-By STR's Dr. J. Scott Yaruss
Many parents and caregivers contact speech therapists because they want their children to stop stuttering. This is understandable, and no one could blame them for having this desire.
Unfortunately, this is not generally something that they can have, for we know that there is no cure for stuttering in school-age children, adolescents, and adults. This basic fact is one of the reasons that we so often emphasize the fact that stuttering is Verbal Diversity™. That is, we view stuttering as a different and equally valid form of speaking and communicating, and not something that must be corrected or remediated.
Still, it is not uncommon for caregivers to request, or even demand, that clinicians work toward increasing their child’s apparent fluency.
Stuttering Therapy Addresses More Than Just Stuttering Behavior
Recall that we may work on skills for increasing ease of speaking and communicating, but we do this in the context of a broader, more comprehensive approach to therapy that also involves helping children learn to navigate stuttering more successfully.
This comprehensive approach necessarily includes therapy activities designed to increase understanding and acceptance of stuttering, as well as activities designed to reduce fear, to increase openness, and to help students speak freely and authentically, regardless of whether they might happen to stutter.
These broader aspects of therapy can sometimes be hard for parents and others to understand. They typically “get” aspects of therapy that focus on speech changes, such as teaching speaking skills. They like seeing their children practice these skills because they believe that mastering these techniques might mean that their children will stutter less.
In contrast, caregivers may not understand why we spend so much time on activities that lead to increased acceptance and openness related to stuttering.
As a result, they may “encourage” their children (and clinicians) to focus on apparent fluency as the primary goal from therapy rather than embracing the broader goals that can make such a valuable difference in a child’s life.
Helping Parents Understand the True Goals of Therapy
Often, clinicians find themselves in a situation where they need to explain to parents why they take a comprehensive approach to therapy rather than simply “drilling speech techniques” and trying to get the child to appear more fluent. Here are some of the answers that we typically give when we find ourselves in this situation.
First, we remind caregivers that “stuttering is more than stuttering,” and we explain to them the broad nature of the stuttering experience. We often use the World Health Organization’s International Classification of Functioning, Disability, and Health (ICF) as a way of showing that living with stuttering may involve not only speech disfluencies but also negative reactions to stuttering by the speaker and by those in the speaker’s environment, as well as adverse impact on the speaker’s communication and quality of life. (For more information about applying the ICF model to stuttering, see this blog post.) and Chapter 12 in School-Age Stuttering Therapy: A Practical Guide.
Second, we help parents understand, in a supportive and encouraging way, that there is no cure for stuttering, and that their child will likely experience stuttering in some fashion throughout their life. How we do this matters, however. We do not like to say to parents, simply, “there is no cure for stuttering,” because they will often view that as an ending point—a hopeless situation in which there is no opportunity for improvement.
Instead, we explain to them that stuttering is the type of condition that people learn to handle successfully as they grow. We then explain that when children are younger, they don’t yet know how to handle stuttering successfully. That is the reason that they struggle and have greater difficulty communicating. As they grow—and as they make progress through speech therapy and stuttering support—they will get better and better at handling stuttering. As a result, stuttering will play less and less of a role in their lives.
Yes, they may still sometimes get stuck when talking, but it will no longer cause a problem for them. That is the true goal of therapy, after all.
Third, we talk with caregivers about what their goals are for their child. We like to say, “Assume for the moment that your child does continue to stutter. What would you like their life to be like in five years?” Most caregivers, when faced with this question, say that they want their child to be happy, to be healthy, to be comfortable communicating even as they stutter, to be able to say what they want to say and do what they want to do, to have friends, and to succeed in school or at work or in their lives as a whole. In other words, they want their child to be okay regardless of whether or how much they stutter.
Then, we tell the parents that these are exactly the goals that we are working toward in therapy. We’re just not getting there the way that they thought we would get there.
The Child Can Be Okay!
Remember, caregivers have often assumed that the only way for their child to be okay is for them to stop stuttering. We can help them reframe these thoughts. Although we may be working on helping children speak more easily, we do not focus solely on the child’s speech skills and “hope for the best.” Instead, we address the speech and all the rest! Thus, we want the child to feel good about themselves, and so we are working specifically on making sure that, over time, the child can come to terms with stuttering and accepts stuttering so that it does not interfere with their self-esteem or willingness to communicate. We want the child to have friends, and so we are working specifically on making sure that the child knows how to be open about stuttering with peers and others so that it does not get in the way of their relationships. We want the child to succeed at school, and so we are working specifically on making sure that they know how to communicate effectively regardless of whether or how much they might happen to stutter in the school (or any other) setting.
In other words, we take all the goals that caregivers have expressed about their child’s futures, and we show them how each goal fits into our comprehensive approach to stuttering therapy.
This Is just a Start...
Of course, there is much more to say on the topic, but these ideas can help you to support caregivers as they move away from an excessive focus on fluency and back toward their real goals (and ours): ensuring that their child can communicate freely, effectively, and authentically, without being held back by stuttering.
For more examples of these types of therapy activities designed to help caregivers understand the goals of therapy, see Chapter 10 of School-Age Stuttering Therapy: A Practical Guide.
For even more helpful information specifically for parents and others, see our booklets: