Thank you to everyone who has responded so positively to my blog posts. My message is primarily directed to parents – but as a parent, it gives me so much hope to know that these ideas are also resonating with professionals who are treating children who stutter.
Having said that, my goal isn’t to change anyone’s mind about how speech therapy is done. (Yes, it is my dream, but I am not delusional.) My primary goal is to give a voice to parents and speech therapists who are just starting out on this journey and those who are confused and dissatisfied with outcomes of today’s widely accepted approach to therapy for children who stutter.
Much of my past five years has been spent researching this field including reports written by professors and researchers published in numerous peer-reviewed journals, books by the late greats including Van Riper, Johnson, Bloodstein, Sheehan and the current voices including all Stuttering Foundation of America’s publications, autobiographies (loved Marty Jeezer – RIP), textbooks by Guitar and Shapiro, every paper that has been published through the annual International Stuttering Awareness Day online conference, the list goes on and on. I went in search of context for the therapy that was being promoted as "best practice" by the American Speech and Hearing Association (ASHA), the National Stuttering Association (NSA), the Stuttering Foundation of America (SFA), and other respected organizations in this field.
What I found was quite astonishing. The foundation for what is considered "best practice" stems from research and evidence that is extremely limited in scope, most often packaged as "preliminary," and the vast majority has been done with adults. Even ASHA, the organization that certifies therapists to specialize in working with people who stutter, acknowledges the lack of evidence and agreement on what the goals of therapy should be in their "Guidelines for Practice in Stuttering Treatment." (http://www.asha.org/docs/html/GL1995-00048.html) They claim to not promote a philosophy, and yet within their guidelines they specifically refer to fluency shaping and stuttering modification as the primary focus in therapy today.
The current state of speech therapy for children who stutter is in a knot of confusion and uncertainty with a bit of chaos thrown in. This blog and my upcoming book are my means of unraveling this knot by sharing what I have learned and what I, as a parent of a child who stutters, have experienced and observed. My vision is for a real option to evolve out of this chaos that is built around supporting parents with the goal of keeping their children talking and keeping talking fun – without one ounce of expectation that a child learn to make fewer speech errors and to "manage" their speech through the use of speech tools and techniques.
Yesterday I caught the tail-end of an NPR program that included a panel of experts on global warming with questions from an audience. The final words from one of the panel members was "we know what the problems are, we have the solutions, now we just need action." There is an arrogance in this statement that carries over into many fields and gets us into so much trouble. When it comes to therapy for children who stutter, we can’t continue to plow ahead with actions stemming from ill-conceived solutions to a problem we don’t fully understand, when the outcomes to those actions can be so damaging to a child’s short and long-term well-being.
The speech therapists we dealt with throughout our journey were all caring and dedicated individuals -–they were simply using the solutions they had been trained to use. They continually succeeded in helping Eli to make fewer speech errors in the clinic setting but caused him to chose silence in the real world. There is so much that can be done to avoid this outcome – and to keep kids talking and fully engaged in the world around them. I suggest that we agree on that outcome, create solutions that support that outcome, and help these kids to develop to their fullest potential.
I agree Doreen. The problem for some is that stuttering is very complex and individualized. As a young child, I was encouraged to speak fluently at all costs. I recall painstaking experiences where I was fluent on almost every word and then received criticism for stuttering. However, I myself always wanted fluency. I stuttered severely with a block on every word. I personally could not talk and acceptance did not work for me. I am glad I sought this goal but I realize this was my journey. It might not be everyone's journey.
ReplyDeleteThe challenge I face in treating stuttering currently is that I have to think "out of the box". I know from my own experiences that I can't read a manual and use those tools solely. The best SLPs I visited as a child and young adult respected the fact that I wanted to be as fluent as possible but also helped me overcome my fears and avoidances. It is not an easy task. The first speech pathologist I mentioned was a fluency specialist. The second was a very wise woman who encouraged me to complete my masters degree in speech pathology despite being told I could not talk to parents while stuttering. (This came from a fluency specialist btw).
This blog is very important as are your insights. Also remember what you have experienced as a parent is not every parent's experience. Some parents have a clearer understanding of how to handle stuttering while others focus on the fluency. Thanks again for your insight. Please post this blog on mine for parents to see. www.allislandspeech.com.
Hi Lori - thanks for your comments. I agree that stuttering is very complex and individualized which is one of the reasons I feel that until we better understand the issue, we need options for children that first do no harm. Having spoken with many parents, I think that most parents are pretty blindsided when it comes to having a child who stutters - and we take the therapist's lead because the therapist is all we've got. Thanks again for sharing...
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