Helping Children Develop Healthy AttitudesToward Stuttering

tuttering

CS enterof

estern ennsylvaniaW PA partnership betw een C hild ren's H o spital o f P it tsburg h and the D epartment o f

C o mmunicat io n Science and D iso rders at the U niversity o f P ittsburg h

J. Scott Yaruss, Ph.D.

Stuttering Centerof Western

Pennsylvania

University of Pittsburgh

Child Factors DeterminingWhen and How to Talk

to Young Children about Stuttering

• Child’s awareness of stuttering

• Child’s concern about stuttering

Children’s Awareness of Stuttering

• Most young children are probably aware of their stuttering at some level– Most of the time they are able to speak fine,

but sometimes it just doesn’t “work right”

– The same is true for nearly every other motor behavior they are learning how to do

• Awareness is not necessarily a problem, but we probably don’t want to increase it if we don’t have to

Some Signs of Awareness

• Mild word substitution

• Mild tension or struggle

• Mild frustration during or after stuttering

• Trying different ways to speak fluently

• Questions such as “why can’t I talk?” asked in a matter-of-fact manner

Guidelines for Talking with Children Who Are Aware

• Don’t over-react…it’s normal for childrento be curious about their developing skills– Children learn how concerned to be from you

• Respond to questions in a matter-of-fact way– “Everybody has trouble talking sometimes…

it’s just part of learning.”– “Sometimes we have trouble talking, just like

sometimes we have trouble walking.”

Children’s Concern about Stuttering

• As children’s continue to stutter, they may become concerned about their speech– Increased tension and struggle– Avoidance of words or speaking situations– Nonspeech behaviors (e.g., hitting mouth)– Embarrassment in talking about speech– More questions about their speech– Fear about speaking

• Help children express their beliefs, feelings, and concerns about their speech

• Help children develop constructive ways of thinking and talking about stuttering

• Decrease the chance children will develop shame, embarrassment, or guilt about speech

• Help children accept themselves, their speaking abilities, and their stuttering

Goals for Talking withChildren Who Are Concerned

A Word about Acceptance• Accepting stuttering does NOT mean

you are giving up on improving their fluency– To help older children who stutter, we need to

look at the big picture -- this involves more than just their speech fluency

• Acceptance of stuttering reduces the chance children will develop the negative reactions that make stuttering more severe

Think about it this way…

If your child were to continue stuttering…

How would you like him to respond?

Stuttering can bevery stubborn...

If we continue to emphasize only fluency, we may end up contributing to the development of guilt and shame that affect many adults who stutter

…not every child will be able to overcome it

General Guidelinesfor Achieving these Goals

• Model……appropriate responses to stuttering

• Listen……to children’s concerns about talking

• Talk……with children about their stuttering

Modeling a Calm Response to Stuttering

• Modeling a calm response to stuttering will help the child learn to do the same

• To do this successfully, you need to be aware of your own reactions to stuttering– Affective: How do you feel about stuttering?

– Behavioral: What do you do when he stutters?

– Cognitive: What do you think about stuttering?

Modeling DifferentWays to Stutter

• For children with significant tension, it may be helpful to model easy, relaxed disfluencies– Shows the child a different way of stuttering

that has less impact on his communication– Helps desensitize the child (and parent)

to the occurrence of disfluencies in speech

• This is more advanced…check with a stuttering specialist to see if this is right for your child– Real desensitization work is best done by the clinician

Modeling EffectiveResponses to Adversity

• Children may develop distorted perceptions about their stuttering and speaking abilities– Over-estimation of stuttering (“I always stutter”)

– Over-estimation of other people’s reactions (“Nobody likes the way I talk”)

– Loss of perspective (“I can’t do anything right”)

• Parents must challenge these perspectives to help children develop healthier reactions

• Explanatory style

Temporary

Permanent

Specific

Pervasive

(Peterson, Buchanan, & Seligman, 1995)

Modeling EffectiveResponses To Adversity

• Examples– “Sometimes learning

takes a little while.”– “That word was kind

of bumpy” (or tense)– “You sure have a lot

of good things to talk about.”

Listening to Children

• Content versus manner: Listen to what children say rather than how they say it

• Affirm any emotions children express– You do not need to solve their problems or

try to make them feel better…just let them know that you hear them and are with them

– This paves the way for an open dialogue about stuttering and other topics

Talking about Stuttering

• Respond to children’s questions

• Label speech-related behaviors and feelings

• Reassure and encourage concerned children

• Reframe the child’s experiences

• Promote discussion by giving the child the opportunity to talk about his feelings

Responding to Questions• If the child is aware enough to ask about his speech,

it’s important to respond– “Why do I stutter?” / “Why am I made this way?”– “Will I always stutter?” / “Will it ever go away?”

• Think about what to say before he asks

• Present stuttering in a matter-of-fact way that:– conveys your acceptance of the child– helps to normalize stuttering (either as a normal part

of learning, or as normal for your child)

Examples of Other ResponsesType Description Examples

Labeling Factual statements aboutchild’s behavior

That word sounded bumpy.

Informing Explanations of child’sfeelings

Sometimes we feel frustratedwhen things are hard to do.

Assuring Parent reassures childabout acceptance

It’s okay with Mom if yourepeat words.

Reframing Parent helps child seebehavior in positive light

This is a good chance tolearn …

Summary• Children don’t know how to react to stuttering

– Left to their own devices, there is a good chance they will over-react or react negatively

– Parents can play a critical role in shaping children’s responses so they will develop healthy attitudes

• Healthy attitudes help minimize thenegative consequences of stuttering– Parents must also exhibit healthy

reactions to stuttering

Some Tough Questions

• How do you feel about stuttering?

• Can you accept your child’s stuttering?

• Can the other parent or other family members accept your child’s stuttering?

• What if the stuttering doesn’t go away?

• Could you stutter on purpose in public to see what it feels like for your child?

Questions for Discussion• How does your child feel about stuttering?

• What situations have you faced with your child’s reactions to stuttering?

• What roadblocks do you see to using these suggestions in your life?

• What other suggestions do you have for helping children develop healthy attitudes?

Questions? Comments?Please contact me!

• J. Scott Yaruss, Ph.D., CCC-SLP

Assistant Professor, University of PittsburghCo-Director, Stuttering Center of Western PA

• Address: 4033 Forbes TowerPittsburgh, PA 15260

• Phone: (412) 647-1367Fax: (412) 647-1370Email: jsyaruss@csd.upmc.edu