Wednesday, December 7, 2011

Join in the "spirited debate" over stuttering therapy for children.

Over the next several weeks I will be posting a series of commentaries on the opinions conveyed in a publication excerpt authored by a leader in the field of speech therapy for children who stutter. She forwarded the excerpt to me in reaction to my book, Voice Unearthed: Hope, Help, and a Wake-Up Call for the Parents of Children Who Stutter. The focus is on elements she believes influence therapy outcomes for children. I will not reveal the author’s identity, as my intent is to challenge the ideas, not the person.

The excerpt begins with the question “what elements, aside from those specific to a particular treatment approach, might influence a child’s responsiveness to stuttering therapy.” Taking the “treatment approach” out of the mix is like exploring a child’s response to shoes that are too small without considering the option of taking off the shoes. It could very well be that the child is sometimes uncooperative or ill-behaved, but let’s start with taking off the shoes!

Terms including “successful therapy” and “positive outcomes” are used throughout the excerpt but never defined. This is an issue I raise in my book – even the experts cannot agree on how to define “success.” Although most often defined as fewer speech errors, the easiest way for a child to make fewer speech errors is to not talk. Is this a “successful” outcome?

The article relates the reluctant behavior of children participating in therapy to problems with “temperament, personality, lack of control, and negative self-perception.” A parent who chooses to remove a child from therapy because they feel the therapy is too difficult or not relevant is “incongruent,” “Incongruent” is defined as an imbalance between intellect and emotion.

Parents are called upon to shift their role from “all powerful fixer” to “ally and advocate.” In reality, too often the therapist becomes the “all powerful fixer” armed with their tool box of speech techniques. Apparently a good parent “ally and advocate” should continue therapy even if they believe that the therapy is too difficult or not relevant to their child’s life. This begs the question -- whose "ally and advocate" has the parent really become?

The publication laments the lack of research that focuses on anything beyond pre- and post-treatment comparisons of measure of speech fluency – a point in which I heartily agree – and I feel that parents have the right to understand. Why does the field of stuttering therapy so enthusiastically promote therapies on the basis of research they openly acknowledge is lacking, yet disregard the parent’s perspective as emotionally and intellectually imbalanced?

Reference is made to the “spirited debate” that continues in this field – another point I feel it is important for parents to understand. Parents can best support their children by familiarizing themselves with all sides of the debate and becoming part of the debate. Voice Unearthed: Hope, Help, and a Wake-Up Call is the first book written about this subject from the parent’s perspective and is available at Ask your local library to carry the book on their shelves so all parents can better understand this debate and the concerns behind today’s therapy for children who stutter.

Thank you for your ongoing interest. Let's keep them talking!

Doreen Lenz Holte


  1. It's not only sad that guilt gets passed to the parent and the child, but that there is any need for guilt at all. I think the fact that there is a need to place blame shows a tremendous misunderstanding of stuttering by the professionals. I'm an adult stutterer who felt guilt as a child and have witnessed children putting blame onto themselves for not succeeding with a therapy that is unproven to have any long-term benefits.

    And a comment on the idea of a "successful" outcome: If an SLP wants to show improvement in a clinical setting, it ain't hard to do. A multitude of things can work in the very short-term to show an improvement in speech, but that's a shallow approach to a deep problem.

    Rather than aiming for unattainable perfection, the goal ought to be continued communication or expanded communication.

  2. Dori - Thanks for the post.

    Years back I was speaking with Gene Cooper - a guy I regard as one of the original GIANTS in the field of stuttering and feel fortunate to call a "friend" - and we were discussing how so many of the current "leaders" in the field of stuttering firmly believe - regarding therapy for those who stutter - that "it is never the fault of the therapy or the therapist when failure in therapy occurs; it is always the fault of the client". It is such a sad state of affairs in the professional field of stuttering. Whoever this "leader" you reference in your blog post is, they are - at least in my view - expressing a level of arrogance that demonstrates why the field of stuttering and its "spirited debate" is really all about the professionals, and not the outcome of therapy or welfare of kids who stutter and their parents.

    The poster "Torey" shows tremendous insight and understanding; I couldn't agree with him more!

    You are right Dori...Keep them talking! Your book, blog, and Yahoo Group are terrific for Parents of Children who stutter! Keep up the good work!