About the Author:
Ana Paula G. Souza Mumy, MS, CCC-SLP is a trilingual speech-language pathologist and clinical assistant professor in the Speech-Language-Hearing department at the University of Kansas. She facilitates the clinical team in the Language Acquisition Preschool and the fluency team at the Schiefelbusch clinic. Ana Paula also teaches the graduate Fluency Disorders course at KU and co-leads an adult chapter of the National Stuttering Association. Additionally, she recently co-founded Spero Stuttering, Inc., a nonprofit geared toward advocacy for the stuttering community via the better equipping of SLPs. She is currently pursuing a clinical doctorate in speech-language pathology, with a focus on bilingualism and stuttering. Ana Paula enjoys singing, writing, and traveling with her husband and two kids.
In 2015, I found myself with 15 years of experience as a speech-language pathologist (SLP) and yet felt completely ill-prepared and lost when my son began to stutter. How could I as an SLP be utterly lost when facing my son’s stutter? Change is needed.
Later in 2015, I found myself as an SLP trainee at an overnight camp for nearly 60 youth who stutter. Though I felt completely out of my element and learned more about stuttering in a week than I remember learning in my graduate school Fluency Disorders course, it was a life changing experience both personally and professionally. I left that experience thinking, how can more SLPs experience the magic of a place like this? Change is needed.
At a conference in 2018, I was surrounded by parents of children and teens who stutter, and I realized for the first time how many parents aren’t aware of the limited training SLPs receive to work with people who stutter. I also realized that so many families don’t have access to specialists in the area of stuttering, and they don’t quite know what to look for in a generalist who knows more about stuttering than the average SLP. How can we connect families with SLPs who are knowledgeable and confident working with children who stutter? Change is needed.
By 2019, I had experienced first-hand the power of support organizations for people who stutter both nationally and abroad. I realized that so many people who stutter often go years and years without ever meeting someone else who stutters. They often find themselves alone and isolated from people who truly understand the experience of stuttering. How can we connect families and individuals with more sources of support and community? Change is needed.
Circling back to the preparation of SLPs, in the last year I have learned from recent studies that have been very eye opening (see reference list). I learned that in 1997, 59% of graduate students in the field of speech-language pathology could graduate without any clinical experience in stuttering. There was an increase to 65.1% of graduate students without clinical experience in 2000, but then thankfully a decrease to 31.5% in 2013. Though we see a higher percentage of students graduating with clinical experience, it was reported that clinical hours in the assessment and treatment of fluency disorders are guided by less experienced clinical supervisors. Change is needed.
In terms of coursework, 17.8% of students could graduate without taking any courses exclusively devoted to fluency disorders in 1997. There was an increase to 22.6% of students in 2000, but then a decrease to 14.2% in 2013. This means a lower percentage of students graduating without coursework devoted to fluency disorders, however, 9.6% of programs still reported having no required or elective graduate course in fluency disorders. Thus, the number of programs providing minimal education about fluency disorders remains high. While the 2019 survey of graduate students showed an increase in knowledge and comfort levels by students, they still reported not having adequate knowledge with regard to administering assessment tests or differentiating between various types of treatment. Results showed students still felt uninformed or uncertain about fundamental aspects in fluency disorders. Change is needed.
In 1997, SLPs indicated that graduate and undergraduate courses mainly stressed theory and treatment was less emphasized. In 2000, there was a reported increase in the number of programs that emphasized clinical application in their graduate courses, rather than focusing primarily on theoretical issues and background. Even with this positive trend, the 2008 study of SLPs showed that 50.8% of SLPs could not differentiate between the two main approaches to stuttering therapy and 46.5% were not comfortable working with children who stutter. Let that sink in…nearly half of the SLPs surveyed were not equipped to work with people who stutter. Additionally, 66.4% did not use attitude scales to assess stuttering, which means a large focus on the behavioral aspects of stuttering while ignoring the affective and cognitive aspects of stuttering as well as its impact on the individual. Change is needed.
In summary, even with many years of experience, studies show that stuttering is a low preference disorder among SLPs and that a vast number of SLPs feel inadequate and uncomfortable treating stuttering.
CHANGE. IS. NEEDED.
All these studies point to a call for the better equipping of graduate students and speech-language pathologists, and so in 2020, a nonprofit organization, Spero Stuttering, Inc., was born! Our vision is to help, empower, and advocate for the stuttering community and their families by equipping those who work with people who stutter. Our heart is to change the reality that many SLPs are ill-equipped and unprepared to work with stuttering.
We seek to encourage and recruit practicing SLPs to obtain more training in the area of fluency disorders by providing guidance, stipends, and recognition for SLP training and hands-on traineeship experiences that promote a philosophy of treatment that seeks to see people who stutter and their families find connection and resources, discover their authentic voices and self-acceptance, and communicate effectively in their everyday lives.
We developed the Ally of StutteringTM Seal to recognize SLPs who are committed to prioritize stuttering as an area of professional growth and who are involved in the stuttering community. The seal is an accessible training path for the generalist SLP to learn more about stuttering, people who stutter, as well as research-based and holistic therapy approaches. It demonstrates that the SLP holding the seal has a special interest in stuttering and has received intentional training beyond graduate school. The seal also indicates that the Ally of StutteringTM SLP is committed to ongoing training and professional development in the area of fluency disorders at regular intervals.
Furthermore, this allows us to connect families and individuals with SLPs with more training and experience, particularly when a specialist is not readily accessible. It is important to note that the seal does not endorse or guarantee the quality of services provided by that Ally of StutteringTM. It is still up to the individual or family seeking treatment to determine if the SLP is a good fit, but we believe there is value in families knowing if their SLP has more training in the area of fluency disorders than the average SLP, since our Certificate of Clinical Competence doesn’t indicate preparedness to work with people who stutter. Our scope of practice in the field of speech-language pathology is simply too large, yet our scope of competence is much narrower. SLPs must recognize this gap, actively seek to learn more, and do no harm in the process!
We now have a growing number of Ally of StutteringTM SLPs (in 25 different states!) who are committed to improved quality of services through more specialized training and engagement in the stuttering community! We have awarded graduate research scholarships for minority students studying fluency disorders as well as Continuing Education and Traineeship (CEAT) stipends for SLPs to obtain more training. With the help of key corporate sponsors (Stuttering Therapy Resources, The Informed SLP, SLP Nerdcast, Northern Speech Services, Change & Impact, Oficina de Fluência, WorkReady Texas, and Higginbotham), we also put on the Strides for Stuttering Virtual 5K Fun Walk/Run fundraiser where more than 70 people participated nationwide, helping us raise funds for this important work.
On a personal note, my son’s stutter eventually resolved, but stuttering left an imprint on my heart, and I have become passionate about serving people who stutter. We hope we can fuel more passion among practicing SLPs, particularly school-based SLPs, equipping them to work with people who stutter with confidence and effectiveness!
Mallard, A., Gardner, L., & Downey, C. (1988). Clinical training in stuttering for school clinicians. Journal of Fluency Disorders, 13(4), 253-259.
Santus, N., Tellis, G., & Kong, F. (2019). Are graduate students receiving adequate education and training in fluency disorders? Clinical Archives of Communication Disorders, 4(3), 236-251.
Steyl, N. A., Klein, J. F., Howell, M. L., & Dalton, J. C. (2016). Increasing knowledge and skills of graduate students in a fluency disorders course. Contemporary Issues in Communication Science and Disorders, 43, 164-173.
Tellis, G., & Barone, N. (2011). Results of a nationwide study: Are clinicians prepared to treat stuttering? Pennsylvania Speech-Language and Hearing Association (PSHA) Convention, Pittsburgh, PA.
Tellis, G., Bressler, L., & Emerick, K. (2008). An exploration of clinicians views about assessment and treatment of stuttering. Perspectives on Fluency and Fluency Disorders, 18(1), 16-23.
Yaruss, J. S., Coleman, C. E., & Quesal, R. W. (2012). Stuttering in school-age children: A comprehensive approach to treatment. Language, Speech, and Hearing Services in Schools, 43(4), 536-548.
Yaruss, J. S., Lee, J., Kikani, K. B., Leslie, P., Herring, C., Ramachandar, S., Tichenor, S., Quesal, R. W., & McNeil, M. R. (2017). Update on didactic and clinical education in Fluency Disorders: 2013–2014. American Journal of Speech-Language Pathology, 26(1), 124-137.
Yaruss, J. S. & Quesal, R. W. (2002). Academic and clinical education in fluency disorders: An update. Journal of Fluency Disorders, 27(1), 43-63.
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