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The therapy has to be fit for the person you’re working with
approach for pre-schoolers who stutter
Stuttering for preschool children is often just a blip and may resolve on its own.
Not a lot of stigma, or judgment; very matter of fact
Focused primarily on physical behaviors of stuttering
Focus on supporting parents and empowering them to help their children
transition from pre-school to school-age and beyond
At some point, in the early school years, children begin to compare themselves to others
‘My hair is different’,
‘My body image is not the same as everyone else’,
‘My skin color isn't the same’
The “non-physical”/emotional component of stuttering is introduced
As we move into the school-age, teen, and adult years, we have to think about how the person may be faced with thoughts and feelings around stuttering, and how that affects their overall experience in life and self-image.
Joseph Sheehan’s Analogy of the Iceberg
We think about how each person experiences the “physical” vs. “non-physical” components of stuttering to determine what therapy approach is best:
How much of the work is above the surface?
Behaviors we can hear or see like a stutter, or a body movement
What's beneath the surface?
Emotions and thoughts we often can't see, both positive and negative; shame, guilt, confidence, acceptance
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The Right Way Vs. the Wrong Way
There is no right way
There is a wrong way, which is to try to do a ‘one-size-fits-all’ solution.
We may be the professionals and we may be the experts, but we're not the boss. A mother's intuition, a father's intuition is the best knowledge and the best guide in the process.
remember what stuttering is
a physical issue not an emotionally based issue
a neurophysiological issue, which involves the coordination of signals and neurons in the brain setting up the coordination of the speech mechanism
Stuttering is NOT
a learning disability
caused by anxiety
caused by parents
Good Communication Values
Plant communication values during moments of opportunity. You don't teach values, you plant them.
If we can listen to what the child has to say and practice active listening at the moment that the child is getting stuck, we can send a very powerful message to that young child. And that message is:
“What you have to say is worth listening to, no matter how it comes out. I'm listening to what you have to say more than how you say it”.
So, you or your child stutters.
Before you consult too much with Dr. Google, let us share some helpful facts to steer you in a helpful direction (also see our infographic).
Sometimes the best place to start is to understand what stuttering is NOT...
Stuttering is NOT an emotional problem
Stuttering is NOT a cognitive problem
Stuttering is NOT caused by parents
Stuttering is likely pre-wired, within the child's neurophysiological "wiring" at birth. Often, stuttering first appears years later during the developmental years of 2-8, correlated to developmental and/or environmental conditions.
Many kids go through some dysfluency or fluency instability for a period of time and move through it. The incidence is probably underreported for those who are younger and experience disfluency for shorter durations of time.
Research suggests that five out of a hundred (5%) kids stutter for six months or more, and only one out of a hundred (1%) retain the trait into adulthood.
So, there is a strong likelihood that this is not going to be a lifelong trait. This can be something optimistic to know, and valuable to keep in mind.
With that being said, when your child is stuttering, you don't care about statistics. You don't want your child to become a statistic.
So I think it's really important for people who care for families to remember that.
Parents don't need statistics. They need help as parents and they want to help their child the very best they can.
I think finding what's right for you, finding the right resource of information for yourself is the best thing you can do. Anyone who knows me, and anyone who knows this issue would agree that binging on Dr. Google is probably the worst thing you could possibly do!
There are good resources out there, and support groups for families who are dealing with this issue with their children.
We are not the only address, but we can be a good one for you.
You can contact us. Stay tuned as we roll-out more content, videos and free webinars like this!
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What to do when a parent wants therapy but a child does not?
Ask yourself: What's the root of the problem?
Thinking about what the child's concerns are and helping to alleviate them can be a big step forward.
Talk about it in a different way
Present therapy in a new light! For example:
“Mommy and daddy noticed that sometimes your words are getting stuck. We love you and we found someone who knows a lot about kids whose words get stuck and we want to get some help, some tips, some advice on how we can do the best we can for you. Would you like to come?”
3. Respect them
As they get older, they start to own shares of their life. Allow the child's voice to be heard, even if it's not what we wish to hear.
Now how about this...
‘How do you work with children who might not want to be in therapy?’
1. Learn what's troubling them
If a child is going through something significant in their life, like a stutter, learn what it is and what it's not. Let them know help exists.
2. Give them an invitation
Give a child an opportunity and an invitation. It can be helpful to present therapy as a project: “Would you be interested in a little project? We'll meet for three times and learn a little bit more about this whole speech thing.”
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Here’s a recap of our video!
Talking about stuttering with your teen can be challenging, but it needs to happen! Read below for some tips on approaching this sensitive topic in a safe and dignified way.
1. Don't ignore the elephant in the room!
The worst thing to do is to pretend the stuttering is not there. That sends a message (and transmits a value/judgement) that this way of talking is a "no-no," taboo, we don't talk about it.
2. Talk about it, in a way that is respectful, dignified and nuanced
Use descriptive language - not judgmental language.
If we can use words that are descriptive and just acknowledge what it is, we can talk about stuttering in a respectful and sensitive manner
i.e.: “It must be hard sometimes, would you like to find some ways to learn how to make it easier to talk about it?”
Being insensitive can lead to negative outcomes including poor self-image, reduced confidence and ultimately, a young person who retreats into a safer shell of silence.
Nothing gets me more upset, than when I hear kids are being bullied.
When it comes to bullying I think there are three important questions:
What is bullying and what is just "kids being kids"?
Where and when does it happen?
What can we do about it?
1. What is bullying and what is just "kids being kids"?
First of all bullying is different than teasing and it's different than abuse. The definitions are shifting with time, but what is definite about bullying is that it's the repetitive targeting of an individual or individuals with some behavior that makes them feel uncomfortable.
It could be something as "innocent" as walking past a student in the aisle, and giving them a little elbow.... over and over and over. That's bullying. It could be something as egregious as inappropriate touching, name-calling and/or teasing in a way that relentlessly and repetitively focuses on the same target over time. That's also bullying.
2. Where and when does bullying happen?
Most often, the bully knows how to slip-in, most often targeting kids in the in-between moments; transitions between classes, recess, lunchtime, dismissal, the bathroom, on the bus, during unsupervised times, and unfortunately, bullies don't keep it reserved for school. Bullying occurs in our communities, in the park, in synagogues, churches, and mosques. And of course, it can occur online in the shadows of social media.
3. What to do about bullying?
OPTION A: Empower the bullied
Too often we turn to the targeted kids - the ones being "bullied" - and we put the onus of responsibility on them. We tell our kids to fight back, speak-up for themselves, ignore... But, often the bullied kids (especially the ones with communication challenges) can't do it. If they could speak-up for themselves, they would. Sometimes, facing a bully can be legitimately challenging, scary and ineffective. And sometimes, it can be more trouble than it''s worth!
OPTION B: Confront the bully
Often the bully is unresponsive to other adults intervention, and too often, even speaking to the parents of the bully is less-than we wish it would be.
OPTION C: Activating the community - adults and young people together
What is proven to be effective is engaging the responsible adults in that space; whether it's teachers at school or people in your community. The shared interest is to ensure that all children are in a safe environment, where all children are safe to grow to learn and to flourish.
There is also another overlooked resource against bullying. That is all the "other kids." Not the ones who are bullying and not the ones being bullied, but all those kids who are watching it happen day-in and day-out. By observing this behavior and standing-by passively, these "other kids" are giving permission and even approval to the bully's behavior!
So, if we engage all the students in class, and the young people in our communities to be "good samaritans" then they play an active part in creating a bully-free environment.
In this video, we learn about a family of school-age child who stutters, working together to find descriptive language - as opposed to judgmental language (i.e. good/bad) - to talk about stuttering.
Top 5 Words to Talk About "Stuttering"
* NOTICE: Can you see the descriptive language - and the absence of judgemental language?
** Also, try to use words to describe what it is (i.e. "tense"); and not what it's not (i.e. "not easy").
You can see how it gets confusing using negatives ;-)
Top 5 Words TO TALK ABOUT "FLUENCY"
* NOTICE: These words are centered on the experience of the speaker / talker; how it feels for the speaker (i.e. sticky, easy). As opposed to focusing exclusively on how it is perceived by the listener (ie. stuttering or fluent).
EXERCISE: Build YOUR OWN (FAMILY) "vocabulary"
TIPS: Try with your family
Keeping it light-hearted (even fun) thinking of words to describe speech (both "stuttering" and "fluency")
Brainstorm altogether, or see if each person can create their own list and then share with each other.
See who can come up with the most words!
Put the words in a notebook, on your phone notepad or on the fridge; and begin to use these words when talking about speech. You can even discuss sharing "your personalized vocabulary" with therapists, teachers, family.
Watch our video!
If we were talking to an adult, we would (hopefully) consider their experiences, their feelings, their concerns... We would consider whether they like surprises, or like to be informed in advance; whether they prefer to skip the details, or prefer to know exactly what to expect.
Speech therapy is not part of the everyday routine. It's not like the universal daily ritual (wrestle) of brushing teeth.
Let's be honest, speech therapy is unusual. It's different. And it's often unclear what it is, what it looks like and how it works.
So, if you're a parent or a therapist, ask yourself these questions, BEFORE speaking to your child. Of course you might discuss some of these questions WITH your child.
And you might speak with the professional IN ADVANCE of your appointment - so everyone is on-the-same-page.
And this conversation should be ongoing, checking-in during the first meeting and subsequent appointments, to ensure the "young person" is taken into account.
What's going through the child's mind?
The example I think of is something I heard from Dr. Carol Westby, one of giants in in research and clinical speech-language pathology. She contributed loads of research, assessments and more to show us how children learn through play.
Now, for example, if you think about how children learn to swim, children don't learn how to swim when they're terrified of/in the water. They learn how to swim only after they're comfortable to "splish splash" and fool-around in the water.
So, what that means for us is this: children don't learn when they're terrified. None of us do.
We may memorize something out of fear, we may be able to spit it back on a test, but we're not really learning, long-term, deep learning. Long-term, deep, learning happens when you feel safe. Learning and therapy for that matter, happens when you feel interested and curious; when you feel secure; when you feel there's someone on the other side that has something to offer you. When you feel that other person "gets you," responds to you and can enlighten you.
WORDS THAT TURN-OFF:
WORDS THAT TURN-ON:
These are ways to create a bridge, to create trust, and once you do that, you can have a very productive relationship, and you can really work on very sensitive things.
I think that's the way to set-up "how we talk about therapy." Whether it's a young child, or an older child, or a teen, or an adult, we should make sure to make it relevant; make sure to address points of concern (and even resistance), and make it matter of fact, and description not judgmental.
If we prepare well, then we can engage in therapy with the confidence that we want to have - and assured that our kids will have the confidence they crave. After all, we all deserve to feel safe and secure.
Check out our video here!
TIP #1: ONLY say things, you would WANT TO hear.
TIP #2: ONLY suggest doing things you WOULD do yourself.
TIP #3: model the behavior you wish to see from others
If we want to help people who stutter especially our kids, then the first thing we should do is say less and listen more - turning-up our active listening. Active listening is all about being present and really listening to what they have to say more than how they say it.
Give these tips a try.
They'll probably be more helpful than telling your kids to slow down.
Watch our video!
As adults, public speaking is the #1 fear, worldwide!
So, how about our young people!?
Rites of passage can create a lot of pressure for kids - and a lot of uncertainty for parents. Sweet-16’s, bar-mitzvahs and bat-mitzvahs, and graduation speeches are all instances in which a child may be expected to speak in front of a crowd. So the question is: If my child stutters or has a communication problem should I make them give the speech, or should I give them a pass not to give the speech?
This is a really big dilemma and there's no right answer. There's no perfect way, there's no way to be a perfect parent, but there are hundreds of ways to be a good one.
I think the #1 rule of thumb is engaging your child, especially the adolescent and the teen and giving them a voice, giving them some self-determination to choose what they would like to do and deal with what their concerns are. Too often, as adults, therapists and parents we think we know what young people feel and we forget to just ask them!
When we ask our kids what's on their mind and ask them what would help them - like: would they prefer it this way or that way - we can be so much more relaxed and so much more confident because the decisions we make are informed by what they're really feeling.
In some cases, the best thing we could do is give them the opportunity to choose to pass. And in another scenario, the best thing we can do is give them the encouragement that they really want, so that they can succeed and shine and communicate effectively. Perhaps there may even be a third way.
I'm thinking of one pre- bar-mitzvah boy in particular - he was a great kid with a strong stutter. His parents asked me what they should do. Now, this boy was a talented videographer and instead of giving his speech live and instead of giving a speech at all, he opted to create a montage that included a pre-recorded speech with animation and videos sliding in and out with a musical soundtrack.
And you know what? No one noticed, remembered or commented about the fact that he stuttered!
The feedback from guests was better than his parents or I could have hoped for! We we blown away.
"That was by far the most unique, engaging, and creative bar-mitzvah speech I have ever heard."
He communicated and presented well enough - and by most measures, even better than average!
When we confront the question of whether to push, whether to give a pass, or to find a third option (I am reminded by the lesson taught to me by my young bar-mitzvah friend) remember to engage our young people.
TIP #1 Ask them what they feel
TIP #2 Ask them what they're scared of
TIP #3 Ask them what they want to do about it
If we do, they'll help us make the best decisions we can!
Watch our video!
Parents often ask what they can do to help build their kids self-esteem.
Self-esteem on the one hand is such an important topic, and on the other hand it's really unclear what it is. What is "self-esteem"? As compared to- what is confidence? What is self-image? Are they the same, different...
I'd like to suggest a paradigm shift. Let's re-think "self-esteem." Instead of being something we build into the child, let's recognize it as an innate gift, included within every newborn child. Consider this: no baby looks in the mirror and thinks negatively of themselves! In reality, every baby is born "in-love with themselves" wholly as they are. At some point later on, experiences and feedback from their environment that can send them messages, and over time those negative/doubtful/critical messages chip-away at what was whole.
So when we think about self-esteem let's think about what our kids are born with, and how they see themselves.
If they have differences (a stutter, speech- language-challenges, learning disability, communication challenge, physical anomalies) then the question we ask ourselves should be early and often, as they develop into childhood and adolescence:
TIP#1 HOW can WE amplify the ways they identify themselves with thier unique strengths, talents and characteristics
TIP #2 How can we influence the self-reflection they see when they look in the mirror of life; so their points of difference are not the defining or dominant characteristics
Certainly their unique completion of being make them no less and no more than anyone else.
If we can help young people grow-up with a sense of who they are, and what makes them unique - then we can raise them with a nuanced sense of self-esteem. This sort of self-esteem will lead to confidence and positive self-image through school years, teenage years, young adulthood and beyond - and most valuable of all, will lead them to grow-up as responsible citizens of the world with compassionate and understanding for themselves, and others.