Wednesday, December 18, 2013

Oh, You Are Such A Good Talker!

Throughout our journey we were occasionally encouraged to praise Eli for his fluent speech.  We never did that… it just didn’t feel like the right thing to do.  Why not?  This suggestion pops up in almost every list of recommendations for parents, from The Stuttering Home Page and the Stuttering Foundation of America to text books and instruction manuals.  The Parent’s Guide on the Stuttering Home Page suggests you

“Praise your child when s/he speaks well; but this should not be taken as praise for not stuttering; praise what s/he says, not how s/he says it. (1)

How do you praise a child when he speaks well without praising how he says it?  If you say “you sure know a lot about Pokemon©!” you are praising them for what they said, not how they said it.  If you say, “I like how you used your easy speech when you talked about Pokemon©,” you are praising them for how they said it, not what they said.   

I asked Eli how he might have felt if I had intermittingly praised his fluent and natural speech when he was younger (he’s 17 now).  He frowned and then responded: 

“Praise the small things.  Praise things that matter.   If you get lots of praise you will focus too much on looking good in other peoples’ minds. Don’t praise something that is commonly expected.  Most people talk without thinking about it. If I get praised for fluent speech, that tells me that if I don’t get praised, I must be doing something wrong.  I will think harder about my speech in order to get more praise.”

“Praise things that matter.” If you praise a child for fluent speech, they will get the idea that fluent speech is what “matters” to their listener.  Is this really the message we want to risk sending?  Doesn’t that come with an inherent risk of adding more anxiety to communicating?  Isn’t it pretty well-accepted that increased anxiety contributes to increased tension and stuttering behavior? 

I had a brief moment of hope when I read the Stuttering Foundations “Tips for Talking With Your Child.”  They say:

Praise strengths unrelated to talking as well, such as athletic skills, being organized, independent, or careful.”  (2)

Oh how I wish they had said “instead of” instead of “as well.”  So close, but yet so far away.    (Check the addendum at the end of this post for more examples.) 

I seriously cannot fathom any scenario where it would be appropriate and safe to praise a child for fluent talking.  It’s just not worth the risk. 

Keep them talking and keep talking fun!


Doreen (Dori) Lenz Holte


Addendum:  Additional examples of suggestions in professional publications to praise fluency. 

“The child’s disfluency should serve as an additional reminder to the parents to compliment the child’s fluency.”  Page 345, Stuttering Intervention: A Collaborative Journey to Fluency Freedom, Shapiro, David

“Children may be especially fluent when they are talking to parents at bedtime, providing parents with the opportunity to comment on this “smooth speech” and to let the child know that they can imagine how good it feels to talk easily.” Page 306, Stuttering: an Integrated Approach to Its Nature and Treatment, Guitar, Barry

“Praise your child’s talking; for example, “You are a good talker,” “I like the way you said that,” or, “It’s fun talking with you.” (Actually, I don’t object to that last one – it is referring to the content, not how it is being said.) Page 73, Fun with Fluency: Direct Therapy with the Young Child, Walton, Patty and Wallace, Mary

Thursday, December 12, 2013

"Let Me Be the Bad Guy"

Hope you all had a great Thanksgiving!  On a personal note, I must start by acknowledging the passing of another lovely “Pall Mall Puffing Potty Mouth Role Model” in my life.  My stepmom of 47 years (referenced in my previous blog) died unexpectedly on November 25th.  She was legendary for showing her love through her amazing cooking, card-playing, sewing, and acceptance of all who walked through her door.  Grandma Fern leaves a hole in our hearts and will be missed by all sixty-six (not kidding) members of her immediate family and so many others.  

On to the subject at hand.  Throughout Eli’s five years of traditional speech therapy we saw several different speech therapists.  Each therapist’s plan hinged on the speech tools included in the stuttering modification approach.  Each therapist encouraged me to do “special time” for 15 to 30 minutes a day, with Eli practicing speech tools while playing games or telling me stories.  I remember being told by one speech therapist to not remind Eli to use his speech tools outside of that 15 minutes of “special time” – she said “let me be the bad guy.”
On one hand, I felt the only way he was going to ever be able to use these tools would be to practice for hours each day until they became wired into his brain.  On the other hand, it seemed the more “special time” we did, the quieter he got.  Our time together quickly became tense and awkward and something neither one of us looked forward to.  I blamed myself – I just didn’t have that magical “whatever” to facilitate this practice in a way that felt fun and comfortable or in a way that would enable him to use these tools naturally in his world. 
I have come to believe that underlying the time and place limitations when it comes to practicing  tools is a lurking awareness of the inherent risks of suggesting a child speak in a prescribed manner.  We know it can do damage, but darn it, it’s evidence-based best practice!!  So we forge ahead. 
I have written quite a bit about the overwhelming lack of evidence supporting any treatment for children who stutter.  Just the other day I heard a comment on public radio that struck a chord, “we’ll have to wait until science catches up with anecdotal evidence.”  Experts continually marginalize the vast amount of anecdotal evidence from parents, teens, and adults who stutter around the uselessness and drawbacks of speech tools with children.  Instead they embrace “promising” strategies built on tiny numbers, inappropriate goals, and limited follow-up while children who stutter are growing more silent and disengaged each day. 
What advice can a clinician give a parent that will magically eradicate the risks out of telling a child to change how they talk?  Why is it deemed more penalizing for a parent or teacher to suggest speech corrections than for a speech therapist in a clinic setting?  Why are correction and modification instructions from mom during special time any different from at the dinner table or in the sandbox.  Mom is mom is mom.  There’s no magic hat that can eliminate mom from the messaging.  Nor does the training speech therapists receive cloak them with magic powers that make it “safe” only when implemented by them or someone under their tutelage. 
We need to do as much as we can to help kids stop thinking so hard about their speech.  Would we ever put 15-minute limitations on activities that increase self-confidence and keep talking fun for a kid?  How about cooking with Grandma, knowing you’re free to say anything you want (because you wouldn’t believe the things she says!)  Or “just playing the game” as Eli so often demanded when I would try and turn the game into “special time.”  Or helping them to pursue a passion such as snowboarding, sewing, art, or a big one in my house over the years -- Pokemon.  Get your 9-year old trading Pokemon cards with his buddies and the talking will flow and flow and flow…
Speech therapists have a golden opportunity to provide guidance and support to parents, teachers and other significant people in these kids’ lives to minimize anxiety and keep these kids talking.  And if these kids are really lucky, they’ll have a PPPM grandma to throw into the mix.   Rest in peace Grandma Fern.
Please feel free to share this essay with others who are affected by stuttering.  Also, I would love to hear of creative ways you have helped a child who stutters to increase verbal output and to keep talking fun! 


Dori Lenz Holte