We would like
to share some of the personal therapy experiences that have
shaped our changing treatment philosophy. As specialists
in the area of stuttering, it has not been uncommon for
us to see children with resistant stuttering behaviors or
children who have had previous speech therapy without success.
Stories like these have led us to feel that in some cases
direct therapy is the most appropriate course:
Andrew, a two-year, nine-month-old male,
was initially enrolled in a very indirect therapy program
that was done in the home. With no mention of talking whatsoever,
we spent our time in fluency-enhancing play activities.
Seven months of indirect therapy yielded little change.
One morning Andy asked me, "Why it is so hard for me
to talk?" Not quite sure how to respond to a two-year-old,
I told him that his talking was not all grown up yet and
lots of little children have trouble talking sometimes.
Following this incident I shifted to a more direct therapy
approach in which I taught Andrew to do "easy speech"
during therapy and openly discussed his speech difficulties.
He began improving immediately. Within months, Andrew was
dismissed from therapy.
Kimmy,
a four-year-old female, had been receiving indirect therapy
for four months. One day she came to therapy in a severe
regression. In tears, she would preface every hard word
with the starter" eyah."
My first inclination was to put her on my lap and hold her
while she cried. While I was struggling to decide how to
respond to her tears, Kimmy told me she was" afraid
to talk, afraid her words would get stuck" I knew I
needed to respond to her fears and validate the pain she
was feeling. I asked her why she was scared of getting stuck
in her words. Even though she could not answer that question,
it was the first time anyone had talked about her stuttering.
I think it felt good to both of us. We then talked about
the "new word" (eyah) she was using to help her
talk She said it was like" chicken talk" because
the next word was hard and she was afraid to say it. Today,
Kimmy is twelve years old and, since the initiation of more
direct therapy, has not stuttered since kindergarten.
Caitlyn, a four-year-old female who began
therapy in the midst of her parents' divorce, was exhibiting
significant struggle and tension behavior as well as secondary
behaviors. Of most concern was her head banging behavior
during her most difficult moments of stuttering. After many
sessions in which I attempted to eliminate this behavior
through fluency-shaping principles, I saw no change. One
day, shortly after Caitlyn banged her forehead on the table
to interrupt a block, I modeled the same behavior. Caitlyn
was shocked and ignored me. After I did this several times
she asked me, "Why did you do that? Didn't that hurt?"
I responded, "I don't know why I did it. But it sure
didn't help me get my word out!" Caitlyn never again
banged her head to help her talk She has been out of therapy
for six years and remains fluent.
Stuttering Therapy- Case Studies