“Although most experts agree…” – really? REALLY??

In 2009, it was reported in a survey conducted by the research committee of the National Stuttering Association (NSA) that:

"Although most experts agree that early therapy helps preschool children overcome stuttering, 30% of parents were advised by a pediatrician or speech therapist to defer speech therapy until the child was older."

As a parent of a 14-year old who stutters, and a consumer of these services, I challenge the NSA research committee to prove to me that “most experts agree” on this matter. What I have found, after five years of my own research, is that this field is wrought with disagreement, controversy, and inconclusive evidence in almost every aspect of stuttering and therapy for those who stutter – especially children!

At the same time, I agree that parents, when concerned about their child’s speech, should not be sent away to wait it out, even if the child doesn’t exhibit stuttering behaviors while in the therapist’s office. There are many wonderful ways a parent can have their concerns addressed effectively and respectfully without putting the child into therapy (see previous blog postings for some suggestions…). In other words, it’s the parents who should be in therapy – to help them learn ways to keep their child talking and keep the pressure off of speech production. What’s the point of doing this if chances are pretty good that the child will “grow out of it?” Why not just wait it out? Three reasons:

1. First off, the indirect therapy I refer to will do no harm. In fact, creating an environment where kids feel safe, supported, and free to speak out is wonderful for any child, not just those who are dealing with communication challenges.

2. Secondly, if the stuttering behavior persists, the parents are far better prepared to keep that behavior at a minimum and also understand how to lessen anxiety around speaking.

3. Lastly, when parents are told to “just ignore it” and then the stuttering behavior persists, parents feel a tremendous amount of guilt and even anger -- guilt because they were not more persistent, and anger because their concerns were ignored by the speech therapist.

There is an assumption here that if the issue hadn’t been ignored, there would have been better outcomes. This assumption is continually nourished by misleading and unfounded comments that permeate literature directed at parents, such as that in the NSA survey. Dr. Barry Guitar, out of the University of Vermont, is a recognized expert in research and treatment of stuttering and is also a person who stutters. He sums it up best when he says

“Stuttering therapy is an obscure blend of techniques, applied to a baffling problem, with frequent failure. Only specialists should be allowed to do this.”

Agreement by the experts in all areas of this “baffling problem” is extremely rare. They don’t agree on how to define stuttering, they don’t agree on what the outcomes should be for stuttering therapy, and the research that does exist is extremely limited and inconclusive. There is also much discussion and concern about the risks of current therapy approaches by many of those experts. Shame, selective mutism, and lowered self-esteem, and general disengagement are just a few of those risks. It is unfair and extremely misleading to both parents and speech therapists to continue to exhibit this façade of certainty and confidence around the treatment options available for children who stutter. The time to accept this reality and to “first do no harm” is way past due, and I hope that many professionals and the organizations who support them will rise to the occasion.

Keep them talking and keep talking fun! Thank you for your ongoing interest and support.

Best,
Doreen Lenz Holte