7/2/11

What Do I Say?

One of the first questions that parents ask me is, “What should I say to my child when she stutters?” Parents are familiar with saying things to their children that are instructive, comforting, or otherwise helpful. Parents respond to children’s speech by imitating an infant’s babbling, teaching a toddler new vocabulary, and expecting ‘please’ and ‘thank you’ from teens. Consequently, it can feel quite natural to respond to stuttering by saying, “Slow down and take your time.; Think about what you want to say first.” When this response is not helpful, they wonder what to say instead.

Speech therapy approaches this problem by asking, “What does the child know?” Some children are not aware of their stuttering, so an adult’s advice to change how they speak can be confusing and frustrating. This goes for the preschooler with mild, typical disfluency and for the older child caught up in sharing ideas, momentarily oblivious to fluency. Indirect therapy dodges the question altogether. It “involves changes in the speech environment” (1): reducing communicative time pressures, modeling a new/easier way of speaking, and changing aspects of certain troublesome speaking situations, for example.

A child “may perform many repetitions, but may not be aware of the relationship of speech to the feeling that he is ‘stuck’ or that ‘something’ is holding him back. It is important to acknowledge this distinction. Although the child may not perceive his speech productions as distorted words, he is aware of a difficulty in speaking – specifically, of feeling stuck.” (2)

The speech language pathologist (SLP) needs to find a way to help the child understand what is going on and speak in a way that feels easier. “Incidentally, the emphasis on feeling here is intentional. The powerless feeling that results from a loss of control often concerns children more than the actual speech disfluencies.” (3). Friendly play and conversation are a part of every session to reveal a child’s learning style and interests, which eventually become woven into lesson plans.

Early lesson plans begin with the SLP voluntarily stuttering in the same way as the child (perhaps with less muscular tension) and then using stuttering modification to change the stuttered words into “easier” ones. If the child comments on this, a conversation about stuttering has begun. If the child does not notice the SLP stutter, then she will describe it and reward the child for noticing it. She might say something like, “When I get stuck, it sounds like this: ‘Th-th-th-the boy is walking his dog…Would you help me by telling me when I get stuck so I can get unstuck?” (4)

Every step of speech therapy involves teaching the child greater awareness AND options for change. “What do I say?” is very specific: praise for speech changes that the child learned how to perform in speech therapy. When the child learns light contacts and easy onsets (gentle beginning sounds), then the parent can praise the child’s use of these skills both in structured homework and in spontaneous conversation. When the child learns to resist time pressure by pausing within sentences (5), the parent can say “I like how you used pauses when you said…”

Note: the adult also uses everything the child is learning. This can be explicit as in, “Let’s play this game so we both can practice pausing.” or; the parent can focus on her own speech privately, pausing as frequently and naturally as possible during a game. For some children, “Disfluencies may be acknowledged with neutrality, compassion, or empathy…or gentle requests for repairs that are distributed at a rate that is considerably less than that for praise.” (6) For children who’s speech therapy program includes corrective feedback, praise must greatly outnumber corrections.

What can you say to your child who is stuttering? You have some choices.

1. Listen carefully to what your child is saying and respond to that content,and/or,
2. Resist time pressure, pausing before any response, and/or,
3. Imitate the stuttered words by using a speech technique to illustrate how they can be spoken easier, and/or,
4. Ask how she feels, ‘opening the door’ for some emotional support, and/or,
5. Manage the environment by scheduling some ‘down time’ instead of another planned activity.

We all experience varying success with children. We cannot expect to say the perfect thing all the time. I recently took a risk by asking about a young teen’s moment of stuttering only to have her burst into tears. Moments like this come with the territory. You know your child better than anyone else. Now you know a little more about stuttering therapy so that you can know what to say.

I recently joined a new blog about stuttering. You might appreciate the July 1 post written by a mom, It’s a Blessing to Raise A Child Who Stutters. (http://stutterguy.wordpress.com/)

1. Ramig, P.R. & Dodge D.M. (2010) The Child and Adolescent Stuttering Treatment and Activity Resource Guide p. 67
2. Ibid., p. 69
3. Ibid., p 70
4. Ibid. p. 71
5. P. Reitzes (2009) Pausing and Stuttering, http://www.mnsu.edu/comdis/isad12/papers/therapy12/reitzes12.html 6. Ibid., p. 71

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.