The “S” Word: Talking to Children, Teens and Adults about STUTTERING (Rita Thurman)

About the Author: Rita Thurman, M.S., CCC–BRS-FD received her Master of Science degree in Communication Disorders from Utah State University in 1977.  She has worked in the schools and in clinical settings in Utah, Idaho, Illinois, Montana and North Carolina.   She has been in private practice in Raleigh, North Carolina since 1985. Her practice focuses on the evaluation and treatment of children, teens and adults who stutter.  She is a Board Certified Specialist in Fluency Disorders and serves on the Executive Board of the American Board of Fluency and Fluency Disorders.  Ms. Thurman was awarded the North Carolina Clinical Achievement Award in 2012 and the NSA Speech Language Pathologist of the year in 2015 for her work to improve services for children and adults who stutter.

Ms. Thurman is a National Stuttering Association Adult and TWST (Teens Who STutter) Chapters leader, coordinates a Parent-Child Stuttering Information Group and sponsors an annual Friend’s Workshop in North Carolina.

A few months ago, a 13-year-old boy and his father came to my office for an evaluation.  The son had been going to therapy for stuttering since he was four years old.  But when I asked the father the reason for the visit, the father said: “We want to find ways to help J. with his bumpy speech.”

Why is it so hard for parents, therapists and even people who stutter to say the “S” word?  Why do we insist on terms like “bumpy speech” or “dysfluency”?  The misuse of terms is not only confusing, but perpetuates the stigma of stuttering. If you can’t even say the word, it must be horrific.

Stuttering and the Preschool Years

But let me back up.  I use “bumpy”, “stopped speech”, “smooth” when a child’s developmental vocabulary requires description rather than labels.  At the age of three and four, those terms make more sense to a child.  But I also tell them: “Sometimes people call that stuttering and you may hear that word.”  I often hear a gasp from a parent when I say that or when I talk about a preschool child’s reaction to their stutter.

When I treat preschool children who stutter, I talk to them about what happens when they stutter, how it feels when it happens and how they react to it.  During a therapy session with a four-year old, after he experienced a significant block with struggle behavior, he stopped and heaved a giant sigh. When I said: “Wow, that was really hard, what did that feel like?”  He replied: “It felt like a big rock came up from my tummy and stuck in my throat so that the word couldn’t come out.”  Wow!  For someone that young to have that insight….it would be a shame to dismiss it or pretend we didn’t notice. It is important to give validity to those physical and emotional feelings as soon as they emerge.

During another session, a different four-year-old described his block by saying: “I don’t know what happens, the word just won’t come out.”  When I asked: “What do you do when that happens?” He said: “I use a different word.”  Avoidance behaviors can start young and need to be addressed.

During the NSA Research Symposium this past summer, Rick Arenas presented his work on anticipation in people who stutter.  His research indicated that a large percentage of people who stutter anticipate the moment.  If a child is reacting to his stuttering moment before it occurs, he has struggle behavior in the moment of stuttering, he senses shame/frustration/embarrassment following the stutter –you need to be there to validate those feelings, not dismiss it.

Sure…many preschoolers are oblivious to the repetitions and blocks, continuing to describe their latest Lego creation, playground adventure or tea party.  Is it OK to talk to those preschoolers about stuttering?  Absolutely! Let them hear the language from a concerned, caring adult–before they hear it from the gutter.

Recently, a Speech Language Pathologist who treats preschool children told me that her strategy for treatment was to make preschoolers think that they were coming in to play games, implying that she would never talk to a preschool child about the reason he was in therapy or the goals of the session. While games can certainly be an effective way to engage with children of that age, it can be very confusing for a child to know that even adults don’t understand why he stutters and worse, can’t talk about it.

Stuttering and the School Aged Child

As children grow, the way we talk about stuttering changes because the experience of stuttering changes.  As children develop and begin to experience stigma in communication situations, we need to recognize and give language to that experience.  In a study about stigma associated with mental illness, Biernat & Dovidio state: “When people reported concealing the true nature of their illness by using ambiguous terms, they were unable to face the challenges of their illness.”

Recently a parent of a third-grade child contacted me to say she was seeking therapy for a “fluency disorder.” When I asked the mother, what type of stuttering she saw at home, she said, “Oh, he doesn’t stutter, he has a fluency disorder.”  Although this family had met with multiple educational professionals when her child had been tested through school, none of them had used the term “stutter.”  I suspect they considered “fluency” a euphemism, when in reality it only served to confuse the true diagnosis and perpetuate the stigma of stuttering.

At this age, stigma can frequently lead to bullying. Janet Beilby’s research revealed “that young people who stutter experience greater adverse impact on their lives and more bullying than their fluent peers.”  Children often don’t want to discuss bullying because they want to handle it themselves, are embarrassed by the event, or are worried that their parents will overact.

But like stuttering, talking openly about bullying can have a positive impact. I have a monthly “communication group” for children ages 7-11 years of age who stutter.  Our meetings give them a chance to develop communication skills but also to talk about stuttering openly with their peers. In the course of our discussions, we often role play bully situations.  When we present the skits and role playing to parents at the end of the session, parents are usually more uncomfortable discussing these topics than the children. But like stuttering, bullying needs to be acknowledged and addressed.

Stuttering and the Teen/Adult

The two greatest social sins a teen can commit is to do something that is “awkward” or something that makes them appear vulnerable.  Stuttering can often result in either or both. In order to elliminate this awkwardness, I like to tell the teens that I work with a quote from one of my favorite comedians: “Tragedy + Time = Comedy.”  Although it can be tough, it is possible for teens to find humor in stuttering-with guidance. This is best accomplished but putting teens who stutter together in a supportive environment while discussing those awkward situations and how to deal with each.

One night in my NSA TWST (National Stuttering Association– Teens Who STutter) chapter, we were discussing jokes, bullying, and teasing.  One teen reported that his first-grade teacher asked him a question in front of the class and when he blocked on his answer, she said sarcastically: “Do we need to call an ambulance?” Although the parents in the room became teary eyed, the teens recognized the enormity of the situation and then created humorous ways that the teacher should have been tortured. They were able to reflect on an upsetting incident with humor….together.

In both my TWST and adult chapters, we try to use the word “stutter” to describe and desensitize to the word.  Some of my teens and adults will tell other people they have a “speech impediment” or say: “I have trouble saying….” This ambiguity leaves the listener questioning whether the person who stutters had a stroke, has word retrieval issues or learning difficulties.  Just saying: “I stutter, so sometimes you will hear that” can be freeing and kind to the listener who is trying to figure out what is going on or how to respond.

Disclosure or “advertising” a stutter can help reduce anxiety and stress in a situation.  The authors Blood, Blood, Tellis and Gabel discuss the importance of talking about stuttering and telling people about your stuttering to reduce stress and isolation. Conversely, in his studies involving people with social anxieties and depression, Goffman, found that patients’ attempt to avoid disclosure resulted in stress, isolation and a sense of shame.

Desensitizing to the word may be a first step for many people.  I give homework assignments to teens that require them to say the word at least once a day.  I believe that saying the word out loud empowers the person who stutters and takes power away from the word that often connotes shame and sadness. After all, the famous villain in Harry Potter was referred to as “he who must not be named.”  What power Voldemort held because everyone was too afraid to even say his name!

When I pair mentor groups in therapy (an adult working with a teen, or a teen working with a child) I always ask the mentor to tell their mentee about their stuttering before we start.  I love the look on a child’s face when a teen says: “When I stutter….” Or “I stutter…” –They have connected in a unique way and were not afraid to say the word out loud.  Often in this situation, the child says: “Wow, me too!”

As we all strive to develop a World that Understands Stuttering, let’s start by using the real vocabulary:  STUTTERING, STUTTERING BLOCKS, STUTTERING PROLONGATIONS, STUTTERING REPETITIONS.

Words have power and energy.  Let’s direct that power and energy towards positive outcomes for people who stutter.  Go ahead…say it out loud.

 

References

Arenas, Richard M. Ph.D., University of Mexico  Contextual Variability of Stuttering:  Its impact on quality of life and how anticipation may be playing a role.  2017 National Stuttering Association Research Symposium

Biernat & Dovidio—Stigmas and Stereotypes The Social Psychology of Stigma 2002

Beilby, Janet. —Social Impact of Living with a Stuttering Disorder: Knowing Is Not Enough. Seminars in Speech and Language. 35 (2)–2014

Blood, Blood, Tellis, Gabel  —The social and communication impact of stuttering on adolescents and their families:  A preliminary study of self-esteem, stigma, and disclosure in adolescents who stutter  –Journal of Fluency Disorders–Volume 38, Issue 4, December 2013,

Goffman E. Stigma: Notes on the Management of Spoiled Identity. Englewood Cliffs NJ: Prentice Hall; 1963.

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The “S” Word: Talking to Children, Teens and Adults about STUTTERING (Rita Thurman) — 127 Comments

  1. Hi Rita,
    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. I love how you discussed the fear of using the word stutter like how in Harry Potter people are afraid to say Voldemort. If a child has already developed the stigma for saying stuttering how would you attempt to change that mindset for themselves and their family? You stated that tragedy + time= comedy. This may be true for those who stutter with being desensitized to the stigma of stuttering through therapy and support groups but what about their families. The families may have helped develop the stigma of the word stuttering and may hold onto it still so how would you go about changing that stigma for everyone else in that child’s life that may have helped perpetuate it?

    • Hi Rebecca,
      That is such a valid question! Often children have developed a stigma about their stuttering and then your work is different than prevention. I think some of the Acceptance Commitment Therapy guidelines are helpful, particularly working on thought defusion. Through this process, the child and parents look at those negative thoughts and learn how to manage them. The comedy equation only works if it is initiated by the child/teen. We or the parents should never try to make it seem light or amusing.

      You are right that some parents have developed a stigma and hold on to that, which overflows onto their child’s perception. I think that one of the most beneficial opportunities for parents is meeting adults who stutter. I host a one day workshop for Friends (the association for young people who stutter) every year in our state and the parents always tell me that the most powerful part of the day is the adult panel. To see adults who stutter openly without shame, announce to a crowd “I am a person who stutters…,” have successful careers as lawyers/doctors/rocket scientists and loving families and children of their own–is life changing.

  2. Hello Rita,

    I really enjoyed reading through this paper! I loved how you address stuttering in kiddos especially! I recently had a child who stutters added to my caseload at the school I am placed at. The mother of this particular child asked us to “take a look at her stuttering” so I started my assessment. As I went through the overt stuttering assessment it started to dawn on me that this 8 year old did not even know that she was a person who stuttered. It shocked me to think about this child’s mother never discussed or even mentioned the word “stutter” to this child! This child knew that something about their speech was different from their friends, but has never been able to learn about it or even to label it! That is why I particularly enjoyed the first section of your writing. Thank you so much for sharing this!

    • You are most welcome! I often have children come in for an evaluation and when I say…”so, I am a speech teacher, do you know why you are here?” I am often met with “I have no clue!” Sometimes, in spite of parents guarding their child and saying nothing about it, the child will say: “I’m here because I stutter.” It is often just matter of fact and that is when therapy is the easiest!
      Thanks for your kind comment!

  3. Rita,
    My name is Amanda and I am a first year SLP graduate student. I found what you said to be very insightful. As a future SLP, I hope to avoid this stigma behind using the word “stuttering”. I very much enjoyed the part where you mentioned you having a communication group with elementary aged students. I think it’s great to have same aged peers who stutter come together and practice their communication skills on each other. This outlet is a wonderful opportunity to talk about their stuttering with others who understand how they feel.
    You mentioned above some instances with parents who did not use the term stuttering in regards to their child’s speech. How did you educate these parents about the term?
    Thank you for your wonderful insight into this topic. I really enjoyed reading what you had to say!

    • Hi Amanda,
      I find that if I use the word a lot, teach children to use it, the parents start to feel comfortable as well. One game that I play in my teen and children’s group is called “Me Too” –although I may need to change it with all the Hollywood #s recently developed…but, it goes like this. You go around in a circle of kids or teens who stutter and say something about yourself (I play soccer, I have brown eyes.) If someone shares that trait, they shout “me too!” You get points for the number of “me too”s you get. The kids soon learn to say: “I stutter!” Everyone says “me too” and you get the most points.
      thanks for reading!

  4. Hello Rita,

    I am a speech-language pathology graduate student and reading your paper was a big eye opener. Although I have never had any clients who stutter, I always envisioned that I would be using the terms “bumpy speech” with a younger client. However, I completely agree with you. I think that it’s best that we introduce the term “stuttering” as early as possible. Children should know why they are experiencing those physical and emotional symptoms. I also think that it is important for parents to introduce the term stuttering to their children as well. The fact that parents use terms like “bumpy speech” gives off the impression that stuttering is something to be ashamed of. Children should know from an early age that there is absolutely nothing wrong with being a stutterer.

    After reading your paper I was curious to learn more about your National Stuttering Association- Teens who STutter Chapter. Besides desensitization, what other topics do you discuss in your group?

    • The teen chapters are a wonderful thing! They are wild, crazy, fun and the teens are given a safe place to come each month. We do a lot of improv, myth busting, team building, role playing games (Ultimate Werewolf is my favorite,) discuss bullying, what makes good communication, discuss value chains, and any crises that anyone is facing that month. The important aspect is to meet other teens who stutter, have fun and feel comfortable communicating with others.

  5. Hi Rita,

    I’m a second-year grad student and SLT here in Utah. I so appreciate your paper! I’ve been working in an elementary and a junior high this year, and despite learning about techniques and the nature of stuttering, it’s still tricky to know how to address the disorder itself. I’ve observed SLP’s who use the “bumpy” wording, but it makes so much sense to limit that to younger children and integrate stuttering as the client gets older. I really appreciated the Harry Potter reference, as well! I’ll be referring back to your paper before IEP meetings and therapy sessions in the future.

    • Aw Utah–my home town! Yes, treating the chronic nature of stuttering is a challenge. I think that the more you involve the child/teen/adult in the process, the more successful the therapy. What does he/she know, understand, believe about their speech and what do they think helps? Including cognitive, emotional goals are crucial and thinking about changing the way a child reacts to his/her stuttering, not using a technique that you think will make it go away. Don’t give the impression that their stuttering would improve if they only tried hard enough, worked hard enough, etc…that set them up for failure and shame. Thanks for your comments!

  6. Hi Rita,
    I am a current graduate student aspiring to become a Speech Language Pathologist. One of my main goals is to be able to have a positive impact on individuals that stutter. I believe the clinician and the patient should both hold positive attitudes to have positive outcomes. I found your paragraph interesting on desensitization, I like how you ask them to embrace it and use it to empower themselves. Often times, stuttering ha a negative stigma but by having them embrace it and having them be empowered by it, it dismantles the stigma. Bullying takes place throughout the school system, in all grade levels, as well as out of a school setting; I really enjoyed how you make it a focal point in your group sessions. How do you address avoidance behaviors in preschoolers? What advice would you give future clinicians in how to approach the different age levels?

    -Elizabeth Pina

    • Thanks Elizabeth,
      I loved your comments and think you are going to be an amazing SLP given how insightful you are already!

      Bullying takes place….throughout life! There will always be someone who will tease, comment (did you forget your name?) and say negative things about stuttering–even adults. The more we recognize this, the more we can prepare our children/teens/adults.

      Whew –avoidance behaviors are tough. Wouldn’t you want to avoid unpleasant situations if you could. I encourage all ages to “say what you want, when you want” because I want to hear your message. If we value fluency above everything, we are sending the message that you must do anything to stay fluent. If we value communication, we send the message that what that child has to say is important.

      However, I wish it were just that easy. It is hard to tell a child to say what they want when, in fact, someone may laugh at them. Creating successful, comfortable communication situations is key. Putting kids together who stutter so that they meet others who share their experience is imperative. Thanks for your comment.

  7. I am a current graduate student enrolled in a fluency course. I loved the notion of this article, to not be afraid to use the term stutter/stuttering when speaking with a client, especially with a young preschool aged client. In my class, we have discussed the importance of building rapport and validating clients feelings and experiences. I particularly enjoyed the thought that it is so important to validate the feelings of the preschool child who is stuttering. I thought the discussion groups for the school age children were such a great idea. These children may be experiencing bullying or other types of encounters so a safe place to discuss those experiences is wonderful. I also loved the concept that as children grow they will have different experiences and different feelings associated with their stutter so they need to be able to express their feelings about these experiences. The overall theme of this article, to use the appropriate term, stutter/stuttering, is so important. I can see the importance of using the actual word, stutter, in order to desensitize the word as well as to help decrease any confusion or wonder when speaking to an unfamiliar listener. In class, we have discussed the use of disclosure statements, and this article has increased my understanding of their importance. Thank you for the article!

    • Thanks for your wonderful comments. It sounds like you have an awesome class!
      Good luck in your upcoming, exciting adventures in the field of Speech Language Pathology. This is year 40 for me in the field and I have loved the ride!

  8. I really enjoyed your perspective on stuttering therapy. I’m currently a 2nd year grad student and am taking a fluency disorders course right now. We frequently discuss the importance of aiding the client with acceptance and I feel like your article goes right along with that! I think using the term “stuttering” openly rather than treating it like a taboo topic opens the channel to that acceptance. I also LOVE your idea of a “communication group” for the SA population, I think it is important to address the covert aspects of stuttering that may emerge because of bullying. Thank you so much for your insights, I really enjoyed what you had to say! Also, I have to say that while I was reading your article, I thought of Voldemort and so when you tied that in at the end, I was very happy haha. Thanks again for your wonderful insights!

  9. Hello Rita,

    I enjoyed reading your perspective on stuttering and the stigma surrounding the word itself. As a graduate student, I expect to encounter parents or PWS who are uncomfortable with the notion of stuttering and, in turn, are afraid to confront the issue head on. Your insight into ways to desensitize individuals to stuttering proved to be thought provoking. I imagine it can be difficult to come to terms with issues one faces, but in doing so, a PWS or their family can then have open and frank discussions about the struggles they may be facing which will help with the family dynamic in general. The overall acceptance of stuttering is an issue that must be addressed with every client and their family to open the door to greater communication about the stigma surrounding stuttering.

    Thank you for your insights,
    Hannah Z.

    • Thanks Hannah!
      I think that another important part of “acceptance” is that it doesn’t mean “throwing in the towel.” I even like the word “recognize” better…although all the ACT literature talks about the A word. Recognizing, understanding and retaining perspective are key to the “Acceptance.”
      thanks again for your comments.

  10. Hi Rita,

    I am a 2nd year graduate student at the University of Redlands. This is my first semester working with a client with a stutter and I’ll admit, I am one who does not like to use any variation of the term “stutter”. I feel like especially in today’s political climate where the idea of political correctness is so stressed, terminology used for people who are atypical is a very delicate subject matter. Prior to starting this clinic, I had only ever encountered one person who stutters and he was my great uncle. Everyone in my family knew he had a stutter and everyone ignored the stutter itself as well as avoided ever talking about it.

    I can understand that calling a stutter a “stutter” may reduce the negative stigma associated with it; reducing the fear of a word can reduce the fear of the thing itself mentality and that “disclosure or “advertising” a stutter can help reduce anxiety and stress in a situation.”

    However, when you wrote about the teen support group that used humor together to empower themselves, I felt a little uncomfortable with the idea of the teens joking about “torturing” the teacher for his/her bully-type comment. I wonder if you’ve ever encountered a situation where specifically joking about “getting back” at those who have bullied them for their stutter has ended up isolating those who stutter even more. Because their method of coping is to imagine a punishment for their bullies, do they not further increase the animosity against bullies and further reduce the desire to talk about and explain their stutters?

    Thank you for sharing!

    Ilse

    • Hi Lise,
      Thanks for your comments! You are right! It does feel uncomfortable for teens to respond that way–but, I am not a teen and I don’t stutter. The people in the group who share that experience recognized that feeling of wanting to get back and that link is crucial for a teen who stutters. Actually, the reaction seemed pretty natural to me at the time. Who hasn’t thought after an unpleasant interaction: “I wish I would have said–“then, realized is was actually better you didn’t. I would have to disagree that the increase in animosity would reduce the desire to talk about their stuttering. It actually increases the opportunity to talk about it and explore their reaction to communication situations. My teens often have strong reactions to situations. It doesn’t mean that they will act on them. Although, I do like the idea of teen vigilantes taking down every bully in town. I think recognizing those emotions, validating them and not passing judgement on them is the best support we can give teens. If we don’t, they won’t talk to us anymore.

  11. Hello Rita,
    I am a graduate SLP student who is currently in a fluency clinic. I enjoyed reading about using the stigmatized “s” word in order to empower those who stutter. I believe this should be implemented when the child is young and you suggested the child to be around 3-4 years old. But I want to know to what level of previous awareness of “smooth and bumpy” speech should they have before you introduce the word “stutter”? I want to know if they need to be very familiar with “smooth and bumpy” before using the proper terminology.
    I agree that the family/parents should use the “s” word when talking about their child’s disfluencies. If you notice that the family does not use that stigmatized word, when would be the proper time to start saying it when speaking to them about their child’s stutters? Should you explain why it would be beneficial to label these disfluencies as stutters?
    Thank you!

  12. Hi Rita,
    I am a second year graduate student studying Speech-Language Pathology at the University of Minnesota Duluth and I am currently enrolled in an Advanced Fluency course. I really enjoyed reading your paper, you brought many great insights into using the “s” word and the stigma of using this word. I think it is important to become comfortable with using this word, and that can start by teaching kids at a young age. Besides the immediate family of the child, who else would you want to educate about becoming comfortable with using this word and labeling the behavior?

    Thanks for sharing.

  13. Hi Rita,

    Thank you so much for your insightful paper. I am a second year graduate student taking a fluency course, so I found your article particularly helpful in discussing how to address stuttering and help clients come to terms with their stutter. I am fascinated by your groups, and how you help these teenagers laugh about difficult situations that happened to them. I think commedy is an incredibly powerful tool to utilize. I also found it particularly interesting that you said the word “stutter” should be used and practiced with all ages, helping them come to terms with their stutter and remove the stigma.

    My question is with the termonology PWS, or “persons who stutter”, versus using the term “stutterer” to describe someone with a stutter. In addition to encouraging the clients to use the “s” word, do you believe this change in termonology has decreased the stigma the world, and the individuals themselves, have about stuttering?

    Thank you again for your important insights!
    -Shira

  14. Hello Rita,

    Thanks for this insightful post-I agree with you in that it would be better to explain to the child and/or parent about stuttering, what it is, etc. (rather than avoiding the term). Do you find that actually stating the word “stuttering” provides any relief to the child? My thoughts are it may be a relief since the child would know it is not his/her fault for having trouble getting words out.

  15. Rita, I really enjoyed reading your article about stuttering. I am a second year SLP graduate student and currently taking a class on stuttering. I feel like you explained it so well when you said that part of the reason we need to talk about stuttering is to desensitize the word. Just like Voldemort, it seems like people are often afraid to say the word or even bring up the topic. In my experience, the less something is talked about, the more awkward it becomes with time. And then it’s even more awkward when it is brought up. By having discussions about stuttering, we are increasing acceptance and awareness, allowing for more open communication. Communication shouldn’t be something we dread, it should be something we enjoy! Thanks again for your thoughts.

  16. Thanks for your inspiring paper. My parents could not say the word stuttering, as it was so loaded with negative emotions. Stuttering wasn’t even accepted as such in our family. I worked hard on my self esteem and have been a speaker, talking about stuttering, for many years. I advertise with buttons, t-shirts and bracelets. For as long as we feel stuttering is something shameful, the world will not change. I didn’t choose to stutter, so I should not be ashamed of it. Instead I’m proud of me, as I’m doing something that’s challenging every single moment of the day, but still do it! I wish we could wipe away that shame and exchange it with pride. And I proudly where my button with my own text “Sure I stutter. What are you good at?”

    Keep talking!

    Anita S. Blom, Sweden