Thursday, February 20, 2014

Book Recommendation for Parents and Speech Therapists

Just finished reading, for the second time, Dr. Gunars Neiders' book, From Stuttering to Fluency: Manage Your Emotions and Live More Fully.  Dr. Neiders is a psychologist and a person who stutters.  He enlists Rational Emotive Behavior Therapy (REBT) to address shame and anxiety so often at the heart of our children’s struggle to talk. 

I’m guessing his intention was to write for an audience of adults as he doesn’t specifically address therapy for children.  That said, I think the insights and recommendations can be very useful in helping parents and speech therapists minimize shame and anxiety in the first place.  While he states “We believe the low success rate is the result of SLP’s focusing exclusively on changing the mechanics of speech,” I also believe that ANY focus on the mechanics of children’s speech comes with tremendous risks of increasing shame and anxiety.  I don’t know that he would agree, I just might have to ask him!

Neiders believes that most speech therapists are “ill-equipped to directly or systematically address the fears and anxieties of their clients” and I would go on to say that most speech therapists are over-equipped to address the speech mechanics.  They see immediate results in their clinics and these results are easy to measure. 

He also emphasizes the whole picture – the goal of overall quality of life versus fewer speech errors.  Neiders states “People who learn to control their anxiety about stuttering often report that they become more fluent.  With or without additional fluency, less anxiety and greater participation in life adds to the overall quality of our existence.” 

If I had read this book when Eli was young, I’m sure I would have done things differently.  Dr. Neiders not only introduces the idea of using REBT-focused therapy with those who stutter, but he also provides a very readable book with simple but potentially life-changing support strategies. 

From Stuttering to Fluency:  Manage Your Emotions and Live More Fully by Dr. Gunars Neiders is available through Amazon. 

Doreen (Dori) Lenz Holte
Author of Voice Unearthed: Hope, Help, and a Wake-Up Call for the Parents of Children Who Stutter

Wednesday, February 12, 2014

Keeping My Fingers Crossed

Recently, in an email conversation with a leader in this field, it was suggested that I should be writing more about the positive experiences families are having connected with speech therapy for their children who stutter.  This professional stated that most therapists’ goals include “getting and keeping our kids talking, listening and respecting our clients and families, measuring success by how much talking is happening, decreasing avoidances, becoming desensitized to the stuttering and other's reactions to the stuttering.”  She goes on to say “many of us spend very little time, if any, addressing the stuttering behaviors.”

While I find these statements encouraging I don’t believe this is what a significant number of children who stutter are experiencing in speech therapy.  At least that’s not what I hear from parents, from teens and young adults who stutter, from graduate students in the field of Communication Disorders, and from multitudes of speech therapists who have connected with me over the years.    

Parents continually report that their children are being directed to use speech tools and are not able to use them effectively outside the clinic setting.  They share the heartbreak of seeing their child withdraw and choose silence.  For the record, I realize this behavior is not uncommon with  children who stutter, even if they have not had therapy.  It also happens to children for a multitude of reasons having nothing to do with stuttering.  But the expectation of suggesting a child talk in a prescribed manner runs a tremendous risk of exacerbating this behavior, a behavior that can be more handicapping than the stutter itself.
I hear from speech therapists who are highly uncomfortable with the direction they are given and at a loss for what to do for these kids.  Many complain that the framework imposed upon them by institutions including public schools and insurance companies leaves little room to focus on  anything but overt stuttering behaviors.  Many teens and adults who stutter considered their time in speech therapy, when therapy focused on the use of speech tools, not only a waste of time and resources, but an experience from which they needed to recover.   While I believe there are some children out there who feel that speech tools were helpful, there are just too many who found them to impede their overall progress in life.  I also know that there are children who have benefitted tremendously from their interaction with speech therapists over the years.  But too many have not and until this changes, I will continue to write about the bourgeoning flip side of this scenario.  

The newsletters from support organizations exude hope and reasons to celebrate, sharing stories of families who are satisfied with the therapy they’ve experienced and adults who have led extraordinary lives in spite of their challenges with stuttering.  That perspective is well covered.  But the field can’t keep pretending this picture is reflective of everyone’s experience and inclusive of the current state of affairs.  They cannot be afraid to acknowledge, embrace, and address the shortcomings and uncertainties that permeate treatment options for children who stutter.  I know there are individuals and professionals out there expressing their concerns and ready to roll up their sleeves, but the effort to marginalize these voices is pervasive and ongoing.   

Change is needed.  Real, safe, and fearless conversation is needed.  These kids and their families deserve treatment that is devoid of the risk of exacerbating silence and withdrawal.  Parents and speech therapists deserve to fully understand these risks, and to have options that focus exclusively on keeping kids talking, decreasing avoidances, and building self- esteem and engagement in the world around them.  ASHA and the support organizations have the power and influence to make this happen.    I'm keeping my fingers crossed!
Keep Them Talking and Keep Talking Fun!!


Dori Lenz Holte