From my early time in school, I’ve had an interest in stuttering and fluency disorders. I led an adult stuttering group in graduate school and had inspiring fluency professors who taught me about the many different aspects of stuttering.
When stuttering treatment is brought up, we typically think about the different strategies that are taught to someone who stutters. These can be strategies such as using easy onsets, cancelling, or a pull-out. These will be strategies that someone who stutters will use throughout their life and are extremely helpful.
Although learning strategies to decrease the amount someone may stutter is important, it’s equally as important to address the overall experience and attitude of someone who stutters.
Fluency disorder therapy is focused on counseling, functional application of speech skills, and compensatory strategies to help the client adapt to their activities of daily living. Some counseling examples include anxiety management, emotional lexicon growth, and family/caregiver education.
Counseling the stutterer is an important piece to the entire puzzle of fluency disorder therapy that helps assist with treating the entire person, not just their stutter.
In addition to counseling, the functional application of compensatory strategies (e.g. easy onsets, pull-out, etc.) increases confidence and carryover of strategy application. An inventory of the child’s daily life will guide the direction of the plan of care for the child. Depending on the individual’s age and activity, the plan of care can vary greatly. Having the child rank the anxiety or increased dysfluency occurrences during each activity of daily life helps to build the plan of care.
Once the need to address each activity is in a hierarchy of difficulty, the application of compensatory strategies can begin. Some examples include:
- The individual has increased disfluencies during school presentations in front of their class. They practice a school presentation on video and rewatches the video to self cue and remind themself to use an “easy onset” strategy when disfluencies may occur.
- The individual stutters more while on the phone. They could call their therapist and tell them three of their favorite things to do over the weekend, while using strategies learned in the therapy sessions.
- The individual stutters more while ordering food at a drive thru. A session could consist of a role-playing scenario where the therapist is taking the order from them and they practice their compensatory strategies while “ordering food”.
These activities all help with building confidence and improving the overall experience of someone who stutters.
Stuttering is often misinterpreted as a diagnosis that can be “fixed” through consistent speech and language therapy. This misconception can cause confusion about stuttering therapy and the prognosis for someone who stutters.
It is important that we, as speech-language pathologists, are educated on the multi-faceted approach to stuttering treatment. This is a disorder that is not cured or fixed, but managed through the understanding and treatment from a skilled speech-language pathologist.
Here are two great, free resources for children who stutter and parents of children who stutter:
Article By: Melissa McCabe, BS, COTA/L