rational stories for children go a long way towards building this resilience, teaching the child ultimately that the power to stay unaffected by external factors lies completely within themselves.
Thank you so much for your response, Dr. Kelkar! It is so interesting to hear more about clinical practice in India and I would be interested to hear more about your experiences. Are there any aspects of your work that you believe to be specific to India?
Great to hear about your interest in culture specific practices related to management of stuttering!
I do believe there are some things unique to certain cultures, and they need to be borne in mind while assessing/ working with those who stutter.
Firstly, as I mentioned, working with a child who stutters involves working with their family, extended family, and to an extent, their neighborhood.
Second, in my experience (and this is completely anecdotal), there is a U-shaped trajectory seen vis a vis impact of stuttering as perceived by caregivers of those who stutter. Parents of preschoolers seem to be the most anxious about the impact that stuttering might have on their child… Parents of school-going children and adolescents seem to prioritise academics more than therapy for stuttering.. therapy resumes a high priority again when stuttering potentially impacts job or marriage prospects. Caregiver concern additionally affects the PWS. To quantify this perceived impact, an Impact Scale for Assessment of Cluttering and Stuttering (ISACS) was developed in 2013 and validated recently by me and some colleagues.. it has an indigenous normative and measures impact of fluency disorders from two perspectives- that of the PWS and that of their significant others.
Hello!
Thanks for submitting such a great question! I think my first question to any client would be – What does acceptance look like to you? Acceptance is one of those terms that gets thrown around a lot and yet it means something different to each person. Starting there may help you to have a really powerful conversation with your client about goals for therapy, etc.
When we know what our clients’ goals are – it really helps us to then guide them in moving forward. One conversation I’ve had with clients over and over is the fact that they can continue to grow and evolve as a communicator (in whatever way they see fit) and work toward accepting their stuttering/lessening the impact that stuttering has on their lives at any given point. It doesn’t have to be one or the other/black or white – as the concept of acceptance often is presented/discussed. Does that make sense?
I also am really interested in both mindfulness and Acceptance and Commitment Therapy (ACT) and the incorporation of both into therapy. I suggest you look into these two topics and they will really guide you in exploring self-talk with your clients.
I hope this helps – please do reach out with additional questions.
Good luck!
~Jaime