Parents who are concerned about their child’s speech development should seek an evaluation from a qualified speech-language pathologist. Stuttering specialists are speech-language pathologists who have been recognized by the American Board of Fluency and Fluency Disorders (ABFFD) as having achieved advanced training and clinical skill for working with people who stutter and their families. A list of Board-Certified Specialists in Fluency Disorders (BCS-F) can be found at www.stutteringspecialists.org. The speech-language pathologist will help you determine whether treatment is appropriate for your child.
All preschool stuttering therapy is not the same, and neither are the styles of therapists who work with preschool children who stutter. It is important to remember, however, that your child’s stuttering differs from that of any other child. Therapy must be developed and modified in an on-going manner to meet your child’s specific needs. For that reason, we would be concerned about any therapy that tries to fit your child into a generalized “program,” where the same approach is used for all children, regardless of the nature of their stuttering. Such approaches are relatively common, and it is up to you to make sure your child is getting treatment that is specifically tailored to his or her needs.
Depending upon the assessment findings, different types of treatment may be recommended. Traditionally, clinicians have recommended so-called “indirect” therapy approaches for preschool children who stutter. These approaches are based on the notion that children’s speech is influenced by an interaction between the child’s speaking abilities and the environment that he or she is in. (Note that these environmental factors do not cause a child to stutter; however, certain aspects of the environment may make it more likely that a child will exhibit increased or decreased stuttering in certain situations.) Thus, indirect therapy consists of parent education, parent training for making communication changes at home, or a combination of both. During parent education, parents learn more about normal language and fluency development, stuttering, and the conditions that may sometimes exacerbate (but not cause) a child’s production of speech disfluencies.
Recently, more direct forms of therapy have also gained popularity. With these approaches, children are specifically taught to produce more fluent speech, either through modeling of easier speaking styles, or through feedback about the child’s fluency, provided by the parents or the clinician. This decision to employ more direct therapy will depend upon many factors, such as the amount of stuttering that is seen over time and the impact the stuttering is having on your child’s attitude towards communication.
Family knowledge, involvement, and input are critical factors for the success of both direct and indirect therapy. It is also important for parents to provide an atmosphere of acceptance of all types of speech, including stuttered speech so the child will learn that he is okay, even though he stutters..
As you review different therapy approaches, you are likely to hear some people say one approach or another approach is best. Keep in mind that every child who stutters is different, so different approaches may work better for some children than for others. The most important thing you can do is find a knowledgeable, caring stuttering specialist or clinician with expertise in stuttering who can help you make informed decisions about which treatment approaches will be best for your child.