Tag: stuttering therapy dallas

Fluency/Stuttering, Speech Therapy Tips

Stuttering Therapy Goals that Promote Functional Confident Communicators

by cherylhoperising1 Comment on Stuttering Therapy Goals that Promote Functional Confident Communicators
Stuttering Therapy Goals that Promote Functional Confident Communicators

Blog Post Adapted from Poster Session Presentation at ASHA Connect July 2020 entitled Helping your students who stutter be Functional Confident Communicators:  Setting therapy goals that promote success

It can be difficult for SLPs (Speech Language Pathologists) to write therapy goals for their students/clients that stutter. And it can be difficult for people who stutter and/or their families to know what type of goals they might work on in therapy will help them communicate functionally and confidently. Why is this so hard?

There is also a history behind how stuttering goals have been written.

This history has resulted in therapy goals that are focused on stuttering (or the lack thereof), rather than on the person who is stuttering. They have caused stress to the person who stutters and their family, they have caused shame to the person who stutters and their family, they have not focused on helping the person who stutters actually communicate more effectively, and in many cases, they have not only not helped the person who stutters, but resulted in causing them harm. So what could we be doing that is better? Let’s see how we can start the process of writing better goals. First, let’s look at some key issues we need to consider.

In order to move beyond these initial thoughts, let’s take a look at person centered treatment, and what it means. Person centered treatment has a focus on placing the individual and their families interests, motivators, wants and needs at the center of the process. Here are some guiding questions we can ask about a student/client’s stuttering from a person centered perspective.

And here are some goal areas we can look at for students/clients who stutter:

The assessment process will guide how we match the needs of the person who stutters with goals to work on in therapy. These will be individualized to the person. That being said, it can be helpful to have an idea of some types of goals that I have found effective in working with students/clients that stutter as a springboard to get you started. These examples were written while working with Elementary School aged students, and as such may not be appropriate for older students/clients or in a private therapy setting. But hopefully, they can help get you started with knowing where to go. Here are some examples:

Fluency/Stuttering

So you’re a Speech Therapist, -you work with people that stutter, right?

by cherylhoperising
So you’re a Speech Therapist, -you work with people that stutter, right?

So you’re a speech therapist, that means you work with people that stutter, right? Hands down, this is the most common reaction I have to telling people I don’t know well what I do. What is interesting about the question is the fact that, although, yes, I do work with people that stutter, it is one of the least common disorders that SLPs (speech language pathologists, aka speech therapists) treat. It is, however, one of the speech difficulties people have that I enjoy working with the most, and it is one of the areas I have chosen to specialize in in my private practice.

So, how does a speech therapist work with someone that stutters? Many of you may have seen the King’s Speech, where initially King George IV has a speech therapist/teacher that has him work on his stuttering by putting marbles in his mouth. This is, of course, a ridiculous thing to do in general, let along to help with stuttering, but it was in fact, a technique that was used at one point in time. Thank goodness we know so much more now!

Speech Therapy for a person that stutters is, first and foremost, an individualized process tailored to each person based on their needs, interests, and goals. Treatment can include both indirect therapy and direct therapy, and includes a strong counseling component.

Indirect therapy includes family training and education, as well as training communication partners (teachers, family, friends…..) about stuttering. There are things that communication partners can do to help a person that stutters increase their confidence in their ability to communicate, such as not speaking over them when they can’t get a word out, giving sufficient pause time in a conversation, and not rushing the person when they are talking.

Direct therapy may include any or all of the following:

  • Training and practice using tools to increase fluency (decrease stuttering), with an emphasis on client directed use of the tools. Client directed tool use is important: it is paramount that the client gets to decide if they will use tools at all, and if they do, which ones, where, and when. The job of the SLP is to train a person on the varying tools, offer them the opportunity to practice with feedback, and get feedback from them on the tool. Questions such as how they like the tool,  how helpful they think it is, and are they interested in using outside the therapy session. No one wants to be forced to use a speech strategy that they don’t like, and that isn’t helpful.
  • Educating the client on how speech is produced (speech anatomy and physiology for non SLPs!), and providing training on recognizing tension/stress in their body and how to work on reducing that.
  • Training the client that stutters on how to be a self-advocate in a variety of communication settings, which may include discussion or how to deal with bullying, discrimination or harassment because of their speech difficulty.
  • A review of the client’s attitudes/beliefs/feelings about their speech and their stuttering, as well as discussion regarding their individual needs in relation to being able to communicate more easily across a variety of settings.
  • Guidance with identifying communication situations that are stressful, and avoidance reduction strategies to help with reducing stress and being able to effectively communicate in those situations.
  • Learn about both famous and non famous people that stutter, and exploring their journeys through reading things they have written, watching video clips, art …..

An extremely helpful addendum to speech therapy is to help clients find other people that stutter to be around, talk to, problem solve stressful communication situations with, and learn from. Finding a safe community among other people that stutter is the key to being comfortable communicating that many people that stutter need. The National Stuttering Association (NSA) has chapters throughout the USA, a list can be found here: https://westutter.org/chapters/

In my practice, I hold the belief that treatment for clients that stutter is functional confident communication, not perfectly fluent speech. Stuttering, if it is not developmental (blog post on that soon!), is a lifelong speech disorder. It can improve, but it does not go away. (Any therapist, business, or other professional that tries to sell a cure or permanent fix is not being honest). I want clients to be able to communicate whatever they want, wherever they want, with whomever they want, regardless of how fluent their speech may or may not be.

As working with stuttering is a passion of mine, you can look for future blog posts on a variety of topics related to stuttering. If you have specific questions or things you would like to know about in future posts, please reach out to me through the contact page and let me know. I look forward to hearing from you.