What became of those great tools my child learned during speech telepractice?
It seems only logical that if a stuttering child can overcome that stutter during her speech telepractice session that she would apply those same strategies to “real life”? After all, children (teenagers in particular) will do just about anything to avoid stigmatizing themselves. So the obvious question is, “Why do they forsake the very tools that will save them this indignity?”
While those techniques that modify stuttering are learned rather quickly in treatment, many speech therapists became frustrated and discouraged when they see this progress evaporate soon after the session’s conclusion. What is it–the child’s laziness, the family not doing “their homework” with the child, or is it perhaps a deficiency in the SLP's strategy?
It may be helpful to consider that instead of looking for whom to blame, the real answer may be something entirely different...
Reason # 1: Mommy, this is just too hard!
First, you must recognize that implementing the changes made in the speech telepractice session can be exponentially more difficult when considering the factors present in real life that didn't exist during the session. Feeling time pressure of articulating the sound, navigating interruptions, or the fear of “failing”; any of these could cause the child to go blank.
What can you do to help?
It is critical that in addition to teaching the child the strategies to overcome her stuttering that you begin to gradually integrate the implementation of those strategies into real life situations that the child will need to confront. Whether it is the classroom, the playground or even in the home, the child needs practice using the tools and thus gain the confidence that is so essential.
Reason #2: But Mommy, this makes me sound so weird!
All of the various techniques that can help a child to reduce her stuttering have a common denominator– pausing. So while the child may have mastered a technique, she will still sound different from her friends, or in her words, “weird!” Feeling weird is enough to shut up any child and could explain why the child is ignoring her well-taught strategies outside of the sessions.
What can you do to help?
You may want to help to desensitize the child to the negative feedback she will probably receive from her peers when she implements the strategies you taught her. Role play with your client by sharing some of the unintended verbal abuse that she will probably encounter and help her to cope with it by fortifying her with responses, emboldening her to persevere.
Reason #3: Mommy, I know it’s great, but it just isn’t worth it!
Just like we make a cost-benefit analysis in our decisions, the stuttering child will as well. Superficially, it seems like a no-brainer. With so many benefits that will improve verbal fluency, why wouldn't the child implement the strategies? But consider the costs- greater effort, losing focus on the message, and the fear that the strategy won’t work- leaving her with nothing.
How Can I Help?
You need to be straight with the child. Discuss the benefits and the costs of utilizing the strategies in various situations. As the child’s awareness and acceptance of her stuttering grows, her feelings, the discomfort experienced, and other’s reactions become more tolerable which will decrease the stuttering. This will lower the costs of the tools and promote their usage.
The Comprehensive Approach
Although there are many very effective strategies to reduce the pain of stuttering, you must realize that actual speech telepractice accomplishment is only when the child can apply the strategies in “real life.” Work to understand why your client is failing to implement what she learned, and craft strategies to address those challenges, helping her to be truly successful!