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!
Best,
Dori Lenz Holte
Dori,
ReplyDeleteThank you for your post and sharing your story. My name is Scott. Not only am I person who stutters (and have since I was 2 or 3, but I'm a Speech Pathologist and professor). Verbal output is the first goal, and at the end of the day, that coupled with comfort and confidence in being an effective speaker (as deemed by each individual speaker) can be our only goals. Maybe instead of practicing "speech tools", you can have Pub Speak time, or Tell Me a Story Time. This is where YOU and your child BOTH practice organizing and telling stories (essentially public speaking skills). They don't have to be long. You can pose crazy questions, "what if you were a bug, what would you want to do?" You could create plays and act them out. This time is not only about speech, you can also introduce basic public speaking skills (by modeling) like body movement, gestures, vocal variety, eye contact. All parts of being an effective speaker. Thus not even addressing "techniques" but addressing skills for communicating, and hopefully increasing confidence as a speaker by enjoying speaking. Techniques may have their place, however a person (of any age) may benefit from gaining confidence in how they communicate before they can make choices about specific speech behaviors. Just thoughts... with compassion and kindness,
Scott
Hi Scott -
ReplyDeleteYou are spot on! Eli would have loved that kind of "special time," as long as it wasn't positioned as being about his stutter. All kids would benefit and there are certainly no risks, only fun and growth, engagement and nurturing.
Thanks so much for your insightful suggestions.
Dori