I recently had a new client’s mother discuss with me her concerns for some disfluencies (stuttered speech) her son has.\u00a0 The client’s mother was bothered because other therapists that had worked with her son had said, \u201cWe can\u2019t treat it because he never does it around us.\u201d<\/p>\n
This frustrates me a little, but I actually understand the therapist\u2019s difficulty.\u00a0 It is incredibly hard to treat something you don\u2019t hear yourself.\u00a0 But the truth of the matter is, that just because the therapist doesn\u2019t hear it, doesn\u2019t mean it is not a problem.<\/p>\n
It is often common for children with disfluencies to be more aware of their speech around others that they are less familiar with (i.e. a speech teacher).\u00a0 They might work extra hard (even subconsciously) to appear fluent.\u00a0 They might talk around the words\/sounds that they would typically stutter on and try to avoid them completely.<\/p>\n
However, when these same children are in a more relaxed environment where they feel they can let their guard down and be more themselves (i.e. at home), they might produce more disfluencies.\u00a0 This is because they might not care as much how their stuttering is perceived by close family and friends.\u00a0 They assume their loved ones will look past it.\u00a0 Or \u2013 they just want to relax when they are at home.\u00a0 All of these things are understandable.<\/p>\n
The problem however, is that sometimes these types of children never receive appropriate treatment because they have a way of hiding their disfluencies from professionals who can help.<\/p>\n
I have dealt with this many times in my practice and have come up with a few tips that you can try when working with a client who has disfluencies (whether you hear them or not).<\/p>\n
1.\u00a0 Always trust what the parent is telling you.<\/p>\n
It has been my experience that some parents feel like no-one believes them when they say their child stutters.\u00a0 If a parent is concerned \u2013 you (as a therapist) should be too.\u00a0 Parents don\u2019t tend to make up concerns about their children.\u00a0 They don\u2019t want their children to struggle.\u00a0 Why would they pretend their child is stuttering if they aren\u2019t?\u00a0 I always tell my parents \u201cI am the professional \u2013 but you are a professional too when it comes to your child.\u00a0 You know your child better than anyone \u2013 so if you tell me something about your child \u2013 I am going to believe you.\u201d<\/p>\n
2.\u00a0 Get as much detailed information from the child\u2019s parent\/other family members as you can.<\/p>\n
Ask specific questions about the child\u2019s stuttering habits.\u00a0 Approximately how often do they stutter in a 5 minute conversation?\u00a0 Do you notice their stuttering habits change in different environments?\u00a0 Do you notice their stuttering habits change around different people.\u00a0 Which environments do they speak the best in, or the worst?\u00a0 Which people do they speak the best around, or the worst?\u00a0 Can you imitate what your child sounds like when he\/she is stuttering?\u00a0 Are there specific sounds, words, phrases, or sentences that seem to increase your child\u2019s disfluencies?<\/p>\n
3.\u00a0 Try to get a video of the child stuttering.<\/p>\n
With cameras built into almost every mobile phone now-a-days, this should be easy.\u00a0 Just have the parents on alert to try to capture the child\u2019s true stuttering habits.\u00a0 I prefer for this to be done without the child\u2019s knowledge \u2013 if possible.\u00a0 Children are going to automatically work extra hard to conceal their stuttering habits if they know they are being taped.<\/p>\n
4.\u00a0 Observe the child in their natural environment.<\/p>\n
If the only way to observe the child in their natural environment is to view a video taken by the child\u2019s parents \u2013 then use it.\u00a0 However, there are other ways to see the child\u2019s true stuttering habits.\u00a0 Drop in on the child\u2019s classroom (especially during an activity that requires verbal communication).\u00a0 Observe the child during lunch time or during recess.\u00a0 You can begin to see how the child communicates in a variety of settings, and this information will become very beneficial to you as treat the child.<\/p>\n
5.\u00a0 Stress the child out.<\/p>\n
I know this sounds harsh \u2013 but stuttering is often triggered by stressful situations.\u00a0 If the child is never stressed around you \u2013 it is likely you will never hear any stuttering.\u00a0 When I say stress the child out \u2013 I am not implying that you be mean to the child or make them feel bad.\u00a0 Just put them in everyday situations that may cause slight panic.\u00a0 Some ideas are: public speaking (set up some kind of activity that requires the child to speak in front of other people), talking on the phone (have the child call a local pizza shop and ask about the specials), ordering food (take the child out for ice-cream and have them order their own).\u00a0 Anything that might take the child slightly out of his\/her comfort zone – you can use these opportunities to both observe disfluent speech, and work on correcting it.\u00a0 When observing it \u2013 take notes about what type and frequency of stuttering you hear.\u00a0 When working on correcting it \u2013 you can discuss the scenario ahead of time.\u00a0 Practice what the child will possibly say.\u00a0 Work on keeping the child calm.\u00a0 Role play the situation ahead of time.<\/p>\n
6.\u00a0 Help the child become more aware of stuttering by having them keep track of your (pretend) stutters.<\/p>\n
Often times children who stutter a lot \u2013 don\u2019t even realize when they are doing it.\u00a0 It is key to increase their awareness of their stuttering habits.\u00a0 To do this \u2013 you (as the therapist or parent) need to model what disfluent speech looks like.\u00a0 Carry on a conversation with the child, play a game with the child, read a story with the child \u2013 during one of these activities \u2013 produce random but noticeable disfluent speech (imitate the child\u2019s stuttering habits if possible) and have the child track your disfluencies.\u00a0 This will not only help make the child more aware of disfluent speech in general, but will help them understand how stuttering can interfere with communication.<\/p>\n
7.\u00a0 Help the child become more aware by keeping track of his\/her own stutters.<\/p>\n
Complete any one of the activities mentioned in #6 \u2013 but track the child\u2019s stutters during the activity.\u00a0 Both you and the child should track the child\u2019s stutters and then compare your results and the child\u2019s results.\u00a0 This will help you see how aware the child is of their own stuttering.\u00a0 This will also help the child realize how aware\/unaware they are of their own stuttering.\u00a0 You can also video record or tape record the child\u2019s speech and them watch\/listen to it together later and track the stutters heard.\u00a0 Then compare your results.<\/p>\n
8.\u00a0 Teach the child how to prevent\/correct stuttering by practicing pretend stuttering and specific stuttering techniques to overcome it.<\/p>\n
This tip is especially helpful when working with children who don\u2019t stutter around you (the therapist) – but who do in fact stutter.\u00a0 Model disfluent speech and then model how to fix it using a specific technique (gentle onset, pull-outs, reduced rate of speech, etc.).\u00a0 Have the child practice pretend stuttering and fix it by using a specific technique.\u00a0 If they have practiced fixing disfluent speech (even when it is not real) they will have the tools to fix disfluent speech when it is real.<\/p>\n
Good Luck and I hope some of these tips help!!!<\/p>\n","protected":false},"excerpt":{"rendered":"
I recently had a new client’s mother discuss with me her concerns for some disfluencies (stuttered speech) her son has.\u00a0 The client’s mother was bothered because other therapists that had worked with her son had said, \u201cWe can\u2019t treat it because he never does it around us.\u201d This frustrates me a little, but I actually […]<\/p>\n","protected":false},"author":1,"featured_media":45,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-467","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"jetpack_featured_media_url":"https:\/\/i2.wp.com\/speechchick.com\/wp\/wp-content\/uploads\/2013\/04\/chrysanthemum.jpg?fit=1024%2C768&ssl=1","_links":{"self":[{"href":"https:\/\/speechchick.com\/index.php?rest_route=\/wp\/v2\/posts\/467","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/speechchick.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/speechchick.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/speechchick.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/speechchick.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=467"}],"version-history":[{"count":1,"href":"https:\/\/speechchick.com\/index.php?rest_route=\/wp\/v2\/posts\/467\/revisions"}],"predecessor-version":[{"id":468,"href":"https:\/\/speechchick.com\/index.php?rest_route=\/wp\/v2\/posts\/467\/revisions\/468"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/speechchick.com\/index.php?rest_route=\/wp\/v2\/media\/45"}],"wp:attachment":[{"href":"https:\/\/speechchick.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=467"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/speechchick.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=467"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/speechchick.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=467"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}