Question about stuttering

When it comes to speech therapy for stuttering, can the therapy help you to outgrow your stutter or is it more along the lines of helping to make it easier to communicate with fluent speakers? Thank you! 

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Comments

Question about stuttering — 3 Comments

  1. You ask a loaded question and I will be curious to see the different perspectives.

    We know from the research that a large percentage of preschool children who stutter have spontaneous recovery by the age of seven (82-85% depending on the study.) We also know that there are risk factors for stuttering to persist: familial incidence, male, speech delays, temperament, etc. I have seen children past the age of seven “recover” and I have heard this term used by teens and adults. What “recovery” means is different for each person. Have they stopped stuttering? Stop reacting to it? Increased comfort with skills that reduce the cognitive demands to manage their speech? It is different for everyone.

    Spontaneous recovery or targeted recovery is an individual journey. As is onset…I have seen onset in elementary school, middle school and even high school. Did they have the propensity to always stutter and it is now surfacing? The more we learn about stuttering, the more we realized just how much we have to learn. The goal of treatment is always to make it easier for someone who stutters to communicate with everyone, not just “fluent speakers.”

    • Hello! Yes, I second what Rita and Hilda have both said here. In addition to the goal of treatment as stated, and adding to Rita’s statement of stuttering being an “individual journey” I will add that as an SLP our goal is to LISTEN to the individual sitting in front of us. What is their goal with their personal journey with their communication? It is their communication we are helping, not our own. 🙂 What do they want from the experience? Do they want more fluency or do they want communication confidence? We must be able to listen to that, or we will botch there therapeutic relationship/alliance with the individual who stutters/parent/whomever it may be from the get go. Then, we utilize our education/skill/training to carry out the plan of care as such. If the individual (parent, guardian, PWS) doesn’t know what they want in therapy, it’s a great idea to have a mediation meeting (this is a good idea anyways) between all parties involved, even if the individual you are treating is a child. This gives the child some say in the deal. This gets the parents communicating with the child about stuttering- I only do this with children ages 6 and up as not all children realize they stutter.. and it is not my job to tell them they do so or even label that until the child is ready to label it themselves, or the parent labels it for them. There is so much self discovery in this process, that as SLP’s we provide the template for, but the individual must discover on their own and we cannot do that for them nor should we try to as the clinician. So, in the goal/treatment plan of care establishing process, it is a COLLABORATIVE process. If the individuals involved do not know what they want, then we can explain what therapy can look like, what the nature of stuttering is (we should be doing this anyways) what fluency strategies look like, and if that seems to be their cup of tea or not… not everyone wants “fluency” but some do. We have to respect their journey. We also need to educate those parents that come to us wanting to “fix” their children- this is still happening all the time, and we know better. Stuttering is not something we should want to “fix” ever. It is not a “problem.” Parents just don’t know better, and we do.. remember: they aren’t SLP’s and don’t have the background that we do, so be gentle, kind, and graceful. I hope that this helps. Take care.

  2. Hi!
    It seems that you ask a question which very much is related to stuttering onset and age. Above you find some comments related to preschool children, and for sure, we know that some teens and adults have experienced late ‘spontaneous’ or ‘self’ recovery – with or without previous therapy (ref. Finn 2004, Neumann et al. 2019). In my further response, I will mainly focus on adolescents or adults.

    I so much support Rita’s statement that one important aspect in therapy is to make it easier to communicate with everyone.

    Some more comments related to aims in therapy: In the study of Hayhow et al. (2002), obtaining a sense of control in communication was highly valued for a group of people who stutter, and this aspect was confirmed in a recent study by Sønsterud et al. (2019). This study showed that negative emotional and social impact of stuttering may result in social and linguistic-related avoidance behaviors. Therefore I would consider that we need a broader definition of progress and outcome goals. For some people, improvements may well be a reduction in stuttering severity, whereas for others, improvement may be realized through changes in approach and avoidance-related behavior. I also see in therapy that improvements in fluency may lead to improvements in the speaker’s talkativeness – and furthermore, to improve the speaking ability or to communicate more easily in social and professional settings may lead to improved self-confidence and quality of life. What we see in therapy and research, is that changes, improvements or adjustments in one part of a system may lead to changes in other parts (synergistic effect).

    I am not sure if my response here covers your question/comment. Anyhow, there are so many aspects to talk about when considering stuttering therapy and outcomes.

    With the best wishes from
    Hilda

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