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Today I am sharing a video I found this week on a stuttering forum on Facebook. It was made by a young woman who stutters, imagining what if the covert stuttering “voice” in her head were a real person, pressuring her to hide her stuttering to avoid negative interactions or feelings.

I am so impressed both by the concepts the filmmaker is exploring, and also by the technical production by someone so young. I sometimes have difficulty taking a photo with my phone, but she can film in split screen, and edit the dialogue between her two selves!

This is a fantastic conversation-starter for older students, who may be grappling with the same issues around hiding their stutter vs. letting people know that they stutter. I am adding it to my growing playlist of stuttering videos on YouTube. I hope you enjoy it as much as I did!

 

highway-road

In October I presented at the Washington Speech Language Hearing Association’s annual conference. I spoke about QuickDrill Therapy, and had a great response to my session.

While I was at the convention I had the privilege of hearing Elyse Lambeth from Children’s Hospital in Seattle present about tools for stuttering therapy. One of the tools she shared was the concept of “fluency lanes.” I loved her graphic, and have adapted it into a handout that I use with my students.

fluency20lanes20preview

The handout is a drawing of a freeway, with the goal of “say what you want to say” at the top. The goal for every student who stutters is that they are able to say what they want to say, when they want to say it. We work on speech strategies as a way to help students towards that goal, but they have other options also. The real goal is not that a student use X strategy. The goal is that each student will chose whatever option works best for them in each situation, even if that option is stuttering openly. Sometimes saying what you want is more important than using a strategy.

The graphic helps students to visualize their options. The box at the side of the road is a parking space. A student is “parked” if they decide not to talk at all. Will it get them to their goal? No. But it is an option they have the power to chose. In therapy we talk about this option, and the consequences of choosing it. Will people know what you think if you stop talking? How will you let your friends know what you like or what you want to do with them? I rarely have a student chose to park instead of drive, but it is still an important option to point out.

The bumpy shoulder on the side of the road is for when students avoide words to prevent stuttering (circumlocution). If a student continues talking, but is avoiding words to keep themselves from stuttering, it will take them more time to go around the tricky words. They might not say exactly what they want. They are still talking, but it is a slow and bumpy road.

The lanes on the road are for different ways to say what they want. One of the lanes is to continue talking and allow the stuttering to happen. Easy stuttering is always an option for communication, and sometimes it is the fastest option! A student can always feel okay choosing to stutter if that will get them to their goal. Working on stuttering acceptance, easy stuttering, and voluntary stuttering are good ways to practice communication in this lane.

The other two lanes are for changing the way you talk (fluency shaping) or using a strategy to alter a stutter (stuttering modification). I don’t differentiate between these two approaches much with elementary-age students, but the difference may be significant in some situations. A student can chose to use their tools to speak more fluently, which will get them to their goal of saying what they want. A student may chose to travel in these lanes if it is important to them that they not stutter while they talk, such as during a class presentation, or talking with a particular person or in a particular situation.

The freedom to chose how to communicate is a fundamental human right. I love this handout because it helps children who stutter to express themselves however they want!

 

stuttering-foundation-logo

I am thrilled to announce that I have received a fellowship to attend the Stuttering Foundation Western Workshop this year! The workshop is 5 days of professional development around stuttering therapy – this year focusing on adolescent children who stutter. I got my acceptance letter in the mail on Friday, and have not stopped grinning since! I’m sure this will mean more posts about stuttering in the future, as I learn more and more about my favorite topic. Now you know what I will be doing in June!

Previous Stuttering Foundation workshop attendees.

 

Stuttering therapy is something that many SLPs have a hard time with. Only 1% of the population stutters, so it is one of the less common disorders we treat. It is one of the disorders we cannot cure, which also makes it tricky to work on in therapy – how do you work on something that will never go away? It is highly variable, which means that what worked for one student may not work at all for the next. And the success of stuttering therapy depends as much on the motivation of the student as it does on the skill of the therapist.

I think that is why SLPs focus so much on teaching fluency strategies. We want to measure things, and we want to target specific skills. We see a motor pattern (blocks, prolongations, repetitions), and we think “I can fix that!” So, we spend hours and hours focusing on motor patterns, but in the end our students are burned out from the drill-n-kill approach, they still feel weird about their stuttering (which of course is still happening), and maybe they don’t even like the strategies we taught them. No wonder stuttering therapy is hard!

Part of the difficulty is the over-focus on speech strategies. They seem the most “concrete”, so they are the easiest to target, but they are only a part (and sometimes a small part) of the whole picture. Stuttering is multifactorial, which means that it is influenced by multiple factors.

The graphic above was developed by Dr. Charles Healey, who is a person who stutters and a professor at the University of Nebraska. He has identified 5 main factors which impact stuttering: Cognitive, Affective, Linguistic, Motor, and Social. He calls this the CALMS model of stuttering.

  • Cognitive: what a person knows about stuttering
  • Affective: how a person feels about their stuttering
  • Linguistic: how language demands impact stuttering
  • Motor: prolongations, blocks, repetitions
  • Social: how stuttering impacts a person socially

As I said above, we SLPs tend to focus on the motor component of stuttering by teaching speech strategies to increase/establish fluent speech. Sometimes we have “stuttering facts” activities which teach kids about stuttering, and we’re pretty good at providing language therapy to address linguistic demands.

The two most challenging of the 5 factors to address are affective and social – how a person feels, and how stuttering impacts them socially. Talking about feelings is tricky, as anyone with a significant other already knows! On top of that, we need to address self-advocacy, how to manage social situations, stuttering acceptance, and feelings of anxiety, particularly for middle and high school age students. It sometimes feels like I should have a counseling degree on top of my CCC-SLP.

How do we target feelings and social impact in stuttering therapy?

Since emotions, stuttering desensitiztation and stuttering advocacy are so important, how can we target them in therapy? Using voluntary stuttering is one way. Using YouTube videos of people who stutter is another. I’ve done lots of activities over the past few years, used tons of topics and videos (many from current events), and had quality conversations with my students about accepting their stuttering. I finally decided to consolidate my ideas into one spot, to make sure that I can hit important topics and could always have ideas ready to spark important conversations.

Stuttering Chat Pack is a collection of 36 questions, topics and scenarios centered on the experience of stuttering. Students have the opportunity to think about their stuttering, figure out how to advocate for themselves in different situations, and explore how they feel about stuttering. The only way to normalize talking about stuttering is to talk about stuttering! I have used it several times in the past week, and am so glad to have all my ideas down in one place. Since it is a powerpoint presentation I don’t have to print it – I can bring up the topic for the day on my laptop without using any paper! I like to let my students pick a number (1-36) for the “question of the day”, but you could just as easily do it chronologically. Here is an example of one of the pages:

I use one page per week, as an icebreaker before we begin to work on strategies. I notice that my students have become much more confident talking about stuttering, and more comfortable about their own stuttering, since I started incorporating these kind of conversations. My ultimate goal for every student who stutters is for them to have easy communication, and to like the way they talk. Talking about stuttering helps!

I know, I know. It’s been ages since I’ve posted. I can only say, that’s because I’ve been very busy doing therapy! Also, I’ve been busy updating the Fluency Homework for the Whole Year packet, which is up on TPT. I added 10 new stuttering missions, so there are now 4 per month (3 in December and June).

I have a lovely graduate student intern coming on board this month, so hopefully that will give me some breathing room to post more frequently.

Happy February!

 

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I’ve been working this month on creating a brochure to share with parents and teachers when a child is first diagnosed with stuttering. Many parents have questions, and it can be hard to remember all of the things we talk about at an evaluation or IEP meeting. I designed a brochure to summarize current research on what we know about stuttering, and why speech therapy is important.

CLICK HERE to download the brochure from my TPT store.

Here is the text from the brochure:

What is stuttering?
Stuttering is the disruption of fluent speech. People who stutter may “get stuck” on words, phrases or sounds. They may repeat these words or sounds multiple times. They may “block” and not be able to say anything at all. Stuttering is involuntary; the person who is stuttering does not have the ability to stop stuttering. It is not a choice, or something caused by bad habits.

What causes stuttering? Did I cause my child to stutter? 
Stuttering is a multifactorial disorder, which means it is influenced by many different things. It has genetic causes, which we know because stuttering tends to run in families. Stuttering can be triggered by emotions, stress, or particular situations, but it is NOT caused by these things. Stuttering is not caused by parenting style, bad habits, or anything you or your child chose to do. It is neurological, and involuntary.

Is there a cure?
There is no cure for stuttering. Children who begin stuttering after age 4, or who continue stuttering beyond preschool, are classified as having a persistent stutter and will not grow out of stuttering. Speech therapy can help a child or adult speak more easily, but cannot cure the underlying condition. Persistent stuttering is permanent.

Does stuttering stay the same over a person’s lifetime?
Stuttering is unpredictable, and impacted by many factors. It can be triggered by strong emotions (feeling excited, nervous, or scared), by particular people, by specific words or sounds, by life changes (moving, new baby in the family) or even by growth spurts or puberty.

Stuttering severity is often cyclical, so stuttering might be mild for a time, then increase and be moderate or severe, then come back down to mild or even imperceptible. These cycles are normal, and can happen at any time during a person’s life.

Speech therapy can help get stuttering under control, and support a person who stutters as they manage their stuttering.

What can I do to help my child?
The biggest thing you can do to help your child who stutters is to remain supportive and listen to what they say rather than how they say it. Here are some tips:

  • Listen attentively to what your child says.
    Don’t interrupt or say words for your child.
  • Avoid competition among family members when speaking.
    Make sure everyone has lots of time to express their thoughts.
  • Model a slow, relaxed speaking style
    with short phrases and pauses in between thoughts. This helps reduce pressure on your child to speak quickly.
  • Be honest.
    It is okay to acknowledge that your child is struggling with his/her speech. Talking about stuttering openly can help reduce anxiety or other negative feelings about stuttering.
  • Be positive!
    Make sure your child knows that it is okay to stutter, and that you love hearing what she/he has to say.

What should I expect from speech therapy? 
Speech therapy will not cure stuttering. A few people who stutter will be able to achieve 100% fluency using speech strategies, but most will still have occasional disfluencies in their speech.

The purpose of speech therapy for stuttering is to make talking easier, and to give the person who stutters control over their speech. Learning speech strategies helps a person who stutters control their fluency when it is important to them, and makes talking easier when they are expressing their ideas. Learning about stuttering is also important to help a person avoid feelings of guilt or frustration, and to reduce anxiety about stuttering.

Speech therapy can make stuttering less severe, and support a person who stutters in finding (or keeping!) their own voice.

Resources

If you feel your child is stuttering, you can receive a free communication evaluation and, if your child qualfies, speech therapy through your public school.

Contact your local public school for more information about stuttering therapy for your child.

This made me cry, sitting in my office this morning. I hope each of my students who stutter find their way to this place.

“My voice is the only one like it. My stutter is not a speech impediment… My speech, composed by God.”

 

Credit to http://stutterrockstar.com/ for posting it.

Today I worked with a 5th grade student on phrasing. Phrasing is a fluency strategy where the speaker pauses at the end of each phrase. You can take an easy breath during the pause, or just take a brief moment to collect and think about what to say next. Phrasing is a very effective speech strategy for many of my students. However, it is also tricky to get them to slow down enough to use it, or to remember to take the time! (CLICK HERE to download a list of my most-used strategies, with descriptions and examples of each).

We practiced first while reading a grade level passage out loud. The passage was in a sheet protector, and we marked places to pause with a dry erase marker. Poetry is another great way to practice phrasing – it not only increases fluency, but also improves inflection and expressiveness.

The trickiest part of learning phrasing is always getting beyond doing it when you can see the marks on the page, and doing it during conversational speech. Today, I found a great activity to do just that!

Rory’s Story Cubes are a fantastic activity for many language tasks, but today we used them as a pacing guide for telling a story. Here is what we did:

  1. Roll the dice
  2. Tell a story using all the dice
  3. Pause after using each die

The dice gave a natural way to pace, and my student realized that she can use the “pause time” as thinking time to help her conversation be more fluent AND have more interesting things to say!

If you can’t find Rory’s Story Cubes in your local store they are available on Amazon, OR you can purchase the app!

This weekend I found a wonderful animated video about stuttering, which I’ll be using with ALL of my stuttering groups this week!

Reasons I love this video:

  • It uses kid-friendly animations
  • It gives a simple, yet *accurate* overview of why people stutter
  • It talks about the range of feelings experienced by some people who stutter
  • It talks about the variability of stuttering
  • It gives tips for how to talk with someone who stutters

I’m adding it to my YouTube playlist of stuttering videos. You can find my other favorite videos here.

I found this short clip this morning while browsing my stuttering sources on facebook! I’ll be using this clip from WBTV in Charlotte, NC this afternoon with a group of students to talk about how to approach fear of stuttering in public, and job opportunities for people who stutter as adults. This man obviously has been able to make the most of it! I enjoyed hearing him tell his story.

CLICK HERE to see the clip.

CLICK HERE to view my previous post on using video clips in stuttering therapy.