An evaluation for stuttering is the start of a journey, and just like any other new journey, the most difficult part is often the beginning. Many children and families are nervous at that first meeting with a speech language pathologist, simply because they do not know what to expect.
The evaluation process for childhood stuttering should involve the entire family. Parents will be asked to complete a written case history form, asking questions about your child:
Once the questionnaire is completed, you may be asked more specific questions about your child and about his or her stuttering. Hopefully, the examiner will be interested in the whole child, and not just the disorder: What does your child like to do? What is she or he good at? What does she not like to do? What is she not good at? What are four or five words that best describe your child?
Just as the parent interview should involve the child as a whole person, the speech pathologist will want to learn as much as possible from your child about his life:
Depending on the age of your child, the speech pathologist will try to learn your child’s feelings and attitudes about his speech, and the impact that it has on him in different environments (at home, at school, etc.).
Your child will also be asked to complete either full tests or screenings to examine his stuttering and overall speech (articulation and phonology), language, and hearing proficiency. Finally, the evaluation will end with either a meeting with the examining speech pathologist to discuss the results or an agreement to meet at a later date, once all of the tests and information have been scored and interpreted.
Stuttering therapy can be very different for each child and family, depending upon your child's age, the severity of the stuttering, and your child's motivation to change. Generally, the younger your child is, the more parent driven the therapy will be, and the older your child is, the more the child will be in charge of the therapy process. Parents often ask the following questions:
Stuttering therapy is very individualized. Some families of preschoolers may only need a handful of sessions before being able to change the home environment enough that the stuttering “falls away” never to return. For many children who stutter, however, stuttering will continue no matter how much the home environment is changed. Often, therapy will require one to two sessions per week during the beginning of therapy. Once the stuttering begins to dissipate or the family and child are able to manage the stuttering on their own, therapy may begin to occur less frequently.
With very young children, the focus will usually center on making the child a typically fluent speaker. Parents will learn how to change the speaking environment by slowing down their speech rate or ensuring that the child is not interrupted while speaking. Parents may also learn strategies to increase the fluency of the young child. The therapy session itself will be mainly play-based, and the child and family will learn more about stuttering, about fluency, and about ways to increase moments of fluent speech and decrease moments of stuttering. It is also important to remember that stuttering is not a bad thing, simply a way of talking that takes longer, and is more difficult, than other ways.
As children get older, the chances that they will always stutter to some degree increases. A child’s ability to take responsibility for his therapy also increases. Because of these two factors, therapy may begin to focus less on fluency than with the successful management of both fluency and stuttering. Children and teens who stutter need to learn to be excellent speakers and communicators, whether or not stuttering occurs. Children and teens will learn more about fluency and about stuttering. They may learn that many famous people, people who are wonderful speakers, are people who stutter. They will also learn to recognize situations in which they are more or less fluent, and learn to problem-solve ways to increase their success when speaking in places that used to be problematic. Children and teens will also learn individual strategies that allow them to manage their stuttering well at school, at home, and in their social lives.
While this may seem like a simple question at first, it may be the most difficult question to answer. Some children will be able to change their speech in such a way that it will be obvious that therapy is beneficial. However, even the most motivated child and therapist may have difficulty changing the child’s speech in all (or even any) environments. If this is the case, it is important to remember that stuttering therapy is really about communication. While some children may not be able to stutter less no matter how hard they try, if the child has learned strategies to cope with his stuttering, that is a great success. If the child is simply talking more at home or at school, that is also a great success. If the child is now participating more in class, making phone calls to peers, and advocating for themselves, these are all signs that therapy is making a real difference in the child’s life, whether or not the actual stuttering has been reduced.
Joseph F. Klein, Ph.D., CCC-SLP
The College of St. Rose