Treatment plan for working with stuttering children

MonicaGaiolasAbout the author:  Mónica Gaiolas lives in Lisbon, Portugal and is a Speech and Language Therapist (SLP) since 2003 and a PhD Student in Educational Psychology.  She has worked in schools and clinics in Portugal with several types of speech and language pathologies, one of which is stuttering, an area of particular interest. In 2010 she published a children’s book called: “Ernest, the stuttering boy and his family” which has been translated into English in 2015. In 2015 she also designed an app for working with stuttering children called,   “Ernest, Stuttering App”.   She has also performed several formations and workshops related to stuttering as a form of calling the attention of the educational community to this matter.

My name is Mónica Gaiolas, I’m a speech therapist (SLT) from Portugal and it would be a pleasure to participate in the ISAD online conference with a video made by me.  I have worked for several years in schools with stuttering children and I recently developed an app for working with them.

The video I made for participating in the ISAD online conference is entitled: “Treatment plan for working with stuttering children”. This treatment plan focuses on several objectives essentials for working with stuttering children. I hope you find it useful.

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Treatment plan for working with stuttering children — 40 Comments

  1. Gone check on my Ipad for this app. Looks awesome…thank you so much for this.

  2. Olá Mónica! I am a speech-language pathologist from Brazil working in the United States. Are any of these resources available in Portuguese?

    • Hello,
      Thanks for your interest in this app.
      This app is in Portuguese, Brazilian and in English, you can search it by the names:
      Ernesto, jogos para gaguez
      Ernesto, jogos para gagueira
      Ernest, stuttering app

  3. Dear Colleagues,

    I hope this treatment plan helps many professionals to cope with stuttering children. Also, from my experience it helps children doing home practise (which is fundamental to improve fluency).

  4. Dear Monica,
    Thank you for your presentation. What age are the children for which you use this e-book?

    • Dear Leonoor ,
      Thank you for your comment. This e-book is appropriate for children between 5 to 11 years old. And also is a good tool to inform school about stuttering

  5. Hi Monica, I find interesting about your work, we can learn to Mali to support children who stutter in Mali and Africa. I wanted to know if it is possible to develop a program? Thank you

    Salut Monica, je trouve intéressant votre travail, que nous pouvons inspirer au Mali pour soutenir les enfants bègues au Mali et en Afrique. je voulais savoir s’il est possible de développer un programme? merci

  6. This app looks like it would be a fun way for children to work on their stuttering. Have you had any feedback from parents and children about how they like the product?

    • Dear Emily,
      The feedback about the app has been very positive, parents confirm it’s a good tool to do therapy exercises at home, in a fun but working way

  7. Monica, I am currently a speech-language pathology graduate student who intends to work with children in the school setting after graduation. I have little experience working with people who stutter. In today’s society technology plays such a big role in children’s lives, it can sometimes be hard to motivate them to work in treatment sessions. By using apps such as these children sometimes are not even aware they are working on their stuttering because they become so involved in the games and activities that the app offers.
    I really like how you first target desensitizing and acceptance, because with children especially in the educational settings sometimes they do not understand why they are different than other children, and can have a hard time accepting it if they are being bullied or laughed at. One thing that really stuck out to me was when you said have the child draw how they feel about stuttering in the assessment process and then again at the end to see how their view changes. Do most children you have worked with in Portugal have a change in their view? I wonder if the change in view would also differ from culture to culture.
    Another thing that stuck out to me was how the games in this app allow children to listen, speak and practice. Having that auditory recording feature is very beneficial so that the child can play what it should sound like and then play their recording and decide if they sound similar. This is definitely one app I am going to look at getting when I have a child who stutters on my caseload.

    • Dear Markinelson,
      Thanks very much for your words about the app.

      Concerning your question, I believe that how society views stuttering differ from culture to culture and that has an impact on how stuttering children view it.

      However the suggestion in the app about doing a drawing about what stuttering represents to the child before and after the treatment plan, focus on the children feelings toward stuttering – that can change over the time with proper intervention (desensitizing and acceptance ) you can also start from the drawing in the assessment session and then do some behavioral therapy to improve acceptance.

      As the drawing sheet allows very precise lines you can also ask the children to write some words about what stuttering represent to him and then work with him from that starting point. So yes, the way children and parents view stuttering can be changed.

  8. Dear Monica,
    I am a Speech and Language Therapy student from England. I enjoyed watching your video presentation it was very informative. I really like the look of your app and I think it will be a useful tool for my placement and when I graduate.
    My daughter has had a stammer for a couple of years now. However, after over a year of SLT intervention it appears to have resolved. As a parent I could see us using your app at home, and I think my daughter would have enjoyed using it.

    As an SLT student and a parent I understand how important homework/practise is, but it can sometimes become difficult to get a child to engage when all they want to do is play! Therapy homework is one of many homework tasks they have to complete after a long day at school and I see your app as a fun alternative to their often mundane school homework.

    • Dear staceykerry,

      Thank you for your feedback. Motivation in therapy is very important indeed.

      A suggestion I leave for speech therapists concerning speech exercises is to add linguistic complexity to them in a more advance treatment stage. This App has only single word utterances, however you can add linguistic complexity by asking the child to do 2 or 3 or 4 words utterances with the word given by the app (the app – game speaking – allows to tape record for some time long).

  9. Hello, Monica.

    I enjoyed listening to your video. It was very insightful and the demonstrations helped further explain the activities. One aspect I particularly appreciate about your video is how when talking about stuttering through the use of the book, the child is the one who determines what makes a good communicator; nowhere do you say that fluent speech is what makes a good communicator. This leaves it up to the child to identify how they want to talk as opposed to having the end goal be strictly focused on fluency and stuttering be portrayed as a “bad” way of talking. This ties in with the goals of acceptance and desensitization you talked about.

    Also, I like how the drawing program allows children to express how they feel about their stutter. This is definitely a wonderful way to assess their level of acceptance which will help drive intervention decisions.

    Thank you for sharing your treatment plan for working with children who stutter. It was very interesting and helpful.

    Kate Collins

    • Dear Kate,
      Thank you for your sharing about the App.

      It is very important that the child understands that communication is between two or more persons and that the responsibility of good communication is of all the interlocutors.

      So identifying good and bad communicators is essential because any stuttering kid can be a good communicator and I think that’s an important message.

  10. Hi Monica,

    Like other commentors, I really like the Acceptance part where the child draws a representation of their feelings about their stutter before and after treatment. This would really encourage discussion and hopefully acceptance. Technology is a big part of children’s lives and I am excited about this app to help with fluency. Is it also available in Spanish?

    • Dear Tara,
      Thank you for your words. For now, the app is only available in Portuguese, Brazilian and English.

        • Dear Ana Paula,

          Thank you for your initiative of translating this app!

          I visited your page, very interesting and informative, congratulations!

          I also receive your e-mail, we will keep in touch to discuss things further,
          All the best!

  11. Monica,
    Thank you for the many resources you presented which can be used while working with a child who stutters. I really think the book “Ernest the Stuttering Boy” can be a great tool while working with children. It is always easier to desensitize when discussing somebody else in a similar situation. As a SLP student the book as well as the app will be a great tool to have while working with children.From past experiences do you find that children really relate to the book and can generalize what they read?

    • Dear Libby,

      Thank you for your interest in the treatment plan and for both your comments.

      Concerning the e-book, from my experience most children feel alone with their stuttering because normally they are the only ones in their classes.

      So reading the story of a boy who experiences what they are living is important. First the stuttering children start to talk about the story apart of it (they talk about Ernest) then because they start to talk about stutter them became more comfortable with the theme and start sharing their own experiences.

      About different characters; for me it is not the different stutter characters that have the main importance, but the situations. Because the situations a stuttering kid experiences are the ones that have a future impact on dealing with stuttering in their today lives.

  12. With technology becoming more and more a presence in our lives and in children’s lives, I think this app would be a fun and engaging way for children to take part in therapy without really knowing they’re doing therapy tasks. I was wondering their was only one version of the e-book? Do you plan on writing or including more e-books or stories including different children/characters so children can find a particular character they relate to or identify with?

  13. Hi Monica,
    Thank you so much for sharing your app. With today’s technology, it’s nice to be able to incorporate the iPad during sessions. Is the app designed primarily for the SLP to use in treatment or as a tool for families to use at home? Since it is so important to include the family during the intervention process, I think your app is a wonderful way to promote stuttering awareness and the best ways for the parents to educate their children about stuttering as well.

    Thanks again for sharing,

    • Dear Amy,

      Thank you for your words about the app.

      The app was conceived for both families and SLP.

      For families in the perspective of understanding and educating about stuttering and to be a part of the intervention process: being for instance a good communicator and giving their children time to speak. Also to follow the children speech practise at home.

      For SLP in the perspective of the treatment plan presented here and also to incentive the speech therapy exercises practise at home.

  14. HI Monica,
    I tried to locate your app on Apple. It appears that you have to own an Android to do so. Do you have plans to make it available on an I-Pod? The app looks like it would be appealing to kiddos and keep their interest. Please let me know what your future plans are. I have liked your Facebook page and will be looking for updates on there.
    Thank you,

  15. Thank you Monica for the great resource for working with children who stutter, technology has made it easier to access different types of therapy techniques to help find the right one that may work for a particular individual. Thank you for sharing!
    SLP trainee

  16. Hi Monica.
    Thank you for sharing your APP. I have worked with children within the age range for this APP that would have benefited from it. Apps are always a great way to help children learn, especially when interactive as your is. I like that the children are able to record themselves and form their own opinion about how it sounds. I am curious if there there are other techniques taught beyond light articulatory contact? Or perhaps if there will be others added?
    Thank you again for producing such a fun usable therapy material.
    Kendra S
    SLP Graduate Student

    • Dear notsimple

      For now this app has only the technique light articulatory contacts, but you can add other techniques (using the words given by the app) and ask the child to imitate you (taping recording himself and also self-evaluate).

      Sometimes I use voluntary stuttering with this app for instant and also used to add some linguistic complexity by asking the child to produce 3 or 4 words utterance with the word given by the app.

      Hope it’s useful,
      Best wishes

  17. Dear Monica,
    I love this app! I have been using different apps during therapy with children and I love how this app allows the child and the SLP to work together! I was wondering if your app had different examples of stuttering patterns and do you think allowing a child to listen to different stuttering patterns would help them identify their patterns?
    Thank you!
    Molly Bates

    • Dear Molly Bates

      Thank you for your words!

      In the e-book Ernest stuttering boy inside the app, there’s a page that has written examples of different types of stuttering, and the child can identify his own, with the help of a SLP. Hope it’s useful!
      Best wishes!

  18. Monica, this seems like a very excellent resource for speech therapists working with children who stutter! Thank you so much for sharing. I am a graduate student getting my degree in speech therapy and I will definitely use your app and your book with my fluency clients!

    • Dear Stephanie ,
      I ‘am glad you find it a useful resource! Thank you for your feedback,
      Best wishes for your practice!

  19. Hi,
    I am a graduate student and currently taking a fluency course. I am completing my practicum with an elementary SLP. She has two students who stutter that are very different from each other. One will not acknowledge he stutters and shuts down when it is brought up. The other does not seem to be aware of his stuttering due to some concomitant cognitive issues. I am very interested in this app because it is something that the first student can do at home, in privacy, or with the SLP if he is willing to open up. I, also, think it would engage the second student and help him become aware of his stuttering moments. Thanks for posting this, I want to introduce it to the SLP I am working with.

    • Dear daylenewoodruff ,

      Thank you for your feedback.

      I believe that the app principally the e-book Ernest stuttering boy will help both of those boys and the appgames will be a fun way to practise speech exercises.
      Best wishes for your practice!

  20. Monica—
    What a wonderful App! I especially love the social skills focus on child+parent/family desensitization and acceptance. You mentioned in a previous comment that this App is for children ages 5 to 11—are there ways to modify the games and tools of this App to be applicable to older children?

    • Dear eJones,

      You can extend the app game’s age, until 15 years old, I have already used with that year range. The adaptations have to be mastered by the SLP, there’s no way to do it in the app, but you can still use the app (words and facilities) in other ways by giving yourself the model you want adolescents to follow.
      Thank you for your words about the app,
      Best regards