Hope you all had a great Thanksgiving! On a personal note, I must start by acknowledging the passing of another lovely “Pall Mall Puffing Potty Mouth Role Model” in my life. My stepmom of 47 years (referenced in my previous blog) died unexpectedly on November 25th. She was legendary for showing her love through her amazing cooking, card-playing, sewing, and acceptance of all who walked through her door. Grandma Fern leaves a hole in our hearts and will be missed by all sixty-six (not kidding) members of her immediate family and so many others.
On to the subject at hand. Throughout Eli’s five years of traditional speech therapy we saw several different speech therapists. Each therapist’s plan hinged on the speech tools included in the stuttering modification approach. Each therapist encouraged me to do “special time” for 15 to 30 minutes a day, with Eli practicing speech tools while playing games or telling me stories. I remember being told by one speech therapist to not remind Eli to use his speech tools outside of that 15 minutes of “special time” — she said “let me be the bad guy.”
On one hand, I felt the only way he was going to ever be able to use these tools would be to practice for hours each day until they became wired into his brain. On the other hand, it seemed the more “special time” we did, the quieter he got. Our time together quickly became tense and awkward and something neither one of us looked forward to. I blamed myself — I just didn’t have that magical “whatever” to facilitate this practice in a way that felt fun and comfortable or in a way that would enable him to use these tools naturally in his world.
I have come to believe that underlying the time and place limitations when it comes to practicing tools is a lurking awareness of the inherent risks of suggesting a child speak in a prescribed manner. We know it can do damage, but darn it, it’s evidence-based best practice!! So we forge ahead.
I have written quite a bit about the overwhelming lack of evidence supporting any treatment for children who stutter. Just the other day I heard a comment on public radio that struck a chord, “we’ll have to wait until science catches up with anecdotal evidence.” Experts continually marginalize the vast amount of anecdotal evidence from parents, teens, and adults who stutter around the uselessness and drawbacks of speech tools with children. Instead they embrace “promising” strategies built on tiny numbers, inappropriate goals, and limited follow-up while children who stutter are growing more silent and disengaged each day.
What advice can a clinician give a parent that will magically eradicate the risks out of telling a child to change how they talk? Why is it deemed more penalizing for a parent or teacher to suggest speech corrections than for a speech therapist in a clinic setting? Why are correction and modification instructions from mom during special time any different from at the dinner table or in the sandbox. Mom is mom is mom. There’s no magic hat that can eliminate mom from the messaging. Nor does the training speech therapists receive cloak them with magic powers that make it “safe” only when implemented by them or someone under their tutelage.
We need to do as much as we can to help kids stop thinking so hard about their speech. Would we ever put 15-minute limitations on activities that increase self-confidence and keep talking fun for a kid? How about cooking with Grandma, knowing you’re free to say anything you want (because you wouldn’t believe the things she says!) Or “just playing the game” as Eli so often demanded when I would try and turn the game into “special time.” Or helping them to pursue a passion such as snowboarding, sewing, art, or a big one in my house over the years — Pokemon. Get your 9-year old trading Pokemon cards with his buddies and the talking will flow and flow and flow…
Speech therapists have a golden opportunity to provide guidance and support to parents, teachers and other significant people in these kids’ lives to minimize anxiety and keep these kids talking. And if these kids are really lucky, they’ll have a PPPM grandma to throw into the mix. Rest in peace Grandma Fern.
Please feel free to share this essay with others who are affected by stuttering. Also, I would love to hear of creative ways you have helped a child who stutters to increase verbal output and to keep talking fun!
Dori Lenz Holte