Role of the SLP

Hi, after learning about fluency disorders, speaking with PWS, and watching videos about PWS, the most common theme is how little the SLP has helped them in the past. Why are a majority of SLP’s failing to make a positive impact on children who stutter? How can we, as future SLP’s, change the dynamic and actually help them when they’re young as opposed to waiting until they’re adults to attempt and try again?

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Role of the SLP — 3 Comments

  1. Dear Carrsm1 (sorry, I did not see a name except your login),

    Thanks for writing and asking questions. By asking questions we can learn so much.

    Your question is complex is involves many different perspectives and variables. I will try to cover a few that I keep seeing and discovering.

    1. The child might not have been ready for therapy as a kid. For many reasons a child might not understand why they are in therapy, what they are doing, or even want to go. So the clinicians has to take ownership of explaining (honestly) what the are doing, and the rationale for doing it. And the client has to take ownership of wanting to attend and their motivations.

    2. The clinician might not be doing effective treatment. The truth is stuttering is a lower incidence for our field, so school SLPs are spending more time and energy on other parts of the field that occur more often. Is that an excuse? NOPE! It means that the SLP needs to take ownership of their education and try and learn more from the many professionals out there who focus on stuttering.

    3. The client-clinician bond is a huge factor. The client might not bond with the clinician because they don’t want to be in therapy. That is not the clinicians failure, that is just what the client feels. The client might not be ready for therapy (again for many reasons) so the bond does not develop. Again, not the clinicians fault or failure, that is simply where the client is at that moment in time. The clinician might not be someone who develops effective rapport. That is on the clinician to learn this skill to engage with a client who IS ready for help.

    4. Communication between families and the SLP and engagement with therapy may be a factor. A clinician may not communicate what they would like families to do at home and families might not follow through, and vice-versa. There is ownership on all sides.

    So what we are looking at is not just one sided. We hear many heart felt stories of how SLPs “failed” a person who stutters. However, we all need to step back and look at all of the factors and take ownership of those factors.

    This is not about blame, this is about learning. What is the clinician, client, and family doing to help and what is not helping? Is the client ready for therapy? Is the family ready for therapy? Is the SLP ready to perform therapy? These questions have many complex answers, and probably shouldn’t involved pointing fingers. Rather what can we learn about ourselves to make ourselves better, improve, grow, and evolve.

    These are very brief summaries of a few of MANY factors that may influence success of a client.

    I hope this helped a small way. Small steps add up to large ones!

    with compassion and kindness,

  2. Hello!
    Dr. Scott has pretty much covered it all, so I’ll just add one little thing.. the therapist-child bond is a big factor that can significantly improve the child’s involvement in therapy, and sometimes, help the child become ready for therapy when he/ she wasn’t , at the outset. Every child comes with a wonderful, unique personality. All you need to so is really get to know the child as a person, and by this I don’t just mean building a rapport. Acknowledge through your words, expressions and gestures what makes the child so different, and so interesting.. and you’ll see them willingly follow your lead, put in their best efforts, and eventually realize for themselves that they they are much more than their stuttering. And that’s exactly what we’re ultimately aiming for, isn’t it?

  3. You’ve already received great answers to this question, but I want to add one more, sort of less pleasant answer, as well.

    One of the challenges that we face as a field is that too many SLPs simply don’t understand stuttering. They think they do because they base their judgments on what they see and hear rather than on what the speaker is experiencing. They think that observable fluency is the “primary” aspect of the stuttering experience. For many people who stutter, however, this is not the case, and focusing too much on fluency can lead to the types of problems that you’re talking about.

    So, though it’s not nice to say, I think a big part of the problem is our field itself. We need to change, and one of the best way to do that is to listen more to people who stutter.