Stop Blaming the Parents and Children for Unsuccessful Therapy

I hope all of you were able to share time with loved ones, enjoy some R&R, and eat too much…which is pretty much what happened over this holiday season in the Holte household!

This is second in a series (how many, who knows?) of postings inspired by a book excerpt authored by a respected leader in the field of therapy for children who stutter. This person sent the excerpt to me in response to my book “Voice Unearthed: Hope, Help, and a Wake-Up Call for the Parents of Children Who Stutter.” Again, I will not name the author as I am challenging the messaging and belief system – the same messages and belief systems embraced and promoted by many leaders in the field of speech therapy for those who stutter.

Too often the blame for poor therapy outcomes with children falls directly on the client unit – the child and/or the parent. The author quotes others as stating that “What a client wants from treatment and how those goals can be accomplished may be the most important pieces of information that can be obtained.” So a parent wants a child who does not stutter. The child could either care less about their speech, or will want the same, to not stutter. If they knew how to accomplish this, they would probably not be seeking professional help. What should the therapist do with these “important pieces of information?” The easiest path, in the short-term, is to focus on encouraging the child to use speech techniques that are intended to accomplish this goal.

Ideally (in Doreen’s world), a therapist responds to this “important piece of information” by explaining the risks in attempting any therapy that incorporates teaching a child speech techniques designed to minimize and/or eliminate the stuttering behavior. These risks include silence, disengagement, poor self-esteem, and ironically, increased secondary behaviors and tension around the stuttering moments. Parents deserve to understand that while their child is using techniques that successfully eliminate or minimize stuttering moments, especially while in the clinic setting, they may also be acquiring behaviors and beliefs that can lead to a far greater handicap – some that can last a lifetime. The short-term successes can lead to long-term disaster.

It is also recommended that therapists suggest to parents that “most of the time parents have a fairly good idea of not only what is causing the stuttering problem but also of what will help.” I seriously have to pick myself up off the floor every time I read statement. In reality, most of the time parents are blindsided and have no clue as to how to effectively support their child as is the case with many speech therapists I’ve spoken to. Another reality is that as of this date, even the best researchers only have vague theories as to the cause of stuttering and how to best address it, especially in children. Again, this feels to me like a deflection of accountability – away from the therapy itself and onto the client unit.

We, as parents, deserve the opportunity to hold these influential experts accountable for their published statements. Our perspective, along with our questions and challenges, must be welcomed and embraced so we can all, together, do better by these kids.

I look forward to your feedback. Wishing you all the absolute best in 2012 – and remember – keep them talking and keep talking fun!

Best,
Doreen (Dori) Lenz Holte