As kids transition from elementary school to middle school and then to high school, how can parents ensure their child’s speech therapy model transitions with them?

Parents should take time to get to know their school SLP and begin early to advocate for their elementary school child in an effective and supportive manner. I also recommend that parents learn all they can about stuttering. When parents are well-educated consumers, they are better equipped to effectively advocate for their children. Approach the SLP with the information you have and ask what s/he thinks. Explain that you want to know what treatments are available for your child. Offer to help get information if s/he needs it and make it known that you want to work as a team.

Parents also need to learn about their child’s stuttering. Children’s level of awareness and concerns about speaking and stuttering can change over time. This occurs due to maturity, experiences and perceptions. It’s okay to talk about stuttering, fears and concerns. It’s important to know what concerns a child may have about going to middle school, especially in regards to communicating.

Usually, there is an annual IEP review at the end of the school year to review the child’s progress and to make recommendations for the next year. It would be helpful to have the elementary SLP and classroom teacher and the middle school SLP and teachers at the meeting. Sometimes this is a challenge, but it is ideal. Navigating the transition can be tricky since there will be six to eight weeks of break in the summer during which time the motor speech aspects of a child’s stuttering may change along with possible changes in attitudes and emotions. Therefore, a second transition meeting is recommended prior to or just after the start of middle school.

Ideally, the elementary and middle school SLPs should be there along with the parent. Perhaps an informal meeting could be scheduled as a parent-teacher conference, rather than a formal IEP meeting if this is easier. The student might attend, depending on their developmental maturity. A discussion of the child’s summer in regards to stuttering, attitudes about communicating, and significant experiences could be addressed. In addition, goals would be addressed as well as the child’s concerns about communication in the coming year.

The transition from middle school to high school is going to be very different than the previous one. Students are more mature and have a desire for more independence. Some teens continue to receive speech therapy services in school, others opt for private services and still others opt to discontinue therapy. Teens should be actively involved in decisions about therapy and goals. Parents can encourage and advise at this stage but the teen’s choices should be respected.

For the transition to high school, parents can request a meeting with their teen and the SLP to make the initial introduction as the school year begins. This does not have to be a formal IEP meeting but could be more like a student-teacher conference. During this meeting, the previous years’ speech therapy goals will probably be reviewed, but the meeting should also involve discussion about the student’s interests and activities as well as his or her concerns about stuttering and/or communicating in general. The meeting might also include a review of IEP goals and discussion about how well they match the student’s goals.

Submitted by Karen Kumar, CCC-SLP

How often is an IEP reviewed?

The IEP serves as documentation for speech-language therapy. Progress must be reported quarterly at the same time that report cards go out to general education students. Progress reports address each IEP goal and the progress toward them. Goals are stated in measurable terms and data must be collected to support subjective reports of progress. For example, if the goal is to be 80% fluent while reading, the progress report must say what the percentage of fluency is while reading at the end of the quarter.

Because the IEP is valid for 12 months, the same goals can be carried over to the next school year. For example, if the IEP is written in April, the “end of year report” would be the first quarter progress note on the IEP. That goal would then be continued until next April. If the student meets the goal before the end of 12 months, a new goal must be written at a higher level or the goal (and possibly eligibility) can be discontinued. The IEP must be renewed before the end of 12 months or the student must be discharged from services if they are no longer needed.

Each school district has a procedure for managing student files at the end of each school year. Some records are retained by the same SLP; others must be given to a new SLP, such as when the student is changing schools. Many districts now use computerized IEP programs so that authorized personnel can access electronic records across schools. Procedures for managing files for students as they transition to other SLPs or to other schools or districts vary with the district. You may ask your district representative what the policies and procedures are where your student attends school.

Submitted by Lynne Remson, CCC-SLP

How much emphasis should be placed on carry-over of speech strategies and techniques at home?

This depends on a lot of several key factors. Perhaps the two most important are the child’s age and the specific goals the child is working toward in therapy. For example, for a very young child who is not yet working on speech fluency, then it may not be appropriate to place any emphasis on speech at all. For a school-age child who is learning to use speech techniques, then it would generally be appropriate for there to be some type of home practice routine to support generalization and to help the parents understand what is going on in therapy. For an adolescent, it is quite unlikely that there will be benefit to the parent reminding the teen to use speech techniques, so an emphasis on “speech” would not be helpful. Indeed, I’m not sure that any emphasis on “speech” would ever be helpful – if what is meant by that is emphasis on “fluency.” An emphasis on communication is always helpful, and this is what the parent should provide. Indeed, for all ages, it is critically important for the parents to provide a supportive, accepting atmosphere where the child knows that it is okay to stutter even as s/he is working toward enhancing fluency, minimizing the burden of stuttering, or whatever other goals may be selected in therapy.

Submitted by Dr. Scott Yaruss, CCC-SLP

What might a parent look for that would indicate a therapy model is outdated or ineffective?

This is a tough question to answer. In general, treatment that focuses on fluency to the exclusion of more balanced goals for improving communication and reducing the burden of stuttering on the child’s life are, put simply, inappropriate for children who stutter. There are different times in therapy where treatment might address speech production goals to a greater or lesser extent, but any time treatment is out-of-balance, then this can cause problems for the child. Clinicians and parents should be very aware of what the child’s overall goals are for treatment, and if those goals are too narrowly focused in any one area, then it would be sensible to take a step back and ensure that the goals are sufficiently broad-based that they address the child’s entire experience of stuttering, particularly including the adverse impact of the disorder on the child’s life.

Submitted by Dr. Scott Yaruss, CCC-SLP

Is it effective for kids who stutter to be in group speech therapy with kids who have speech disorders other than stuttering?

This depends upon many factors, in this case, the nature of the child’s goals in therapy, the child’s own personality, the skill of the clinician, the nature of the other children’s communication difficulties, and more. There are certain times in therapy when the goals for a child who stutters may be quite consistent with the goals for other children with communication difficulties. There are other times when this would not be the case. Clinicians and parents should be aware of what other children in the group are working toward and ensure that the goals and messages of therapy for other children in the group are consistent with the desired outcomes from therapy for the child who stutters: improved communication, reduced anxiety about speaking difficulties, and, of course, addressing whatever the specific speech or language difficulty is. If the goals are congruent, then treatment can be quite successful for all involved. If not, then not.

Submitted by Dr. Scott Yaruss, CCC-SLP

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