Building Resilience in Children Who Stammer – Sarah Caughter

 

About the Author:

Sarah Caughter qualified from Newcastle University, UK in 2004 and worked in early years and mainstream school settings until joining the Michael Palin Centre in London in 2009. Sarah completed an MSc in Cognitive Behaviour Therapy with children and young people at the Anna Freud Centre, London, in 2015. She worked as a clinical tutor on the same programme in 2016.

Sarah completed an intensive train the trainers’ course in Canada in 2016: ‘Reaching In Reaching Out’: a program designed to support professionals working with young children, to build their own resilience, as well as nurture these skills in children. She currently teaches this program to healthcare professionals in the UK. She has a particular interest in supporting children and young people who stammer who have mental health difficulties and in building resilience. She has recently published two peer-reviewed journal articles on resilience in children who stammer.

Resilience can be described as our ability to cope with and bounce backfrom lifes challenges. This is particularly pertinent in light of the current global pandemic. Resilience is an important skill in helping us move through such challenges. So why is resilience important for children who stammer specifically?

The research tells us that children who stammer can develop negative attitudes towards their speech from an early age. Some children can experience teasing and bullying because of their stammer. In addition to the everyday challenges all children face, it may therefore be that children who stammer experience more and frequent difficulties. This may have an impact on their confidence, emotional wellbeing, and the way they participate socially, as well as their fluency.   

We know that caring relationships and positive role models in everyday interactions can foster resilience development in children. Adults can support children to develop accurate and flexible thinking patterns that help them cope with inevitable challenges. 

Children can develop resiliency skills which can help them to bounce backin the face of difficulty. These important skills include the ability to:

  • return to a calm state in a stressful situation;
  • express their emotions;
  • identify their thoughts about a situation and to challenge unhelpful thinking patterns;
  • to think flexibly;
  • to connect with others and build positive relationships; and
  • to develop a positive self-concept and to reach out to new opportunities and take risks.

Below are some strategies for parents and professionals to support children in developing a range of resiliency skills: 

  1. Breathe! As adults, we can use breathing techniques to help manage our emotions, reduce anxiety and feel calmer when stressed. There are some online mindful breathing exercise videos which are effective ways to teach children breathing strategies, including Starfish breathing (not to be confused with the Starfish Project) and Breathing Buddies. Remember that the exhalation, or breathing out, is just as important (if not more so) as the in breath. 
  1. Work on building your own resilience and remember this is an ongoing process. The Resilience Factor (Shatte and Reivich, 2002) is a useful book for adults to learn ways to boost their own resilience.  
  1. Model how to talk about your feelings. Children learn from the adults around them. If we show them that its okay to talk about how we feel, we can help them to understand that all feelings are normal and accepted. Talking about other people’s feelings (e.g. in stories or television programmes) can also help with this. 
  1. Help children to express their feelings. Children may find it easier to express their emotions in ways other than talking about them. Drawing a picture, using Playdough or using puppets can all be creative outlets.  
  1. Help children to be flexible in their thinking – children can sometimes show all or nothingthinking at times and adults can support them to become more flexible thinkers by using questions. E.g. if a child says they had a bad day at school, an adult might acknowledge this and then ask which part of your day was ok? 
  1. Encourage children to be kind to themselves by asking what would your best friend say to you?or what would you say to your best friend if they were feeling the same way? 
  1. Model imperfections – we learn from making mistakes and if we are able to view failureor mistakes as opportunities to learn and grow, we can push ourselves to do things that are challenging. Adults can model a helpful way of responding when things dont go to plan, to support children to manage their own emotions and thinking patterns and to aim for good enoughrather than perfect’. 
  1. Notice the positives – write down one thing every day that you are pleased to notice. Shifting our perspective to what is working well helps to boost our mood and help us to recognise our strengths and resources. Adults can encourage children to do this too (e.g. by writing words or drawing pictures). 
  1. Give authentic and descriptive praise to build childrens confidence – be accurate and specific in your description (avoiding generalpraise words such as good/brilliant/fantastic) focusing on effort and the process of learning e.g. You concentrated really hard on learning how to pedal and keep your balance. You showed lots of determination! 
  1. Encourage a can-doattitude by supporting children to challenge set beliefs of I cant do it, to build their belief in the things they can do, to take risks and try new things. 

We all have the capacity for resilience but it needs to be nurtured to grow, and its an ongoing process. At different times of life and in different situations, we will need to develop specific abilities more than others. Its important to take care of ourselves (as professionals or parents) so that we can support children by modelling resilient responses ourselves (Pearson & Kordich Hall, 2006). This will help children to develop their own resilient thinking patterns, embrace challenges, bounce back from difficult times and reach their full potential. 

Pearson, J., & Kordich Hall, D. (2006). Reaching in…reaching out: Resiliency guidebook

 

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Comments

Building Resilience in Children Who Stammer – Sarah Caughter — 30 Comments

  1. Hello Sarah

    Thank you for this very interesting paper. I hope that we will be able to use this guidance in order to help our parents, and thereby to help the children who stutter.

    Hanan

  2. Hi Sarah,

    I really enjoyed reading your paper! I think all of the suggestions you provided are clear and manageable ways to create an environment for children where stuttering is okay. I think it is so important to realize that adults and fluent people can benefit from these strategies in their personal lives anyway, and it is so important to model for children how to react and be resilient. I especially appreciate strategy #6 in your paper- “encourage children to be kind to themselves.” I think it is so easy for us all to be harsher with ourselves than we would be to other people in the same situation, so the advice to simply be kind to oneself can serve as a great reminder that no one is perfect, but being overly harsh to oneself doesn’t add anything productive to one’s life.

    Thanks again!
    Athena Kavounas

  3. Dear Sarah,
    Thank you for your clear suggestions. I was so happy to see (as I am also a yoga-mindfulness teacher) that you talked about teaching children to go to their breath.
    Best of luck in your work!
    Kristin Chmela

  4. Dear Sarah,
    Thank you for this list of strategies. I agree that this is an excellent resource for parents and any professional working with children who stutter. Of course, it’s easier to talk about being resilient than it is to actually practice resiliency. That’s why it is so beneficial to have specific steps we can take on a regular basis to build resiliency. I think it’s particularly important that adults model how to talk about their feelings. If children see adults doing this, it will help them understand that they too can talk about how they feel. They will then be better prepared to deal with the emotional aspects of stuttering when they arise. Thank you!
    Lauren

  5. Hi Sarah,
    I agree with your statement that children can develop resiliency skills, especially during these times. I believe that all of the strategies that you present in this article are beneficial to the children and can help them develop the skills to be resilient. Two of the strategies that especially stuck out to me were modeling to children about how to talk about their feelings and helping them express their feelings. I believe that being able to build that trust and rapport with the children goes a long way, as it helps prevent any misinterpretations in emotions and helps us adults be able to counsel the child if they express any negative emotions.

  6. Hi Sarah,

    I thoroughly enjoyed reading your tips for teaching resilience to young children who stutter. Resilience has been hard for us adults to manage in the wake of COVID, so how can we expect children to manage these unprecedented times easily? Another point that you made that resonated with me is that resiliency is not “all or nothing”; I know some days we can feel on top of the world, only to feel defeated the following day. We can teach that these feelings are normal and to be expected in a time where things just feel off. I also liked that your point #9 focused on specific and authentic feedback. It can be easy to give constant feedback to try to make the little ones (our ourselves) in our life feel better, but it can reach a point where it becomes so routine that it doesn’t carry the same weight. It’s critical to pinpoint exactly what the child is doing right, and why you’re so proud of them for doing it.

    Thank you for sharing your insight; many of us can benefit from your tips!

    Alexa Abadee

  7. Hi Sarah,
    Thank you so much for sharing your insight! I thought this was a great read and offered so many useful and functional tips. I am currently in graduate school and taking a fluency course. We have learned about how much therapy includes the emotional component and you have offered so many suggestions of how to target that. Something that really stood out to me was your comment about resiliency and how we all have the capacity for it, but it must be nurtured to grow. I think this can be applied to all aspects of life. In order to be successful, we must be effortful with our actions and intentions. I think as a future clinician these are all ideas I will keep close in order to instill confidence in clients.

    Thank you again!
    Karissa O’Cain

  8. Hi Sarah!

    Thank you for sharing this piece with all of us! As a second-year graduate student, I have learned that the secondary behaviors that come with disfluencies are a huge part of the battle. The emotions and shame that these children deal with everyday are heartbreaking. If an SLP is lucky enough to intervene before these emotions are apparent, the child may have a better prognosis. However, we know that is not always the case. Thank you for providing these tips to SLPs! Resiliency skills will not only help them with their disfluencies, but just in everyday life! We are constantly being knocked down, but it is important to never let yourself get knocked out!

    Thanks again!
    – Lauryn Mellberg

  9. Hello Sarah! I can only imagine the difficulties children may be experiencing during these times. Thank you for providing ways for adults to support children and encourage resiliency. The statement “it’s important to take care of ourselves (as professionals or parents) so that we can support children by modelling resilient responses ourselves” really stood out to me. Children tend to model the behaviors they see. Therefore, as adults, if we do not practice resilience skills and take care of ourselves by talking about our feelings, expressing our feelings, or being kind to ourselves, we lack the ability to encourage children to do the same.

  10. Hello Sarah!

    The content of this piece is so important for those who work with children to understand. Teaching children through example and gentle guidance to be kind to themselves and mindful of their thinking will give them the tools to build resilience. Furthermore, the strategies you have outlined, particularly with flexible thinking and expressive acknowledgment and management of feelings, are crucial to developing sound emotional and mental wellness. These internal constructs will work to enable and preserve a well-adjusted self-assuredness against any adversity that may arise throughout a person’s life.
    I loved the example exercise for encouraging kind thoughts about the self, people would generally never be as unkind to others as they are to themselves. Recognizing this can go a long way in building awareness of harmful thinking.
    This was a lovely read. Thank you for your words.

    -Catherine Usery

  11. Sarah,

    Thank you for sharing your insights on how to build resilience. I’ve thoroughly enjoyed everyone’s input on defining resilience. However, you make such a succinct point, “work on building your own resilience and remember it’s an ongoing process.” Just as each person who stammers is unique, the way we face our challenges and build resilience is unique to each individual. Another important point you raise is encouraging children to be flexible in their thinking. This is such an important life skill and does not only apply to stammering. I believe that clinicians should always push for a growth mindset, I which the child knows that there is progress and growth with every step of their journey. Lastly, I am reminded of the important roles parents place for their children who stammer. While there may be no cure for stammering, students can be equipped with the emotional intelligence to be resilient individuals.

  12. Hi Sarah,

    Thank you for sharing some beneficial strategies about helping children develop resiliency skills! I also believe that it is important to educate children to express their emotions and encourage them to always be kind to themselves. It is important to help educate parents, teachers, and other professionals about stuttering and how they can support children who stutter. This paper has helped me understand some great strategies that I can use with my future clients. I am currently in graduate school, and I am learning how to help people who stutter self-advocate for themselves. It is vital for children who stutter to know how unique they are and to always be positive about the way they stutter.

    Thanks again for sharing this great paper!

    Kind regards,
    Victoria

  13. This paper offered great tips for encouraging children to express their feelings in a variety of ways. I love that you mention other ways for children to better express themselves. Activities like drawing, using playdough or puppets are all great ways to understand a child if they are not comfortable doing so verbally. I also liked #8 where you talked about noticing the positives. I think this is beneficial not only for children who stutter but anybody. It is so easy to focus on the negatives and take for granted all the other positives that are around us. This simple act breaks the negative mindset and offers a new perspective on one’s day. Often, children who stutter battle with both external and internal stresses that may go unnoticed. Writing down one positive can offer some release. As a future SLP, I will be sure to incorporate some of these strategies in my sessions. Thank you for sharing!

  14. Hi Sarah,

    I thoroughly enjoyed your paper and the strategies you presented. In particular I feel that numbers 7 and 9 are key to the shift in focuse to positive feelings and more resiliant behavior. I agree that for a child of any age it is important that they understand that mistakes are an opportunity to learn and develop skills and not something to be hide. Focusing on a positive mindset and highlighting the things done well will provide the resiliance they require. Thank you for your insight!

  15. Hi Sarah,

    Thank you for sharing these strategies on how to build resilience with our kids who stutter. I thought all of these strategies you provided are functional and can be implemented by both parents and SLPs. More specifically, I found strategies 3 and 9 to really resonate with me. I think it is important to model for children how to talk about their feelings; I think this strategy can be used with kids who stutter and even those who don’t as many kids have difficulty expressing their feelings. Additionally, strategy 9 is also crucial in that when the child knows exactly what they did well, they are more likely to continue that behavior. When we just say “good”, it can be confusing as to what we are referring to. Thank you for providing these strategies to use to help build resiliency in our kids!

    – Casey Edwards

  16. The suggestions discussed in this paper are very helpful and I think that it would be beneficial for all parents of children who stutter and professionals who work with PWS to read through it. I think it is extremely important for children who stutter to develop a strong level of resilience to ignore the unnecessary comments, regarding their fluency, that they will most likely receive. I like the tip of reminding children to breathe because I think it could really help them stay calm and centered in a stressful situation. Also, I think the note about the importance of adults helping children who stutter identify negative thought pathways could be really helpful. I think that facilitating positive and flexible thinking by recognizing good moments in situations and by giving authentic and descriptive praise could be extremely valuable for children. I appreciate the recommendations for promoting emotional expression and positive self-concept development in children as well. Thank you for sharing your knowledge in this well-written article!
    -Lorena Zarotsky

  17. Hi Sarah,

    This article was extremely helpful, and I can definitely take away from some of these strategies myself. It is so important to develop resiliency and as I learned in my fluency course in graduate school, the more resilient someone is, the better they are at managing their stuttering. Families can help their children to develop skills to manage stress, which decreases the likelihood of stuttering becoming persistent. I especially think #7 is super important because we’re not perfect and we all make mistakes. Children are learning and watching adults model, so if adults are using their mistakes as opportunities to learn and grow, children will follow. Thank you again for these strategies!

  18. Dear Sarah,

    This article was extremely helpful in describing ways that we can help children who stutter develop resiliency. With stuttering, it’s so important to help children develop ways to manage anxiety/stress that can then induce more stuttering. I especially like your idea about modeling imperfections, so many young adults/children put so much pressure on themselves to be like their parents, or to be A+ students and they don’t learn that we aren’t actually perfect and that not everyone get’s straight A’s or has perfect impeccable speech. Specially for chidren who stuter who have more delicate temperaments, i think modeling failure, and modeling that it’s okay to not always be perfect and show them that we all make mistakes, and we are all just trying our very best. I firmly believe in modeling and so if we can learn to model different ways to relax, but also just show children to embrace themselves and feel okay even after failing some big, then i think we can help them be more resilient.

    I will definately use these strategies as I go on to practice in a a year.

    Thanks,

    Michelle

  19. Hello Sarah,
    I really appreciate the strategies that you offered to parents and professionals to help children develop resiliency skills. It is extremely beneficial for children to learn these during tough times that can cause anxiety, fear, and stress. I am huge believer of Cognitive Behavioral Therapy and it is amazing how you tie your experiences and knowledge into this article. I think it important for children to learn how from adults how to talk about their feelings (#3) and express how they feel (#4). This will then carry over into their thinking, which flexibility (#5) and positive thinking (#6) are essential. In the end, this ties to their behaviors and actions of stuttering, which is why modeling imperfection (#7) and praising authenticity and confidence (#9) are crucial as well. In addition, I appreciate when you mentioned that this is an ongoing process where adults and children should work together to take care of themselves and each other during these uncertain times.Thank you again, I really enjoyed reading this article.

  20. Hello Sarah,

    Thank you for your insight on resilience building techniques! I especially love the focus on adult modeling for expressing emotions and modeling imperfections. Learning to express emotions is a strategy that everyone could benefit from, as it provides more open communication between people and helps us connect. It is also important to show children from a young age that no one is perfect and that’s ok. I feel this is especially important for children who stutter because it reinforces that everyone is imperfect, that being fluent doesn’t define perfection, and that we should embrace our imperfections. Modeling is a great way to teach these strategies because children look up to the adults in their lives for guidance. If we can display resilience, then the children in our lives will be more likely to build resilience as well.

    Thank you again for these strategies. I will make sure to keep these in mind when I am out in the field.

    Sincerely,

    Caitlin

  21. Thank you Sarah for sharing this piece, I found many aspects incredibly insightful. I feel as if sometimes parents are hesitant to use some of these strategies in hopes to “protect” their children. I agree however, that modeling behaviors such as expressing our feelings and accepting our mistakes would be key in facilitating their own resilience. If parents and adults hide all real experiences from children, they aren’t going to understand how to face it when it happens to them. I also really love number 6. I think most of us are our own worst critics, but helping a child practice self-love and positive self-talk from a young age could do wonders for developing confidence that gets them through their struggles later on in life. I am a student studying to become a speech-language pathologist and I will be sure to save these strategies and use them as a resource in the future, thank you!

  22. Hi Sarah,

    Thank you for providing these strategies for supporting children in resiliency. I am a graduate student studying to be an SLP. Your advice to “give authentic and descriptive praise” was a great reminder for me as a student clinician. For both children and adults it is easy to fall into repetitive general praise. I feel that particularly in this time of online therapy, clients and students want to feel seen and connected with. Thank you for sharing your knowledge, I will be putting all of these strategies to use!

    Christa

  23. Hi Sarah,

    Building resilience in children who stutter is so important and I applaud you for outlining various strategies that parents, caregivers, and professionals can do to help support in children in building resilience. You’re so right, this pandemic has really shed light on what it means to be resilient and I can only imagine how one who faces extreme challenges each day needs to recoup and gain resiliency. I found your statement about how a child’s stutter can affect not only their feelings and attitudes but, it can also affect the overall fluency to be a good reminder on how stuttering can increase stress therefore make an individual more disfluent. Your ‘bounce back’ strategies are a great guide on how parents and professionals and work in flip the negative attitudes children who stutter may have. I particularly enjoyed how you discussed that parents and professionals should model how to talk about feelings. I think this is so important for all children as I feel as if sometimes we get into a routine where all we say is “I’m feeling good” or “I’m happy” and this is not teaching children that we can express our emotions in more than one way. Thank you for your guidance in working to build resiliency in children who stutter!

    -Rochelle Draper

  24. Hi everyone,
    It’s really encouraging to hear the same themes coming up, that it’s so important for children to talk about their feelings and to have a positive and flexible mindset. These skills can be modelled to children from a young age and there is such an important window of opportunity between 2 and 8 years old, when children’s thinking patterns and ways of viewing the world become more entrenched.

    Thank you for everyone’s positive comments and I’m so pleased aspects of this article have been helpful. I appreciate your time in reflecting on this topic.

  25. Hello Sarah,

    The recommendations you set forth in your paper are so valuable! I never really thought about the different ways you can foster resilience but it is such an important skill and mindset to have. One of the most important points you make, in my opinion, is to model imperfections. Too often we are consumed with the mentality that we need to be perfect to succeed, as we are very success-driven people. However, I think it is crucial to model imperfections so children have very real, human role models to look up to. The recommendations you set forth really aim to change the communication environment for the PWS, as this is one of the biggest changes we can make for children at a young age. Furthermore, it is so important to notice the positives. I think we all often become consumed with striving to be better that we do not take the time to acknowledge the little successes that are pushing us along the way. Thank you so much for your input. These are practices I will definitely be implementing in when I become an SLP!

  26. Hi Sarah,
    As a grad student in speech pathology, these tips are something that really resonated with me and made me reconsider how I’m approaching therapy with children. I really like the idea of flexible thinking; it seems like something that would especially be helpful in contexts beyond just stuttering, especially in older children or children who struggle pragmatically. I’m currently working with two students on fluency currently and I’m very excited to use some of these strategies in the upcoming weeks. Thank you for sharing!
    Best,
    Kennedy

  27. Ms. Caughter, the strategies you described in your article are awesome! As a future clinician, I will try to incorporate these exercises into my therapy sessions, because I think it is important for children who stutter to learn resiliency skills, early on. The drawing exercise was one of my favorites because art is such a great outlet for people to express their thoughts and feelings without fear or judgment. I personally love art, so by doing a drawing activity, it would allow the child to express their feelings, but also start the conversation about feelings and allow me to model that it is ok to talk about our feelings, another great strategy you suggested. Overall, I thought your article was informative and helpful. It provided me with simple strategies to create a positive therapy environment and strategies that the children who stutter can incorporate outside the therapy room, where they may not feel as comfortable. Thanks!

  28. Hi Sarah,

    I really enjoyed reading your paper. I think these strategies can be useful for any age and whether you are a person who stutters or not. I recently read another paper from the conference that also discussed the importance of resilience. It mentioned that resilience is not a characteristic you either have or don’t have, but it is something that you can create. Similarly, you mentioned that, “We all have the capacity for resilience but it needs to be nurtured to grow, and it’s an ongoing process.” I agree that nurturing this development is an important role that parents play in children’s lives. Parental and adult support is crucial when children are dealing with challenges. We often learn how to navigate challenges in life from those who have gone through it before us. The strategies you discussed are perfect examples of what adults can model for children.

    Thank you for sharing!

    Best, Nicole

  29. Hello Sarah,

    Thank you for sharing some really great strategies on how to support children in developing resiliency skills! I am currently a speech language pathology master’s student and really appreciated reading your paper and learning great information that I can incorporate into my future practice! Every person who stutters is so unique and therefore, I think it’s great that you listed one of the strategies to be “building your own resilience”. Resilience looks different to each individual who stutters and being able to acquire resilience is also a unique journey for each individual. I also love how you discussed encouraging children to be kind to themselves. As human beings, we often are very hard on ourselves and our own worst enemy. For this reason it is so important to teach children to learn to love and respect themselves. This also goes hand in hand with your strategy #8, which is to notice the positives. Being able to recognize our strengths is so important because it allows us to feel empowered. I look forward to using these strategies in therapy!

    Sincerely,
    Ariana Arakelian

  30. Hi Sarah,

    Thank you for sharing strategies to help parents and professionals prepare their children for the difficulty of stutterring. As a PWS I understand the challeges that children will face daily. Teaching our children to be kind to themselves and having a “can do” attitude is the key.

    Semper Fidelis,

    Frederick Canteen