Anna Writes about Stammering

As a child, I grew up with a sister who has Down Syndrome and communication needs, including a stammer. As I grew older, I began to wonder about what causes a stammer and how I could help.  During my first year of practising as a speech and language therapist, I had the opportunity to participate in some training around how to support people with stammers. Since then, I have worked with numerous children on their stammers including self-acceptance skills, developing their awareness into how common stammering really is, and introducing specific strategies to improve children’s independence with managing their stammer. I have also supported schoolteachers and parents with developing their own insight into how they can support children with stammers.

Therapy for children and young people with dysfluency tends to involve working collaboratively with children, their families and school staff following a whole team approach to set goals, and plans for therapy all together. Therapy sessions include direct and indirect therapy. This may involve, face to face sessions or teletherapy sessions or even a mixture of both.

Direct therapy: This may involve discussing feelings toward stammering, identifying what helps them when they stammer this helps us understand what’s working well and what they need help with. For something, that feels so automatic as speech, there’s a lot of planning that goes into it, so I often use ‘communication chain’ as a helpful visual to highlight where the stammer can occur. We may watch an MRI scan video of somebody talking to truly depict all the ‘mechanics’ that go into our speech, including coordinating our breathing and articulatory (mouth and throat) movements. I may also discuss the demands and capacities model. All of this supports children’s understanding and insight of themselves and their own communication. This learning can be extremely valuable for children. I then often work on boosting the child’s confidence, this tends to include: teaching the child ‘it’s okay to stutter’ (this is sometimes known as ‘Voluntary Stuttering’), building awareness around how common stammering is by discussing some facts, I also like to show the child/young person a video of lots children who stammer to support them to recognise there are lots of other children who stammer too. This is because, quite often children believe it’s only them who has a stammer. I introduce strategies including breathing techniques, slowing down the rate of speech, pausing techniques, sliding (where you ease into the beginnings of words, like going down a slide, starting off slowly and then speeding up) and easy onset (where you let a breath out before saying a vowel sound). We practise techniques within certain situations/phrases which the child has identified as tricky. For example, we may use techniques to practise challenging names or sounds or words, to pretend to order food from a menu, to practise reading out loud and so forth. I have also worked with children, together creating resources such as ‘Communication Passports’ personalised to the child’s interests and including individual information about their stammer, so that they can share this with new people such as supply teachers who may not be aware of their stammer.