Successfully Treat Stuttering in Schools? Yes, You Can!

If you are a school-based speech-language pathologist, you’ve probably had this experience:

Several weeks after the start of the new year, after your schedule is finally settled (sort of), you receive a note from a classroom teacher that reads, “I think a child in my class is stuttering. You should pick them up right away!” You can practically sense the anxiety in the teacher’s plea for help, and then you notice that your own anxiety is rising too! Why does it have to be stuttering?

If this scenario resonates with you, you are not alone. Research has shown that many SLPs, particularly in schools, simply don’t feel confident in their skills for helping children who stutter.¹

There are several reasons for this, but one of the most fundamental is the sense that many clinicians just aren’t sure that what they are doing in stuttering therapy really helps. Yes, most clinicians know a bunch of techniques that help children speak more fluently, but students don’t seem to want to use those techniques outside of the therapy room. This leads to problems with generalization and an overall feeling of inadequacy for both the student and the clinician.

School-Based SLPS Can Successfully Address Stuttering

The solution to this problem is already within your grasp! It is all based on selecting the right goals for therapy.²

When we approach stuttering therapy from a communication perspective instead of focusing on speech fluency, we open up a whole world of positive outcomes for our students. There are many ways in which clinicians can make a real difference in the lives of school-age children who stutter to help them minimize the adverse impact of stuttering so that they can communicate freely and effectively.

Clinicians may assume that the primary goal of therapy for school-age children who stutter is to help them speak more fluently. After all, that’s what the parents want, that’s what the teachers want, and that’s what the students themselves want. As a result, you may have written IEP goals indicating that a child will use various strategies for fluent speech. You have likely spent hours drilling these techniques through various games and activities to get your students to practice, practice, practice! Even with all of this effort, however, the student keeps on stuttering.

What if I told you that the fix for this situation is recognizing that increasing fluency is not necessarily the best goal for stuttering therapy?^{3, 4} Moreover, what if I told you that the key to improving your stuttering therapy is to use more of the skills you already know from working with students who have other conditions?

“Stuttering Is More Than Just Stuttering³“

Observable disruptions in speech are the most visible or noticeable aspects of stuttering to listeners. According to people who stutter, however, these observable behaviors are not the most important aspects of stuttering.^{5, 6}

What is most important to those who stutter is the impact that stuttering can have on their ability to express themselves, to say what they want to say, and do what they want to do. What bothers people about their stuttering the most is how it affects their lives.⁷ Certainly many people who stutter would rather that they simply not stutter, particularly during their school-age years. Still, if we move beyond those surface speech behaviors, which often prove to be intractable, we find that the real burden of stuttering comes from the difficulty that people may face in completing everyday life tasks.

For school-age students, those difficulties relate to talking to their friends, meeting new people, using the telephone (for something other than texting), reading aloud in class, giving a book report, and, as they get older, asking someone out on a date or interviewing for college or a job or military service. These are the things that matter in their lives, and that is what we ought to focus on in therapy.

What Can School-Based SLPs Do to Help?

SLPs can make a real difference in the lives of students who stutter. The key to success is to shift our focus away from observable fluency and toward helping students feel more comfortable and confident expressing themselves, regardless of whether or how much they might stutter. In other words, the true goal of stuttering therapy is to support effective communication, just as it is for children experiencing other communication difficulties—and you already know how to do that!

Rather than asking how much a student stutters, ask how much they participate in class. Rather than writing goals about how many times a student uses a technique, focus your goals on whether the student reads aloud in class or gives their book report (whether stuttering or not). Rather than counting the number of times a student uses a technique, ask whether they ordered the food they wanted at the cafeteria or said exactly the words they wanted to say, without fear.

When we help students communicate more easily, we reduce the burden of stuttering, which is what will ultimately make the biggest difference in their lives, and it is something that all speech-language pathologists can achieve.

For more information on the various elements of working with young and school-aged children who stutter, I offer a series of courses on MedBridge that cover evaluation of stuttering, how to minimize bullying, working with the families of children who stutter, tools for measuring stuttering, strategies for modifying observable disruptions in speech, and much more.