Freedom of Speech (Pallavi Kelkar)

About the Author: My name is Pallavi Kelkar and I’m from Pune, Maharashtra in India. After completing my Bachelor’s degree in Audiology and Speech Language Pathology, I went on to do a Master’s and then a PhD. I have completed my doctoral work in the area of fluency disorders and my thesis is currently under evaluation.

Because of my special interest in fluency disorders, I have conducted awareness programmes in the past, as well as started a self- help group for persons with stuttering. I have completed a basic and an advanced certificate course in Rational Emotive Behavior Therapy and have found principles of this therapy really useful for helping my patients cope with stuttering.

I have presented and published papers in fluency and other areas at national and international conferences and scientific journals.

I have recently developed a tool for evaluation of the impact of fluency disorders (stuttering and cluttering) based on the ICF. The tool measures impact from two perspectives- that of the person with stuttering and that of their significant others.

When it comes to children, we always have double standards. We never seem to make up our minds whether they are “too young” or “all grown up”. We can never manage to come up with one rule book for everyone…and as an explanation we offer a weak “That’s different”. Sometimes we break our own records at discrimination­­—even for the same child, we apply different rules for different activities!

Imagine this scenario, for instance. A toddler, having just learnt the “art of walking”, is traipsing all over the house, discovering his freedom, experimenting with it and sometimes faltering. The mother knows he might stumble but lets him enjoy himself nevertheless. Never once does she tell him to “be careful” or “walk slowly.”

The same child, while experimenting with his speech and language skills, however, is in for a surprise. He comes home from nursery school, all excited, eager to spill out “what happened”. “Mummy today my- my- my- friend…” he says. He feels lost for words sometimes, stumbles over some, but it doesn’t in the least bother him until – “ Don’t be in such a hurry baby, speak slowly. Tell me properly.” – the mother says, anxious to prevent her child from stuttering – but unknowingly taking him one step towards it. Early stuttering theorists could not have been more correct when they said, “Stuttering begins in the listener’s ear.” (Gateley, g (2003))

The child suddenly realizes something has gone wrong—and speech gradually starts getting associated with stress—which further precipitates stuttering in some children.

In fact, if we delve deeper, we can see that in a young child’s life, speech is always associated with stressful situations. Let’s take a closer look at the life of a 5 year-old boy. When does he usually have to speak? To explain himself when he gets pulled up for doing something wrong… to “introduce himself” to complete strangers, to say a poem in front of a mischievous class of forty. When he does want to speak, on the other hand, his casual dialogue with his friend is interrupted by a strict “Shhh, you’re becoming very talkative in class.” To add to his woes, he has the burden of learning to speak at least two languages, sometimes three! When is speech ever a pleasurable act for him?

Well, the next obvious question that this whole exercise would elicit is, “Can we make it pleasurable?” To get an answer to this we need to give ourselves a checklist:

  • Can we make a ground rule of ‘speaking slowly’ and not remind the child only when he stutters?
  • Can we be good role models for slow and relaxed speaking?
  • Can we speak calmly to our child even while disciplining him, instead of suddenly raising our voice?
  • Can we use his drawings, etc. instead of his speech to “show him off” to relatives?
  • Can we keep some “chatting time” when both we and the child are relaxed and happy?

If we can answer all the above questions in the affirmative, then yes, speech can surely be associated with “fun”. Anxiety and concern about our child’s speech is bound to show its ugly head, but for that there is always the Speech Therapist!

But in the meantime let us strive towards making our children look forward to speaking, and not run away from it. We must also remember that fluency in speech follows fluency in language. Giving the child ubiquitous amounts of language by talking about every new situation, verbalizing every experience, is as important as taking him to an open ground for him to play and run around. Along with the freedom to stumble over a word, let us also give our child the opportunity to stumble upon a new one every day!

 

References

Gateley, G. (2003). Johnson’s diagnosogenic theory of stuttering: An update. ETC: A Review of General Semantics, 60(1), 22-28.

529 total views, 1 views today

Comments

Freedom of Speech (Pallavi Kelkar) — 48 Comments

  1. Thank you for your contribution! I am an SLP graduate student and am currently in a fluency disorders course. I have never really considered how many of the communication situations that young children encounter are in fact stressful or negative. It’s ironic that we push early intervention for so many disorders yet the early interactions associated with fluency can be so negative. It worries me that irreversible damage is done early on that people who stutter must cope with for the rest of their lives. I loved your pleasurable talking checklist! They are fantastic suggestions for a family who is raising a child who stutters.

    • Thanks so much for your feedback! I’m glad you liked the article. I’d like to mention here though that parents need not feel “guilty” on reading this because firstly, the adult’s reaction is not necessarily a cause, but probably one predisposing factor to stuttering; and secondly, they do what they do only with the best of intentions. This article is only a small attempt to make sure the parent’s good intentions are translated into what is really good for the child.

  2. Dr. Kelkar,
    Thank you for writing this post! I think that comparing the beginning stages of walking to stuttering occurrences is a great way to help parents accept a child’s stutter and learn how to manage it, rather than always bring negative attention to any disfluencies. Many times, I feel that parents to not even realize the pressure they may put on their child, so making the act of speaking more pleasurable is a great and achievable idea. When you are working with children, do you ask their parents those questions on the checklist? If so, how do the parents normally react? I was curious to see how the parents/family/teachers/siblings/caregiver typically responded to them.

    • Most parents admit that they themselves speak fast, and ask the child to slow down only in moments of stuttering. The third question usually elicits a “guilt” response from parents. E.g. “Oh I wanted to ask you, did he start stuttering because I yelled at him that one time?” and I then need to talk about predisposing factors as against “one trigger” in cases of developmental stuttering.
      The second issue that clinicians ( and parents ) have to deal with in India is consistency in rules, since many times the child belongs to a joint family system with grandparents, aunts and cousins. So all those dynamics need to be taken into account while counselling.
      Teachers from good schools usually volunteer to ask the therapist for tips to follow in the classroom. In some schools this is not feasible due to sheer numbers of students in each class (around sixty!). But sincere teachers do try.

      Do you find teachers and parents working as a team in cases of children with stuttering that you have helped?

      • Thank you for your response! I am currently in graduate school and have only worked with one student with a stutter. Thankfully, the teacher worked with us and with the parents. The parents were very good at advocating for their child, but at the same time, expected us to do all the work and not utilize the tips they were given.

  3. Thank you for sharing this post. As an SLP graduate student, this checklist is a great resource! When you introduce the strategies that make up the checklist to the parents of your client, do you also want to have these strategies introduced to the child’s teacher? If not, do you think it is enough that these strategies are carried out by the family members?

    Thank you,
    Carly

    • Dear Carly,
      Yes, I do feel that parents and teachers need to work as a team. However in India, many times this may not be possible due to sheer numbers of students per class. However, sincere teachers themselves ask the parents to share the therapist’s strategies with the school, and try to implement them as much as possible.
      Regards

  4. Thank you for sharing this article. I found it very interesting. I have a couple questions: I liked your comparison that you made to when a child is learning how to walk, however I did feel that there was a slight difference in comparing a child learning to walk vs. a child who is possibly developing a stutter. While all children learn to walk and will fall down while trying, not all children start to stutter as they learn to talk. That is not to say that it is an immediate concern, but it is something to take note of. Do you feel that a parent should never correct a child’s stutter directly? Do you think the therapist should follow these rules as well in the therapy room? What are your feelings on this idea?

    • Thanks for your interest in the article.
      Let me first address your statement “Not all children start to stutter as they talk.” The article does not talk about “children who develop stuttering” It in fact encompasses all children, including those that show “normal non fluency” or “beginning stuttering” that might just be a phase in development and disappear on it’s own. (Peters and Guitar give a nice hierarchy of these levels of stuttering in children.) The article attempts to prevent stuttering in these children at least. The motor development analogy makes even more sense then, since pediatric physiotherapists often advise parents to “expose” their child to sensory and motor experiences, so as to “prevent” delays or problems.
      As for your question about therapy, one can never make a blanket statement. The therapist needs to tread very carefully and identify if the child is aware and conscious of his/ her stuttering. If not, then bringing the child’s attention to the stutter would only prove detrimental to progress, in my opinion.
      Hope this helps!
      Regards

  5. Hi! I enjoyed reading your post. I always though it is so important to make speaking a positive experience for children. Your checklist really covers ground.
    My question is, does stuttering solely stem from negative experiences during childhood when speaking? Because sometimes children can receive negative feedback while speaking and still not stutter, so there must be something more that’s causing the stuttering. In addition, children’s speech may not always be associated with stressful situations, yet they still stutter.

    • Hi Annie! Glad you like the checklist.
      Here’s what I feel:
      1. No, stuttering certainly does not stem solely from negative feedback to speech. Hence the term “predisposing factor”. As parents, there are some of these predisposing factors that are not in our control (genetics, language delay). However, we can certainly strive to minimize those that we can!
      2. No, all children that face negative feedback to their speech need not stutter, but then we cannot predict who will. So why not be careful with all of them?

  6. Hello!
    My name is Kara Hendrickson and I am currently a second year graduate student at the University of Minnesota, Duluth. I am currently in an Advanced Fluency Disorders class and we have discussed the importance of manipulating the environment, so the child is equipped with the indirect tools they need to succeed.

    What types of tools do you provide parents with regarding how they should talk with their child? Is there a handout that you consistently use to illustrate the parent communication strategies used with children who stutter?

    I feel that parents really value “examples” and a miniature training seems so beneficial for such an important topic in our field.

    Thank you for your post!
    Kara Hendrickson

    • Hi Kara,
      What I usually do is:
      1. Provide a do’s and don’t sheet
      2. Ensure that they are keen observers in each session
      3. Have at least one session where the parents interact with the child as I observe and give them feedback
      You are right, training parents needs to be an integral part of our sessions.
      Regards

  7. Thank you for sharing this checklist. I love the use of the ‘learning to walk’ metaphor in explaining to parents how they can (often accidentally) give a certain connotation to their child’s disfluent speech, and like you mentioned earlier, much of our job as an SLP is relieving a parent of any guilt they might have. I think it can be easy for adults to forget just how perceptive children can be, and thus it’s incredibly important to educate parents in being more accepting of disfluencies. Making communication a positive experience for the child is key in fostering their self-confidence!

    Best,
    Becca

  8. Hi! Such a fascinating article! I wanted to know why telling a child to slow down creates a larger stuttering problem. I see that is probably not helpful but I’m trying to see how it can hurt a child’s stuttering. Thank you!

    • Hi Sara,
      It’s telling a child to slow down ONLY WHEN THEY STUTTER that might make a child self conscious of their speech and perhaps precipitate more stuttering. Making “speaking slowly at all times” a rule for everyone, in fact, helps!

  9. Hello,
    I really enjoyed reading your article and especially liked the analogy you gave about speech development and learning to walk. Your checklist about making speech pleasurable seems really great. My question is though, how does using drawings and the like to “show him off” to others, help make speech pleasurable? It seems to me that that’s more avoiding speech than using it in a pleasurable way.
    Would love some clarification.
    Thank you,
    Liana Friedman

    • Hi Liana!
      If the child volunteers to talk to a guest, great! There’s absolutely no reason to stop him/ her, stuttering or no stuttering. However, parents (and this happens a lot in India, I’m not sure about other countries) often ask the child to tell their name, say “Hi” or say a poem when they may not be very comfortable doing so. It is on these occasions that speech can get associated with stress, and become not so pleasant. Avoiding such incidents has therefore been included in the checklist. Bringing out something that the child has already done, like a drawing, has been suggested as an option.
      Thanks for your question!
      Pallavi

  10. Dr. Kelkar,

    My name is Haley Dorrell and I am a first year graduate student studying speech pathology. I am currently taking a stuttering course and really enjoyed how your article related to what I am learning in class. Because parents are usually unaware of their actions in increasing their child’s stuttering, what type of parent intervention do you suggest SLP’s provide before, during, or after therapy with the child? How can I as an aspiring SLP learn to educate parents on how they should talk with their child who stutters? I feel that your example of the parent saying, “tell me properly” results in the child being aware of their stuttering. Should the parent ever bring awareness to their child’s stuttering or should they allow their child to become aware on their own? I also really enjoyed your checklist. With that being said, how can an SLP coach a parent on being a good role model for relaxed speech?

    Thank you for your contribution, I look forward to your reply!

    • Parental counselling is an ongoing process. Parents should be equal contributors for stuttering therapy for their child. Training parents happens in every session of therapy, when they are asked to be keen observers. In some sessions I also ask them to “take charge” while I observe and give corrective feedback. For a child who is unaware of stuttering, is stuttering without any “struggle” or secondary behaviors, therapy should focus on reducing predisposing factors like fast rate of speech, open ended questions, competition for speaking, or parental reactions of any form. If a child seems to be aware, or conscious, on the other hand, talking about their thoughts and feelings regarding their speech would, in my opinion be the preferred path in therapy.

      • Thank you for this question, hdorrell, and for your reply, Dr. Kelkar. I had a similar question as well. I am a second-year speech language pathology graduate student and I recently conducted an assessment on a four-year old child who is very aware of her stutter and is showing secondary behaviors associated with it. She is also painfully shy and almost selectively mute while talking to unfamiliar adults. While I was only involved in the assessment and may not be involved in future treatment sessions with this child, it is good to learn when and how to start talking to her about her thoughts and feelings about her speech. I feel that there is a very fine line to walk here in not drawing too much attention to her fluency, but also allowing the emotional space to talk about how she feels about her speech. This is a tricky case since she is so young and may possibly spontaneously recover, but seeing secondary physical behaviors at this young age makes me think it’s best to treat it as if it will be a chronic condition.

        • The “when” is different for each child, how long each child takes to be completely comfortable with you. One marker of this is that the child would spontaneously start a conversation with you. As for the “how”, I sometimes start with the secondary behaviour itself. For instance, asking the child, “Why did you cover your mouth while talking?”, not referring to the block or the “speech” part of it at all. Making the child listen to or look at themselves speaking and asking for their feedback might also help. But for such a young child, I leave a large part of the “talking about feelings” to the parents, continuously coaching them as they do so at home.
          However, the first and most important step here is to ascertain that the child indeed has thoughts and feelings associated with speech. Ask the parents questions like “Does he/ she ever talk to you after a speech situation that was unpleasant or uncomfortable?”
          Therapeutic intervention for thoughts and feelings about speech has to be very subtle, through the use of stories, anecdotes, analogies, many times, not referring directly to the child’s speech at all.
          That was a really long response but hope it helps!

  11. Thanks for sharing your insights. I am a SLP graduate student and never took the time to consider how, as children, we are mostly speaking in stressful situations. I also liked your comparison of talking to learning to walk and how we are free to make mistakes when walking; however, when talking we are often corrected, increasing stress. Additionally, the checklist is a great resource, especially for parents who have a child who stutters.

  12. Pallavi,
    I like that you recommend providing positive speaking experiences for children so that they become excited to speak in a variety of situations. How can an SLP provide feedback regarding parental reinforcement for stuttering,
    without “stepping on toes?”
    Sarah

    • What I usually do is use the pronoun “we” while speaking to parents, making it a group of “well meaning adults” and not necessarily parents. I also stress on the fact that a. Our natural reactions are with the best of intentions and b. These are NOT causative factors but things which, when taken care of, could reduce chances of stuttering.

  13. Hello Pallavi,

    I really enjoyed this article because it explained how our reactions can change a stutter in someone else. I liked the inclusion of the quote “Stuttering begins in the listener’s ear”. It is a true statement but something I never thought deeply about. After all, stuttering isn’t truly stuttering until the person/child develops negative feelings against it.
    I loved the checklist about making speech fun! Such simple ideas to build off that can help a child love speech, not resent it.

    Thanks,
    Karyn

  14. Pallavi, Thank you for sharing your knowledge. As an SLP graduate student I have been learning a lot about stuttering, and how severity usually varies across different situations. I have never thought in depth about the affects a listener can have on an individual who stutters. If stuttering occurs, most parents will follow with “Slow down” not realizing the creation of stress. I agree that it could be beneficial to draw less negative attention to a child who stutters.
    Thanks again,
    Julie

  15. Hello! I am a SLP graduate student at the University of Redlands. I enjoyed reading your article and especially agree with the part that said “speech should be fun” for children and stuttering shouldn’t stop them from enjoying speech.
    I am curious about how you remind a child to speak slowly to help them with stuttering, without pointing out that “you are stuttering now” and frustrating them. During my observation of fluency disorders, the clinician always reminded the client to speak slow and to maintain a speed, but I felt that she was actually reminding them that “you are stuttering now.” Therefore, I was wondering whether you have started research or are thinking about collecting data for making a “Ground Rules of Speaking Slowly”, which clinicians could refer to and apply to their speech sessions?

    • Not yet but I think that’s a wonderful idea!
      To ensure that the instruction “speak slowly” does not get associated with stuttering, I usually put down some basic “Rules for speaking”, stressing that they are important for everyone, not just for the child.
      While teaching the parent to “measure progress” then, I mention that progress does not mean NO BLOCKS, it means remembering to use the rules for speaking, irrespective of a block. So that’s what gets communicated subtly to the child as well.
      A list of reasons why “Slow is good”, stories and analogies stressing the benefits of slow rate help as well.

  16. Hello Dr. Kelkar,
    My name is Rebecca Anderson. I am currently a second year graduate student at the University of Minnesota Duluth and I am enrolled in an Advanced Fluency Disorders course. This was a great article to read. I loved how you said that stuttering begins at the listeners ears. To relieve the pressure of speech and make it more enjoyable for the child would it be reasonable to give a checklist like this to not only the parents but also the various adults in their life such as babysitters, coaches, teachers and other school faculty? I feel it would be best for the child if speech was pleasurable in all areas of their life so they do not develop that stress that can come with stuttering from an adult in their life that did not know how to react to the disfluency. I have seen some therapy sessions that actually reinforce disfluencies for children do you think this would be another way to remove stress and create a pleasurable speaking environment?

    • Sure. Therapy sessions is where we can model for the parents the reactions that are expected/ not expected of them. Having a conversation with the child’s teacher also helps.

  17. Dr. Kelkar,

    I am a speech-language pathology graduate student who has worked with children for over 15 years, in a variety of settings. The analogy you used of a toddler learning to walk, and stumbling along the way, was really useful in helping me understand how perhaps our approach to stuttering can improve. I completely agree that speaking needs to be a positive experience to encourage children to continue trying! However, I also see the benefit in older children being able to identify their stuttering so they can begin to self-correct. In your opinion, is there a certain age range in which you think a child might be best able to acknowledge their stuttering without associating it with stress?

    • No, I’m afraid that is a very individual thing. There might be a 4 year old who is very mature emotionally and therefore very aware of his stuttering, and there might be a 5 year old who isn’t bothered much with it.
      Careful assessment, observation, rapport building and parental interviews are the only ways to find out.

  18. I really enjoyed reading this article! I thought the comparison of a toddler learning to walk versus speaking was such a great way to recognize how little mistakes in speech are treated differently. I had never thought about how a child’s speech missteps are more likely noticed and acknowledged. It was also interesting to think about how speaking situations as a young child can be very stressful. I remember in elementary school where if you talked during class the teacher would always call you out. Then when you were supposed to talk, it was because the teacher called on you or you had to read something out of the book, which could be stressful, especially if you didn’t know the answer.

  19. Thank you for your thoughts on this topic. I am a second year graduate student currently enrolled in a fluency class. I loved the concept of your title, Freedom of Speech. I think it is so important, not only for children who stutter, but for children with any type of communication disorder to feel like they are free to speak and communicate as they please. I think it is so interesting how you addressed that many speech interactions children are faced with can be very stressful and can cause anxiety in the child. I think it is so important to acknowledge these situations and to be willing to allow the child opportunities to communicate in a less stressful environment. I appreciate your comments about helping children to enjoy their speech opportunities which can be a challenge, especially for a child who stutters, but if we can support children in these instances, hopefully their stress can be lessened and the speech tasks can become more enjoyable. Thank you for your article!

  20. Hi, thank you for sharing this post! In order to make speaking more pleasurable, would you use the same checklist in a classroom setting, or would you need to adapt it to match the classroom setting?

  21. Thank you for your contribution! I really like your idea of helping children look forward to speaking rather than running away from it! I think this could work for other aspects of communication delays and disorders as well because you’re right, children are faced with a lot of stressful communication scenarios and we should help them find joy in communicating rather than stress. Thank you for your insights!

  22. Dr. Kelkar,
    Thank you so much for sharing your inspiring thoughts on childhood stuttering through this article. Though I have already been introduced to many of the ideas from your article in my stuttering classes, there are several things I never thought to consider before now. One thought I had about you article was in regards to making speech a “pleasurable act.” People who are able to speak without a stutter, or any other type of “barrier” that could make speaking more challenging, may take this act of speaking for granted. I look back on all of the times I have gotten to catch up with friends over coffee or when I was able to tell a funny story to my family, and I realize that speaking really is a “pleasurable act.” The idea of making this act of speaking pleasurable for kids who stutter has challenged my way of thinking for the better. Taking time out of my day to give them that alone time to talk about anything they have on their minds in a completely stress free environment may just give them that change to express themselves in a way that will help them enjoy the act of speaking. Though there were many other take-ways from your article, this was the main one. Thank you again for taking the time to share all of you knowledge with us.
    -Kathleen

  23. Thank you, Dr. Kelkar for the article. As I am from India, I can relate to the examples mentioned in the article. In India, parents tend to show off their kids to relatives and friends by asking to speak, narrate a story, or recite a poem in front of people who will be strangers to the child. I remember, as a child, I tend to avoid all the situations which required me to talk in front of others. If I was encountered by a question, I always used to depend on my parents to answer that for me. As stated in the previous comments, in India almost everyone is bilingual or multilingual. As a multilingual myself, I often stutter while speaking languages which are not my mother tongue, especially when I am too excited. The pressure on a child to speak fluently and correctly from parents as well as from school results in causing more problem than solving it. The checklist is really helpful for parents and using it will definitely help create speech a pleasurable one than causing anxiety and fear in children.

  24. Pallavi, thank you for sharing this perspective for implementing early childhood therapy. I completely agree that the way listener perspectives are framed contribute to the stressful situation for a PWS. As a future SLP, I appreciate the suggestions for how we should communicate with a child who stutters in a supportive way and as a role model. By educating parents and empowering children, we can take an approach that supports the child in enjoying a speaking opportunity. Supporting a PWS through allowing “Freedom of Speech” with openness and acceptance is key!

  25. Thank you for your perspective. I particularly enjoyed the analogy of a child learning to walk compared to the child learning to speak. I really appreciate your emphasis on consistency, especially in the context of creating “rules” that will facilitate efforts to achieve fluency. Providing children with a model is also very important for consistency. Using drawings as a way to communicate to offset stressful situations is also a wonderful tool. Hopefully, education about stuttering and ways to address it within the family dynamic will alleviate any possible stressors that might precipitate stuttering and allow for a safe and nonjudgemental environment for CWS to feel comfortable expressing themselves.

  26. Dr. Kelkar,

    I really enjoyed reading your article! I am personally interested in the correlation between demand speech and stuttering. Has there ever been a situation where you recommended fluency techniques that were rejected by the child’s caregivers? If so, how would you go about changing a caregivers thoughts/feelings/behaviors in order to promote fluency in a child?

    Thanks for your insight!