I am often asked about what treatment approach is best for a preschool child who stutter. Often, this is in the context of a facebook post that reads something like: “So, I just got a new 4-year-old fluency case. What approach should I use?”
Those who have read my blog before know exactly where this is going: several people with the best of intentions will post a brief 2-word response with the name of a therapy program, without stopping to ask for any further information about the child.
The fact is, we simply can’t know which treatment approach is best for a young child who stutters without knowing more about the child himself. In fact, we can’t even know for certain if therapy is indicated in this age range. There are two reasons for this:
First, most young children who stutter will actually recover from stuttering on their own—even without therapy. It is debatable whether intervention is necessary in those cases. If therapy is indicated, it might be focused on helping to reduce the parents’ concerns more than it would involve any strategies directly focused on the child. So, before we can pick a therapy approach, we first have to decide if any therapy is appropriate.
Second, we have choices when it comes to early childhood stuttering therapy. These include less-direct aspects of therapy, more-direct aspects of therapy, operant conditioning therapy, and combined indirect/direct approaches. Knowing which approach is best requires knowing about the child and the family.
I’ll talk more about both of these issues in future blog posts. For now, I simply want to encourage you: before diving into selecting a specific therapy approach for a young child who stutters, first consider whether therapy is needed, and then keep an open mind about which approach you might apply, so you can ensure that your treatment is individualized to the child’s and family’s needs.
For more about my pet peeves about recommendations for early childhood stuttering therapy, see this blog entry: Child is stuttering? Try this one weird trick!
