“Bouncing Back” from Microaggressions – Heather Grossman and Mark O’Malia

 

About the Authors:

Dr. Heather Grossman, the Director of the American Institute for Stuttering, has worked with people who stutter for over 30 years and was among the first select group of Speech-Language Pathologists to received certification as a Specialist in Fluency Disorders from ASHA (American Speech-Language Hearing Association. She has extensive experience in supervision and has taught graduate courses in fluency and other topics at several Universities including Hofstra, Queens College, and the University of Louisiana. Dr. Grossman’s research has focused on the phenomenon of voluntary stuttering. She is a frequent presenter at both national and international professional conferences. She is also an active member of the stuttering self-help community and regularly volunteers her time to support FRIENDS: The National Organization of Young People who Stutter.

Mark O’Malia, M.S., CCC-SLP is a speech therapist and person who stutters. He is a full-time clinician at The American Institute for Stuttering in NYC, working with people who stutter of all ages. Mark is actively involved in the stuttering self-help community, frequently facilitating and presenting workshops at national conferences for both Friends and the National Stuttering Association (NSA).

Introduction

The term “Microaggression” has been defined as a ‘brief and common daily verbal, behavioral, or environmental communication, whether intentional or unintentional, that transmits hostile, derogatory, or negative messages to a target person because he or she belongs to a stigmatized group’ (Sue et al., 2007).  In the case of stuttering, these communications often take the form of “compliments” that nonetheless transmit a negative message. Unfortunately, listeners are often completely unaware of the negative messages underlying many of the well-intended suggestions that they give PWS. Think about the possible implied meanings behind the following examples:

  • “Ok, just take a breath and slow down”
  • “Can you say it again using your tools?”
  • ”You sound so good!” or “Great job” (after a patch of fluency)
  • “You sound so much better!”
  • “Your uncle grew out of his stuttering, so will you”
  • “You did great, you didn’t stutter at all”
  • “You don’t even stutter that much, it’s no big deal”

Non-verbal examples of microaggression often take the form of listeners attempting to “spare” the PWS from being seen stuttering or talking in general. These include: 

  • Looking away during stuttering moments
  • Gestures that implies “move it along”
  • Guessing/Filling in the stuttered words
  • Speaking “for” PWS so they don’t have to

 PWS must call on their resilience in order for these microaggressions to not result in damaging negative self-talk related to stuttering. 

We assert that therapy protocols that focus on using traditional “speech tools” to achieve fluency, as well as the corresponding positive reinforcement that is provided for producing fluent speech can actually be very detrimental in the long run, eventually leading to excessive struggle to speak fluently and an ever-increasing set of avoidance behaviors to suppress stuttering.

There is one clear dynamic that most PWS will agree with; The consequences of demanding perfect fluency include anxiety, employment of avoidance behaviors, and an increase in physical struggle related to speaking. While it is human nature to ‘prefer’ fluency, it is empowering for PWS to give themselves permission to say what they want to say, stutter and all. As they systematically face communicative challenges head on without employing tricks to be fluent, many PWS come to rediscover their natural fluency, and find themselves stuttering without recoil or negative accompanying thoughts and emotions. Listeners can help those who stutter by supporting them in this pursuit for healthy acceptance. 

CLIENT PERSPECTIVE from a PWS, now an SLP

For many years of my life, fluency was the first thought that crossed my mind in the morning and the last thought that entered my mind at night. I was obsessed with sounding “normal”, and every moment of stuttering was seen as an affront to my ability to belong. I saw the content of my message as much less important than my ability to say something – anything – without a single stutter. 

In reflecting on these thought processes and following the threads back to their origin, I realized that much of my obsession came from the time I spent in and out of speech therapy as a child and young teen. Whenever there was a challenging presentation in class that resulted in struggle behaviors, a phone call that resulted in the dreaded “click” of a hang up, or an introduction that turned into a smirk, a laugh, or the dreaded “Did you forget your name?”, I would bring these situations up in the safety of my speech therapist’s room. While the faces of my well-meaning and kind SLPs changed throughout the years, the message of “That’s okay! Let’s try harder to practice your techniques!” did not change. I would quickly agree, and by the end of the session, I was using my tools with near perfect accuracy. This would be met with a variation of “See! You can do this! You sounded so great there – no stuttering at all!”. 

It was only a matter of time before I was back in class, paralyzed with fear at the thought of raising my hand or reading aloud. My “fight or flight” response was activated, and I was physically, mentally, and emotionally unable to access rational thought to use my “toolbox” in the ways I showed my therapist I could just hours before in the low-stakes therapy room. This would crush me, and my feelings of disappointment and self-blame would be increased when I was met with a variation  of “What’s going on, Mark? You and I both know you can use those tools so well! Speaking fluently is in your grasp – are you still practicing?” from my SLP in our next session. On the outside, I agreed and committed to practicing even harder. On the inside, I was given confirmation that the only way I would ever be worthy of sharing my true self would be if that true self never stuttered. 

This cycle continued for the first 21 years of my life, and it caused me to convince myself that every moment of stuttering was nothing more than an “X” on a data collection sheet, which inevitably led to shame, fear, and eventually, avoidance of speaking situations that would have brought me joy.  

I was stuck in this loop until I found speech therapy as a young adult that fundamentally addressed my relationship with stuttering and the toxic attitudes that came along with it. For the first time, I heard messages that placed explicit value on my contributions to a conversation, on staying with a moment of stuttering instead of choosing avoidance and compromising myself, and validated the fact that facing a fear is a success in and of itself, no matter the percentage of syllables stuttered while approaching it. Fluency was acknowledged, but was not actively celebrated as adding any more or less value to my communication. This allowed me to develop a solid foundation of valuing saying what I wanted to say, sharing my experience of stuttering with others to create a support system, and eventually, making adjustments to my communication behaviors (e.g., establishing eye contact, reducing unhelpful escape behaviors, “leaning in” to moments of stuttering, and reducing tension) because of my personal choice to become the best communicator I could be, rather than an obsessive need to eliminate stuttering in order to feel that my messages had value. 

I have come to learn that it is not necessarily what we say that matters most, but what we are not saying under the surface that leaves a lasting impression. While comments that come from a genuine place of encouragement about fluency can seem harmless or even motivating, they also make it clear what is being valued most in any given situation. By definition, if we are constantly praising moments of fluency and never mentioning the valuable content of a client’s words, we are also sending the underlying message that stuttering is something “less than”. This becomes problematic (or even traumatic) when we have not helped a person develop the skills to “bounce back” from challenging situations where they first may need to work through their fear of speaking. 

The Role of the SLP in Cultivating Resilience 

While we do not claim that there is a “one size fits all” approach to working with people who stutter, we recognize that the words we use as both clients and as speech therapists to describe stuttering directly inform values and goals for communication. No matter the individual philosophy of stuttering therapy used, therapists must be mindful of the messages that they are sending to their clients, and work to minimize any implicit shame that is in the form of “reminders” or “helpful tips”. It is vital that we emphasize communication over fluency as well as spontaneity over diligence. 

For children, we help parents support their child’s freedom to communicate and grow in their resilient coping responses. Rather than praising fluency, we encourage parents to use comments such as: 

  • “I love the way you talk!”
  • “Wow, you made such a great point, that was so smart!”
  • “I know that took courage to talk there and I am very proud of you”
  • ”What you have to say is very important, and I am here to listen no matter how it comes out or how long it takes”
  • “You can talk to me anytime about stuttering, and I will always try my best to understand”
  • “I have struggles too, maybe we can talk about them together..”

For older children and adults, we most likely will need to address “bouncing back” from the negative messages conveyed by past microaggressions. In addition to helping the client identify and dispute the validity of the underlying messages of these experiences, we promote self-advocacy skills to help deflect those that might occur in the future. Helpful therapy protocols may include stuttering intentionally, working on self disclosing stuttering confidently and without apology, and reinforcing open, forward-moving, non-avoidant stuttering. 

We assert that given the many microaggressions that PWS typically experience in their journeys, it requires significant resilience for those who stutter to speak freely without fear of reaction. It is vital that therapists be aware of the often paradoxical impact of rewarding fluency, and instead work toward helping both children and adults who stutter to speak their mind without fear.  

References

Sue DW, Capodilupo CM, Torino GC, Bucceri JM, Holder AM, Nadal KL, Esquilin M (2007). “Racial microaggressions in everyday life: implications for clinical practice”. The American Psychologist. 62 (4): 271–86.

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Comments

“Bouncing Back” from Microaggressions – Heather Grossman and Mark O’Malia — 69 Comments

  1. Nicely written paper on a fascinating topic. One of the problems with microaggressions is they can always be attributed to a reason having nothing to do with stuttering (e.g., “I always look around during conversations”) and it’s hard to tell when that’s true. The one I really hate is when I join a conversation, say something disfluently, & the listener says, “uh huh”, then goes back to talking to the other person. It’s like getting a verbal pat on the head for trying. And I know if I complained I’d get a response of “We were just continuing a previous conversation.”

    • I hate that soo much too. Never forget when it comes to microaggressive or harmful behavior like you described, it should always be about how the person that’s been affected (the stutterer) feels and interpreted the situation. Good intention or not, it is still actions that sting your heart and its important to never diminish those feelings within yourself. <3

  2. Thanks Mark and Heather! I often use the language of “stay in the moment” so we can understand it, but I love Mark’s language even more of “leaning in” to moments of stuttering. I also believe that there are “self-microaggressions” that people who stutter can engage in–“I had a really good week and didn’t stutter at all” or “My stuttering was so bad this week, I don’t know what was going on…” I think that these kinds of comments are important to address in therapy as well.

    The comments delivered by well meaning parents need to be handled gently. No parent wants to hear that they are engaging in microaggressions. Especially when they think that they are doing the right thing. I have the parents and children complete a form called “Helpful or Not Helpful” and they explore together what language values communication.

    Thanks again for an awesome paper!!

    • Thanks so much for your comments, Rita! I certainly agree that helping a client become more aware of the language they use to describe their lived experience with stuttering is an important part of the therapy process. While it may be a comment in passing, it sets the stage for a healthy amount of curiosity of where certain value judgments are coming from in the first place.

      I also agree that the last thing we want is to play the “blame game” with parents for how they have chosen to frame their child’s stuttering in the past. I think this highlights the importance of investing in a therapeutic alliance not just with the child, but with the entire family as well.

  3. Thank you Mark and Heather for this contribution! I especially like that you help parents to reinforce communication and spontaneity.

    Kristin Chmela

  4. This idea of micoagressions is such an important topic to discuss. While, most individuals never mean to be rude to a PWS, comments such as “you don’t even stutter that much, it’s no big deal” minimizes the lived experiences of PWS. Comments like the one mentioned above continue to reinforce the idea of stuttering as something that needs to be cured. This article provides a keen insight into how microaggressions, overtime can cause significant damage to a person’s self-confidence. As a soon to be new SLP, I take heart in being mindful of how I reward fluency. Instead, I hope to help PWS embrace their stutter and understand that they have as much right as anyone else to speak freely and openly without judgement

    • Thanks for your thoughtful comments. I think being mindful of the power of language and working with clients to figure out what is being valued most is such an important foundation for the real work of stuttering therapy. Good luck in starting your new career!

  5. Hello Heather and Mark,

    Congratulations on your thought-provoking paper. I find myself wondering whether a focus on “microagressions” may lead to more resilience, or less. According to one scholar on the subject, “The idea of microaggressions has some merit in that frequent, repetitive annoyances and slights can psychologically build up to be a problem or even intolerable.” I agree. However, there is a downside. The term “microaggressions” has its roots in the belief in Critical Theory that society is constructed with invisible systems (e.g., patriarchy, racism, sexism, imperialism, and, most relevant here, ableism) that manifest in ways undetectable by dominant groups (e.g., people who do not stutter) but felt as a perpetual barrage by marginalized groups (e.g., PWS). Despite the root word “aggression,” according to Theory, a microaggression occurs regardless of intent. Therefore, for example, a person who fills in a word, speaks “for” a PWS, or compliments stutter-free speech cannot be engaging in a well-intended, good-faith effort to be helpful, but must actually be speaking one’s “socialization into systems of oppressive power imbalances,” according to Theory. Since there is no way to mistakenly identify a microaggression due to the absolute authority of the victim’s perception (aka, lived experience, or standpoint epistemology), there is reason for concern that focusing on microaggressions can train people to become increasingly aware of and sensitive to minor affronts that they could even be reading into the situation entirely, with no way to gauge the accuracy of their perceptions. In other words, they may be training themselves to make mountains out of proverbial mole hills, with all of the corresponding psychological baggage this may entail. This problem has been described by Greg Lukianoff and Jonathan Haidt in their book, “The Coddling of the American Mind,” as a kind of “reverse cognitive behavioral therapy,” in which people are taught to become increasingly sensitive to, and less resilient against, minor slights and insults. Insults may be one thing, but unintentional slights are another. I do not know of a compelling reason to label as “microagressions,” and to dial up one’s sensitivity toward, behaviors that might just as easily – and often more accurately and certainly more charitably – be thought of as arising out of insufficient knowledge or understanding, and even good intentions. Best to you both,

    Rob Dellinger

    • Hi Rob,
      You bring up great points. I agree thata possible danger of focusing on microagressions is that it could lead to someone becoming too sensitive and in turn, less resilient to minor slights and remarks that are well-intended. A large part of the REBT methodology I ascribe to involves, as you said, learning to interpret situations more accurately and without drawing negative conclusions.
      However, we often work with people who have been exposed to such microagressions (from therapy and/or past listeners) and have suffered some trauma as a result but who have dismissed their influence in contributing to their deep desire to suppress stuttering. I believe many people benefit from coming to the realization that while they do not need to harp on these past “offenses”, they can nonetheless look at the message that they perceived from the remark or action come to a greater understanding of their own habits of tension and avoidance.
      Thank you for your comments.

      • Heather, thank you so much for the additional information and clarification. I would agree that it is important to develop the skill of interpreting situations as accurately as we can without necessarily drawing negative conclusions. I would also agree that we can suffer trauma that can leave us unaware of trauma’s role in suppressing communication. I was one of those people! Here’s to cultivating freedom (and joy) of communication. Best,
        Rob

  6. Microaggression is such an important topic to discuss. Even though most people do not have the intention of being offensive to a person who stutters, it can still come off in a way that is negative. As a future speech-language pathologist I want to make sure that I am creating treatment plans that benefit my client, not create anxiety or stress to achieve perfect fluent speech. Treatment plans also include the way in which I speak to my client which involves me to be mindful of what I promote. Saying “you did great, you didn’t stutter at all” isn’t the way I should be providing feedback to my client. While it is important to acknowledge a client’s fluency, that isn’t something that should be valued more than anything else regarding their communication. Instead, I want to promote positive feedback by helping them develop a solid foundation and confidence in themselves as a communicator.

    • Thanks for your comment, Mandie! We certainly feel that giving the client a voice in developing their own therapy plan is the way to go.

  7. Dear Heather and Mark,

    Thank you for a splendid paper. I feel that your approach to therapy is simply superb, and wish that it were adopted more widely.

    It is interesting to me to observe that only today, reading your paper, am I understand my reaction of anger, insult, and some helplessness, when receiving the comment that “you don’t even stutter that much”. This is helpful to me. Thank you.

    Further to Rob’s comments, I think that is is necessary for me to be able to recognize a microagression, but detach (defuse, if you will) from the “agression” part of that word. As you write, the remarks are often (not always) not meant to be agressive or hurtful. My challenge is to then recognize the comment, avoid judging it, and prevent myself from getting attached to it. I wonder what your opinion of this would be.

    Thanks so much!
    Hanan

    • Hi Hanan
      Thank you for your comments. I agree that is challenging, and certainly an important part of the cognitive work required to improve one’s relationship with their own stuttering, to NOT become attached to a microagression. This can include simply noticing the thought and watching it float like a cloud moving by.. (eg. “Oh, I’mm having that thought again that others are dismissive of stuttering”) and/or perhaps doing some active disputing based on real-world evidence (eg. “While it is disappointing that the public still doesn’t understand the impact of stuttering, this person’s comment reflects simple ignorance and will have no impact on me..” As we assert, the key is not to let the the possible implications of the message seep in and feed what we refer to as cognitive gremlins that tell you stuttering is “bad” and should be hidden and not discussed.
      Best to you!

  8. Hello Mark and Heather,
    As a graduate student studying to be a speech-pathologist, I really appreciated reading both perspectives to help me better understand the language that I can use to better support clients who stutter. Microaggressions over time have the potential to cause so much harm and in essence send the indirect message that what the person who stutters has to say is not being taken seriously enough. Your article helped better identify what these microaggressions look like and what others can do to advocate for themselves as well as others. Thank you, Daniela Jurado.

  9. Heather and Mark,
    This was such a great paper on such an important topic. I think it is hard sometimes because people do mean well in many instances, but it is so important to hold ourselves accountable and really think about what we are saying and how it may be received. I really appreciate the specific examples of the microaggressions, as sometimes I do not think we even realize the harm we are creating. I really appreciate your thoughts on this topic. As a future speech language pathologist, I find it so important to constantly be learning how to best interact with clients. Without personal anecdotes and opinions, it would be impossible to gain insight into how certain comments are received. Thank you for sharing!

    Karissa O’Cain

    • Thanks, Karissa. I certainly agree that we should all strive to keep learning and growing, no matter our experience level.

  10. Hello Mark and Heather!
    Thank you for sharing your experiences with SLPs and providing insight on verbal and nonverbal microaggressions. It is interesting to see that even SLP’s, who are expected to advocate for their clients, contribute to these microaggressions by encouraging and celebrating fluency, especially being that these methods lead to disappointments and lack of confidence, which is counterproductive. As a future SLP, I understand the importance of focusing on WHAT is being communicated, rather than HOW it was communicated.

    • Thanks for reading! I think it’s always important to help the client (and ourselves) dig deeper into figuring out what the ultimate hopes for therapy are in the first place, and making sure that we are aware of our own language in supporting those goals is key.

  11. Thank you Mark and Heather for sharing this paper full of profound insights! I am a student studying to become a speech-language pathologist myself and I took so much away from this. There were several quotes that opened my eyes to the true intention behind fluency treatment, to enable the individuals to communicate what the want to say. I feel there is so much talk around improving rate and level of fluency, and not enough around empowering your clients to be able to get their message across. I will be sure to keep this important message in mind when I enter the field, thank you!

    • Thanks for reading! Glad to hear this paper helped you broaden your thought process in a new way!

  12. Dear Heather and Mark,
    First, thank you so much for writing on such a powerful topic. I believe microaggressions are not valued and emphasized enough in our current media, however they should be. I was a psychology major back in undergraduate school, and I didn’t even learn about microaggressions and their impact until I was a senior in college. Learning about microaggressions gave me an entirely new insight to the phrases I use on a daily basis along with nonverbal communication that may be perceived negatively. Although I thought I was educated about microaggressions, I was unaware of the all microaggressions and stuttering. (Note: This just shows that I am always and continuously learning in my field of choice). I am currently in my last year of graduate school to become an SLP, and although I have learned how a person who stutters may feel about filling in or guessing their words, I never was aware of the possible impact of delivering well-intended “compliments.” This is something that I will definitely take into my future career of being an SLP, and I gratefully appreciate you expressing how positive reinforcement may be detrimental to the person in the long-run. Positive reinforcement is a concept that weare constantly encouraged to do in the therapy room. Therefore, when first reading that compliments could be detrimental, I was initially shocked. However, after further reading your paper I know how my well-intended words may have a negative impact. In the future, I will encourage one to say what they want and how they want and embrace their stutter. In addition, I will be mindful of the way I am encouraging one’s communication. I love the suggestions you offer for parents to praise communication, such as “Wow, you made such a great point.” However, for adults it is important for us to consider microaggressions that one may pick up on. Thus, in therapy I will encourage self-advocacy such as being confident about the way they communicate. However, even with all the encouragement in the world, it is important to note that some days and experiences will be harder than others. Thus, as a future speech-language pathologist I will continuously be there to listen about their experiences. Lastly, thank you for sharing your genuine and honest story of your experiences with stuttering. I absolutely love how you expressed that “facing a fear is a success in and of itself, no matter the percentage of syllables stuttered while approaching it.” I believe this is the truth of stuttering, that communication should be celebrated rather than fluency. I will continue to carry your story and the message of celebrating communication over fluency.

    Kind Regards,

    Bailey Deason

    • Thanks for reading, Bailey! I wish you the best of luck in your studies and future career!

  13. Dear Heather and Mark,

    As a future speech-language pathologist, I do not want to provide “compliments” for my clients, translating into a negative message. Thank you for sharing examples of microaggressions that clinicians may not be aware of doing when giving treatment. This paper provided me with beneficial information that will help me be aware of giving positive feedback. I will take into the considerations of being careful when having my future clients work during each session, and I will be cautious to how I am giving treatment. I want to help people who stutter feel comfortable when speaking, and I want to encourage them to self-advocate by educating others about stuttering. Thank you for sharing this wonderful paper!

    • Thanks for reading! Sounds like you took some great things away from the article. Best of luck!

  14. This paper was so well written and insightful! As a future SLP, I definitely benefited from learning about your experiences in speech therapy and how the SLP’s praise for fluency was actually adding to the microaggressions you receive from others. From reading several other papers, I can see that therapy for stuttering is not just teaching fluency strategies, but also making sure the client knows that their opinions/thoughts are just as important as everyone else’s and not “less than”. Thank you for providing examples of non-microaggressive comments that show support in the client’s words rather than their fluency. This was really helpful! Thank you!

    • Thanks for reading! Stuttering therapy certainly is so much more than just the physical aspects of producing speech – glad to hear you’re learning that from all of the amazing contributions at the conference.

  15. Thank you for this perspective! It’s really important for speech-language pathologists to hear that focusing on fluency (and ignoring everything else) can be really demoralizing for clients over time. I liked how you encouraged speech-language pathologists to validate patients’ feelings, especially when they are being bullied or feeling down, instead of just moving into, “let’s fix that,” mode. I think it can be challenging for other people to recognize microaggressions, but SLPs should realize when their patient needs moral support or a different therapy technique that empowers them. I also appreciated the examples you gave to cultivate resiliency in both young children, by coaching parents, and adults, by discussing the microaggression and finding ways to combat it in the future. Future SLPs are learning from the past and we talk about self-advocacy and resilience all the time in class!

    • Thanks for your feedback! We always have to remember that while we may have the “perfect” plan for our next session, we are working with a human being who has sudden or unexpected challenges pop up that require us to be flexible and create a safe space for them to process and feel what they are feeling. Sometimes, going into “fix it mode” without realizing this can be counterproductive, or even invalidating.

  16. Hi Heather and Mark,

    I thorough enjoyed reading this discussion on microaggressions that may be experienced by people who stutter. As a graduate student in speech-language pathology, I understand this conversation must be had to ensure that SLPs are mindful of the message that is being conveyed despite their well-meaning intentions. As such, I hope to use feedback from your list and educate the parents of children who stutter to use similar comments that are not underpinned in fluency. Thank you so much for your insight!

    -Justin

  17. I thought this article was really nicely written and very interesting. It was heartbreaking to read about the microaggressions PWS experience. Since the communicative partners that are making these microaggressive comments are often unaware of the damaging messages they are sending I think it is extremely important that more awareness is brought to this topic. PWS should be able to comfortably communicate their thoughts without others perpetuating their fear of stuttering or demanding fluency. Also, I really appreciated the section of the article that expressed the importance of an SLP reminding their client that they value the content of their communication and not just the fluency of their speech.
    Thank you for this wonderful article!
    -Lorena Zarotsky

    • Thanks, Lorena. I agree – getting the word out there is extremely important for people to start questioning the language they use without even considering the implications.

  18. Dear Mark,

    Thank you so much for sharing your experience about therapy and how PWS experience microaggressions both in the classroom and then in therapy. I couldnt’ agree more that most often educators/SLPs/parents of children who stutter engage in what they think is positively reinforcing the ‘no stuttering behaviors’ and focus so much on helping with the individual reducing their disfluencies, when they don’t realize how that is negatively impacting the child. Moreover, the child is being instilled that fluency is everything, and like you said beautifully, “Fluency should be acknowledged, but not actively celebrated as adding any more or less value to my communication.” This point of view is so important and as a future-clinician I want to ensure I deliver that message at every age that fluency is not adding more to anyone’s communication/message. It’s so important that we positively praise communication especially for individuals who are constantly feeling anxious about speeaking, that I think it can truly help boost their resiliency and postive behavior. I really liked how you also encourage disclosure WITHOUT APOLOGY! My boyfriend is someone who stutters and when he meets someone new he and he stutters as he’s meeting them, he will sometimes start with “sorry, I stutter” to like explain and disclose. I know it’s something he definately is working on not doing, on not apologizing, but It’s definately hard for him (it’s like his bad ingrained but polite habit like you said all those years of therapy).

    I will definately take you advice into my therapy room!

    Thanks so much for sharing!

    Michelle Alferez

    • Thanks so much for your comments, Michelle. I certainly understand that apologizing while disclosing is almost automatic, and something that takes time to realize and change. For me, one of the most important moments in my own journey was meeting others who stutter and connecting with others who just, well, “got it”. I would encourage your boyfriend to look into any local resources for support if/when he is ready. I wish you the best of luck in your studies and future career!

  19. Hi Heather and Mark,
    Thank you so much for such an insightful and thought-provoking essay. I think this was my first experience listening to the perspectives of an SLP who stutters. I can see how an SLP or any professional in general who has not had the first-hand experience with stuttering or with someone who stutters could believe their best treatment options or directions are rooted in clinical recommendations from a textbook or something. As a future SLP, I can agree with the feelings of uncertainty and fear that comes with each client guaranteed to be different from the last. But it is how we respond to these feelings that carry the most weight. I am fortunate enough to have grown up and acquired experience with stuttering since my dad stutters and I have had professors who have drilled the importance of being mindful of all contributing factors to stuttering, with a large part being beliefs and attitudes. My dad shared a similar experience to Mark with speech therapy. I think in our field the commonality among us as clinicians is the desire we all have to help or “fix” others. But this can take away from our ability to empower. Like any disorder, it is so important to never fixate on what someone doesn’t have but rather what they do have and can do with it. Thank you so much for sharing

    • Thanks for sharing, Tori. I really appreciate your insights, and couldn’t agree more about the importance of channeling our natural desire to help into empowerment.

  20. Thank you for this article! I am in graduate school to become an SLP and am grateful you wrote this. I always worry about the language I use with all clients/students. I imagine myself at a school focusing on being positive with all my students. How easy to then say “You sound so good” to a fluency student who was speaking fluently. I wish every SLP could and would read this. I will take this article with me as an important reminder to be incredibly cognizant of what you are reinforcing. I feel empowered to have the right words to say and to know how to support a student in becoming confident in what they are saying above how they are saying it.

    Christa

    • Thanks, Christa! So glad to hear you took something meaningful from the article. Good luck!

  21. Hello Mark and Heather,
    Thank you so much for taking the time and efforts to write this paper. As a future SLP, it was so impactful and important to read. Mark, thank you for sharing your experience from both an SLP’s and person who stutters’s perspective. I think as an SLPs, we need to be very cautious in the way that we provide stuttering therapy because as you mentioned, it could be more harm than good in our clients and students. It was really insightful to read about your first-hand experience of what was actually helpful in therapy and what was not. It made me realize that the goal of stuttering treatment is not to become fluent or master techniques/strategies but rather create a safe environment for communication and teach resiliency, confidence, and acceptance. I really appreciated the positive comments to share with families that you added to the end of the paper and will practice using these responses with my own clients and students. Thank you again!

    • Thanks for reading! Glad to hear this can help you in your current and future practice.

  22. Dear Heather and Mark,
    Thank you for taking the time to research and inform us on this interesting topic of microaggressions. Overall, your article left me realizing the true power of our words. Most individuals do not realize how others perceive their words and that is when the communication breakdown or loss of trust begins. In particular, I appreciated your comment to emphasize “communication over fluency” as this is something I will remember throughout my career. As a future clinician, I know it is important to choose our words wisely. We also must consider peoples’ attitudes and feelings. Thank you for sharing a client perspective in your article. It is so important to consider the opinions and experiences of PWS.

    Thank you again!

    • Thank you! I find that listening to the lived experiences of those who stutter is the most powerful opportunity for continued growth as a clinician.

  23. Hello Mark and Heather,

    Thank you both for your experiences and valuable insight! I am currently in grad school to become an SLP, and I love the point you made about focusing on communication over fluency. I can see how focusing on fluency while simultaneously not helping the client to build resilience can be detrimental to the client. Doing this can lead to harboring feelings of failure whenever fluency techniques don’t work or life experiences of the client change. It is important to focus treatment on being comfortable speaking with the stutter, how to build resilience to challenges that may pop up during stuttering experiences, and how to self-advocate and educate others about stuttering. I appreciate the points made in this paper, and I look forward to applying this information when I am out in the field.

    Thanks again,

    Caitlin

  24. I absolutely love everything about this article! I am currently a graduate student taking fluency and one of my biggest concerns is making sure I create an atmosphere of full acceptance for a PWS. I have been curious of verbal and nonverbal behaviors that I may say or do and the message they give. I am thankful for the practical ways you listed out of how to communicate with a PWS that their message matters. I can’t say enough how thankful I am I found this article!!

    – Brandi

  25. Hi Heather and Mark,
    Thank you so much for spreading knowledge in our community about the emotional and mental effects the comments of others, though well-meaning, can have on a PWS. As a graduate student in speech language pathology, stuttering is one of the many communication disorders that I am personally unfamiliar with at the moment because of my lack of experience. Therefore, I really appreciated the example detrimental well-meaning comments commonly made by people so that I also personally understand what is not appropriate to say to PWS. It was also very insightful to see what kinds of comments are encouraged for parents to say, and this common pattern in praising the child’s ability to communicate their thoughts over their fluency is something I will certainly take into my practice as a future SLP. Thank you both so much for enlightening me with firsthand experiences of someone who stutters and both your thoughts and knowledge!

  26. We are grateful that others are finding our paper helpful and appreciate the comments- Thank you!

  27. I love how you started off this paper with defining what a microaggression is and gave clear examples of what they can look like verbally or nonverbally. This is a very important topic because as you said, listeners often think they are helping or giving a compliment, but they are actually causing more damage and negative feelings in the PWS. It was very insightful to hear the client perspective from a PWS and now a SLP. It emphasizes the fact that a clinician can do more harm than good if they just try to reinforce fluency tools with every sign of disfluency. As a clinician it is so easy to want to have an answer for everything and fundamentally “fix” their problem. However, stuttering is a whole different ballgame and it is important to recognize that stuttering is not something that has to be fixed. I have been learning more and more as a graduate student that addressing the client’s negative attitudes and feeling towards stuttering and letting them find their natural fluency is far more beneficial than drilling strategies. Bringing this type of awareness to new clinicians, I hope that future clients will not have to be stuck in this type of toxic loop until 21 years old. Moreover, bringing awareness of these type of microaggressions to friends, family, and the community and giving tips to change their words can help lessen the negative feelings created in PWS.

    Thank you very much for your insightful paper! I will be bringing this advice with me in my journey as a new SLP.

  28. Hello Heather and Mark,
    I am a graduate student at Chapman University studying communication sciences and disorders. I felt it was very important that you defined microaggressions and provided examples of microaggressions when applied to stuttering. I found the phrase suggestions for parents to use is very helpful and promotes positivity and acceptance. Thank you for all of your insight.
    All the best,
    Melissa Francis

  29. Hello Heather and Mark,

    Thank you so much for your valuable insight! I am disappointed to say that I have found myself use the phrase “Ok, just take a breath and slow down.” Although I don’t work with PWS, I have used this phrase with a client with apraxia and dysarthria. Though it is a strategy to help him, I didn’t realize how different this phrase is for a PWS. I appreciate you guys parsing out the different types of microaggressions as related to stuttering.It is very helpful and eye-opening. One of the suggestions that really stuck out to me was, “It is vital that we emphasize communication over fluency as well as spontaneity over diligence.” I think it is so important to encourage confidence in one’s communication, no matter how “different” it may sound. Additionally, being diligent about fluency can perpetuate a very toxic cycle. I appreciate that you guys have provided suggestions for appropriate phrases to use, I will definitely be implementing this in my practice. Thank you so much!

    • Thanks for commenting, Linda! We find that being willing to notice and reflect on our language is an ongoing choice, no matter how long we have been practicing. It is never too late to do that! We’re glad this helped you in that process.

  30. Discussing microaggressions in this format was very interesting to read. The examples you gave were a great way of showing that people can cause harm even when they aren’t meaning to. Telling a person who stutters that their stutter “isn’t that bad” has multiple implications which could lead to negative self-talk. It not only minimizes the person who stutter’s struggles, but it also implies that stuttering is “bad” in the first place. I also like how you explained the negative impact that praising fluency in and outside of a therapy setting can have. Giving clients or students the strategies for fluency is one thing, but exclusively praising their use and implying that more practice is needed is another. This paper does a great job of explaining that the most important part of an SLP’s job with PWS is encouraging all communication and helping the PWS gain confidence in his or her speaking. Fluency is only one way of speaking, and it is important to show clients that it their way of speaking is not wrong or bad.

  31. There were so many equally great points brought up in this article. First, thank you for discussing microagressions and providing examples that are unfortunately, very realistic. I think is important to note that microaggressions, such as a person completing the sentence of a PWS, are often not with the intention of embarrassing or insulting the individual. This is where awareness and education come into play. By educating others that it is hurtful to complete a PWS’s sentence or to compliment their fluency, we can limit the frequency of microaggressions. I love the emphasis that was placed on complimenting the content of a message, rather than the way in which it was said. I think we can all do a better job at this as SLP’s and SLP student clinicians. Thank you for sharing your perspectives and insights!

  32. Wow! Your article brought a new perspective to the term microaggression in relation to disfluency. In school, we are asked to give the client positive descriptive praise, such as “that was a great ‘r’ sound” and “Nice complete sentence”. Basically, we are praising the client for meeting the target goal, but with fluency, its easy to say “you did great, you didn’t stutter at all” which can be defeating for a client because really, fluency shouldn’t be the goal, instead it should be that they got their thought out. After reading this article, I will be more aware of the type of praise I give to PWS, more so because I want to create a friendly environment that does not push for the end all be all to be fluent speech. Thanks!

  33. Thank you for sharing such an insightful paper on such an important topic. Because of the subtlety of microaggressions, it must be addressed in a clear manner that you portrayed. You explained that microaggressions are commonly unintentional, but can be extremely damaging to underrepresented groups, especially those who struggle emotionally. Your paper perfectly explains these microaggressions that can be commonly made toward people who stutter and why they are hurtful. As a future SLP, it is so important that I learn this information and am aware of common phrases that may be negatively received. I believe many more people would benefit from learning about microaggressions and how words can be taken so many different ways, even if they are not meant to do so. Our words are extremely powerful and the language we choose to use should be considered all the time, but especially as an SLP working with groups who struggle with their feelings toward their own speech.

  34. Thank you so much for shedding light on the important topic of Microaggressions, and how it pertains to stuttering. I specifically enjoyed the aspect of your paper in which you demonstrate how speech-language pathologists, although potentially unaware, may contribute to microaggressions with their clients who stutter. I can imagine how easy it may be for SLPs to unknowingly address fluency the same way in which they do with goals pertaining to language or articulation. For a speech-language pathologist, a session in which a client is 100% fluent may be considered a triumph, much like it would be if a child working on articulation finally produced /r/ without errors.
    An additional aspect to your paper that I found very informative was your examples of various complements, tips, and strategies that people who stutter may receive that may ultimately be more negative than positive. Saying “great job” after fluent moments or “Can you say it again using your tools?” are forms of feedback that SLPs say without hesitation to children working articulation or language goals. Therefore, I can imagine how easily may be for that same feedback to carry-over to clients working on stuttering. From now on, I will be sure to be mindful of my approach and feedback while working with children who stutter. I will aim to promote self-advocacy, encourage non-avoidant stuttering, and treat each individual in their own unique way. Thank you for this paper. Microaggressions is such an important topic that needs to be discussed further.

    • You bring up some great points about how easy it can be to give comments like that with the best of intentions, especially when we are so used to doing that in other areas of practice. I think making sure that we are treating the client like they are an “expert” in their own stuttering experience. This can open the door for conversations that go beyond traditional speech tools (such as confidence, facing fears, self-advocacy, etc.) that are important to incorporate into the overall treatment plan.

  35. Hi Heather and Mark,
    Your paper has given me a lot to think about since reading it. I had never applied the term microaggression to stuttering, yet it seems so glaringly obvious that it is exactly what is happening. I look forward to seeing more from you both on this,
    Loryn

  36. Thank you Heather and Mark!! Fantastic paper. So much of the therapy with kids who stutter is permeated with micro-aggression and is so damaging. I am grateful that AIS is out in the world helping form a better, more effective way of helping people who stutter and their families. So. very. grateful.

  37. Hello Heather and Mark! Thank you for such an insightful paper. I think you brought forth great examples of microaggressions towards people who stutter that are often overlooked. Bringing to light subtle forms of microaggressions, such as well-meaning “compliments” or nonverbal behaviors, serves to inform stuttering allies to be more aware of communicating messages that are rooted in good intentions, but, nonetheless may be damaging to a person who stutters. As an SLP student clinician, I also appreciate the concrete examples of more constructive and encouraging messages to convey to people who stutter, as well as the important message of praising people who stutter to express themselves authentically with no judgement.

  38. Thanks for GETTING IT. Sometimes helpful words are still hurtful words, however well-meant. That’s why I’m concerned about certain therapies, none mentioned, that might have a negative impact on children who stutter. So happy you highlight the subtile differences.

    Stay safe and keep them talking

    Anita