Over the next several weeks I will be posting a series of commentaries on the opinions conveyed in a publication excerpt authored by a leader in the field of speech therapy for children who stutter. She forwarded the excerpt to me in reaction to my book, Voice Unearthed: Hope, Help, and a Wake-Up Call for the Parents of Children Who Stutter. The focus is on elements she believes influence therapy outcomes for children. I will not reveal the author’s identity, as my intent is to challenge the ideas, not the person.

The excerpt begins with the question “what elements, aside from those specific to a particular treatment approach, might influence a child’s responsiveness to stuttering therapy.” Taking the “treatment approach” out of the mix is like exploring a child’s response to shoes that are too small without considering the option of taking off the shoes. It could very well be that the child is sometimes uncooperative or ill-behaved, but let’s start with taking off the shoes!

Terms including “successful therapy” and “positive outcomes” are used throughout the excerpt but never defined. This is an issue I raise in my book – even the experts cannot agree on how to define “success.” Although most often defined as fewer speech errors, the easiest way for a child to make fewer speech errors is to not talk. Is this a “successful” outcome?

The article relates the reluctant behavior of children participating in therapy to problems with “temperament, personality, lack of control, and negative self-perception.” A parent who chooses to remove a child from therapy because they feel the therapy is too difficult or not relevant is “incongruent,” “Incongruent” is defined as an imbalance between intellect and emotion.

Parents are called upon to shift their role from “all powerful fixer” to “ally and advocate.” In reality, too often the therapist becomes the “all powerful fixer” armed with their tool box of speech techniques. Apparently a good parent “ally and advocate” should continue therapy even if they believe that the therapy is too difficult or not relevant to their child’s life. This begs the question — whose “ally and advocate” has the parent really become?

The publication laments the lack of research that focuses on anything beyond pre- and post-treatment comparisons of measure of speech fluency – a point in which I heartily agree – and I feel that parents have the right to understand. Why does the field of stuttering therapy so enthusiastically promote therapies on the basis of research they openly acknowledge is lacking, yet disregard the parent’s perspective as emotionally and intellectually imbalanced?

Reference is made to the “spirited debate” that continues in this field – another point I feel it is important for parents to understand. Parents can best support their children by familiarizing themselves with all sides of the debate and becoming part of the debate. Voice Unearthed: Hope, Help, and a Wake-Up Call is the first book written about this subject from the parent’s perspective and is available at www.voiceunearthed.com. Ask your local library to carry the book on their shelves so all parents can better understand this debate and the concerns behind today’s therapy for children who stutter.

Thank you for your ongoing interest. Let’s keep them talking!

Doreen Lenz Holte