Therapy for school-age children and teens who stutter is quite different from therapy for preschoolers who stutter. With preschoolers, goals often focus primarily on helping the child speak more easily. Certainly, easier speech is still a relevant goal for many older children who stutter, but other goals become increasingly important as children grow.
For example, therapy for school-age children and teens who stutter may also address their feelings about stuttering, the physical tension or struggle that they may experience during moments of stuttering, and, especially, the reactions of people in their environment. These factors cannot adequately be addressed if therapy focuses primarily or solely on fluency, so a broad-based approach to stuttering therapy is absolutely necessary.
It is impossible to provide a concise overview of everything that might occur in therapy for school-age children and teens who stutter. Every speaker has their own individual needs and concerns, so therapy must be individualized. Caregivers should be wary of any clinician or other professional who suggests that all children who stutter need the same treatment. Clinicians should identify the specific needs that each individual speaker has, and then develop a customized therapy plan that addresses those needs.
Ultimately, the aim of therapy for school-age children and teens who stutter is to ensure that they can communicate effectively and freely, and that stuttering does not hinder their ability to say what they want to say, when they want to say it. This does not require that the child be fluent, and most children who stutter will continue to stutter throughout their lives.
Nevertheless, stuttering does not have to be a burden for them. The goal of therapy is to help them handle stuttering effectively, so that it does not negatively affect their ability to communicate. Remember, people can stutter and still communicate effectively—and they can still achieve their goals in life without being held back by stuttering.
Achieving these goals requires a comprehensive yet individualized approach to therapy . For example, children may benefit from learning skills for speaking more easily. These skills may involve changes to the timing or tension involved in speaking; common examples include “easy onsets,” “easy speech,” “easy starts,” “slow speech,” etc. Because each child is different, speech-language pathologists should work collaboratively with each and every child to identify which techniques are most effective for them.
Children may also benefit from learning skills for stuttering more easily. When children feel “stuck” in their speech, they may try to get out of the stutter. Often, this involves tensing their muscles as they try to force their way forward. Therefore, a common therapy approach involves teaching students a different way of stuttering—one that involves less physical tension.
At first, it may seem that teaching children to stutter differently is counter-intuitive. People sometimes ask, “isn’t the child supposed to be learning not to stutter?” In response, we highlight the fact that school-age children and teens are highly likely to continue to stutter, even if they have learned skills for speaking more easily. We want to help speakers reduce excess physical tension and struggle during any remaining moments of stuttering, so that stuttering does not get in the way of saying what they want to say.
One reason that speakers tense their muscles when they stutter is the simple fact that they do not want to stutter. Stuttering can be embarrassing, and children are often (understandably) fearful of the reactions that they may receive from other people. As a result, they struggle to get out of the moment of stuttering as quickly as possible, and this can lead to even more struggle. As speakers become less uncomfortable with stuttering—and as the environment becomes more supportive and accepting of stuttering—then they are likely to struggle, and stuttering becomes less physically tense.
Thus, another component of therapy may involve helping the child and those in the child’s environment become less uncomfortable with stuttering. The more that people can accept the fact that the child stutters, the easier it will be for everyone to focus on the real goal of speaking, that is, communicating. Put simply, acceptance of stuttering leads to easier stuttering and more effective communication.
Acceptance of stuttering also helps to minimize the overall impact of stuttering on daily life. School-age children and teens sometimes try to hide their stuttering from others by avoiding opportunities for talking. They may try not to say words they think they are going to stutter on, or they may make arrangements with their teacher so they do not have to read aloud in class, etc. These accommodations can help them avoid the in-the-moment embarrassment about stuttering, but they also cause students to miss out on key opportunities for their development. Therefore, learning to accept stuttering can also help students participate more fully in life.
Finally, we want to again emphasize that therapy must also address the reactions of the people in the child’s environment. Children who stutter are highly likely to experience bullying by their peers and misunderstanding by caregivers and others. It is imperative that everyone in a child’s life learn more about stuttering, so that they can provide a supportive environment that focuses on what the child says rather than on how they say it. This type of education, advocacy, acceptance, and support will also help to minimize the impact of bullying and other negative reactions the child might face.
In sum, treating children who stutter is a complicated process that often involves several different components depending upon each child’s individual’s needs. Caregivers should work closely with a skilled speech-language pathologist to learn how to best support the lessons the child is learning in therapy with support at home.
For more information about stuttering in school-age children and teens, see School-Age Stuttering: Information and Support for Parents and Other Caregivers from Stuttering Therapy Resources.
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