Children who stutter might enjoy some support with
conversation. A teenage student recently said to me, ‘I’m not very good at
putting my ideas into words,’ and I’m willing to bet this is partially from
lack of practice. Children who stutter, unable to keep pace with fluent
speakers, sometimes withdraw from conversations and miss out on developing this
form of self expression. Others forge ahead, speech/language systems
struggling, like a car in serious need of a tune up. How can parents and others
create conversations that encourage children who stutter to say what they want
to say, when they want to say it and do so with easier speech?
1. Take the time.
In “The
Flight from Conversation”, (1) Sherry Turkle reports that some of us are so
plugged-in to technology “we’ve become accustomed to a new way of being ‘alone
together.’” People are engaging in fewer extended, face-to-face conversations
as they e-mail, text, and twitter to readers in other places. As parents and friends
of children who stutter, we may need to plan ahead to deliberately engage our
children in conversation during those free moments after school, in the car, in
shared activities, at a mealtime, and/or before bedtime.
2. Practice whenever possible.
“Hello, Gramma? It’s me – Michael.”
This conversation appears in the comic For
Better or For Worse in my Sunday paper. (2) Michael, about 8 years old, is
talking on the phone. “Tell her about your hockey tournament,” prompts his
mother, who is sitting nearby. “Uh - we won our hockey tournament,” says
Michael. “Thank her for the sweater she sent you,” says Mom. “Thanks for the
sweater you sent me,” mimics Michael. And so the comic continues, Michael’s
mother coaching him through a conversation with his grandmother. As adults, we can find ways to show our
children how to discuss TV shows, movies, books, video games, school projects,
social concerns, family issues, extra-curricular activities, and hopes and
dreams. Topics of conversation arise naturally when parents share in their
children’s activities.
3. Learn
new skills.
Adults develop skills for talking
with supervisors, customers, co-workers, parents, spouses, and friends.
They read self-help books to learn the knowledge, jargon, and conversational
expectations appropriate for managing conflict, purchasing a car, increasing
sales, and nurturing relationships, among other things. How to Talk So Kids
Will Listen and Listen So Kids Will Talk is
a time-tested book about talking with children. And, there is a sequel
for talking with teenagers. These books are easy reads that illustrate “new methods of communication…that
parents could teach themselves…with hundreds of examples of helpful
dialogue…[and] cartoons that …show the skills in action. “(3) The Stuttering Foundation offers a few tips
specifically for talking with children who stutter. (4)
4. It’s ok to stutter – easier when
possible.
Stuttering that a) occurs less
frequently and b) involves less
oral-motor tension than your child typically experiences is considered “easy
stuttering.” Easy stuttering might take the form of repeating whole words
instead of parts of words, as in “game-game-game” instead of ga-ga-game”, or,
repeating a sound fewer times, as in “g-game” instead of “g-g-g-ame. “ Blocks and prolongations that are briefer and
accompanied by less oral-motor and facial tension may be ‘easy stuttering’ for
your child. You might notice easier stuttering once a week, then twice a week , then every day. Maybe you’ll notice ways to help your child
stutter more easily.
5. Ask about factors that affect
stuttering.
Stuttering can interact with other
conditions such as ADHD (6), language demands (7, 8, 9) and thoughts and
feelings (10). Conversations with a speech
language pathologist can help you manage situations to support easier speech. (
5) A speech hierarchy is a list of
speaking tasks that control conditions to make fluency easier for your
child. Ask about where your child’s speech homework falls on such a hierarchy so that
you can discuss the SLP's long term therapy plan.
6. Five minutes may need to become ten.
a. “I have this game at home” may take 2
seconds to say fluently.
b. “I-I-I-I have th…..is g-g-g-game at
home” may take 5 seconds.
c. “(pause) III (slow/gentle beginning
sound) have /(pause) thhhiis (slow/gentle sound) g {freeze} game at home” may
take 10-15 seconds.
A compassionate and patient listener will allow plenty of
extra time for a child to reduce oral-motor tension through the use of fluency
enhancing techniques such as pausing, slow/gentle beginning sounds, reduced
speaking rate, freezing, and cancellation. It is the rare listener indeed who
understands that conscious speech-language-motor planning is a time consuming
and laborious process at first. When listeners prefer fast and fluent speech,
children may avoid words on which they expect to stutter, holding back on all
they wish to express. “I used to do that all the time,” a child recently said
to me. Now, he talks more and stutters more, which actually gives us more
opportunities for conversation and change.
The value of conversation became
apparent as I met my students at local retail stores to work on the
carryover. While experimenting with
different ways to give feedback about speech goals, I stumbled upon the obvious.
The most valuable feature of these lessons is not the feedback about speech. It
is the hour-long, sustained conversation. Validating a child’s thoughts and
feelings via attentive, sensitive, respectful, and prolonged conversation is
the foundation for carry over work. In Turkle’s article, she writes,
“ A 16-year old boy who relies on texting for almost everything says
almost wistfully, ‘Someday, someday, but certainly not now, I’d like to learn
how to have a conversation.’” I think we
can start that lesson today.
(1) S. Turkle (2012) The Flight From Conversation. New
York Times, April 21.
(2) Boston Sunday Globe, April 22, 2012.
(3) A. Faber and E. Mazlish (1980) How to Talk So Kids
Will Listen & Listen So Kids Will Talk, NY, NY: Avon Books. p. viii.
See also A. Faber and E. Mazlish (2005) How to Talk So Teens Will
Listen & Listen So Teens Will Talk, NY, NY: Harper Collins.
(4) 7 Tips for Talking with Your Child. Stuttering
Foundation, http://www.stutteringhelp.org/Default.aspx?tabid=632
(5)
M. J. Cooley
Hidecker, R. S. Jones, D. R. Imig (2009). Unsing Family Paradigms to Improve
Evidence-Based Practice. American Journal
of Speech Language Pathology, 18, 212-221.
(6) J. Donaher (2011) ADHD and Children Who Stutter. Stuttering Foundation, broken link
(7)
K. Ntourou, E. G. Conture, M. W. Lipsey (2011). Language Abilities of Children Who Stutter : a
Meta-Analytical Review. American Journal
of Speech-Language Pathology, 20, 163-179.
(8)
Trautman, L.
S., E. C. Healey, J. A. Norris (2001) the effects of Contextualization on
Fluency in Three Groups of Children. Journal
of Speech and Hearing Research, 44, 564-576.
(9)
C. T. Byrd,
K. J. Logan, R. B. Gillam (2012) Speech disfluency in School-Age Children’s
Conversational and Narrative Discourse. Language,
speech, Hearing Services in Schools, 43, 153-163
(10) L. Scott (2010) Imprementing Cognitive Behavior
Therapy with Children. Stuttering Foundatin, broken link