Advice from Speech-Language Pathologists Around the World

Editor's Note: Speech-language pathologists, if you submitted advice via e-mail and it isn't posted here, we apologize. Because of Hurricane Matthew, our e-mail service has been down.

1. What's the first thing you tell a worried parent about stuttering?

In case you were wondering, you did not cause your child to stutter.—Elaine Kelman, London, England

Your child is not broken. He or she may continue to stutter, or not, but the most important thing you can do is to accept, love, and listen to your child.—Melissa Petersen, Seattle, Washington, USA

Watching your child struggle to communicate is very difficult. By reaching out, you have taken the first step in learning ways to help your child now and in the future.—Ellen M. Kelly, Nashville, Tennessee, USA

I would say that your child's stuttering is not your fault but you can help her/him.—Katri Luhtalampi, Tampere, Finland

Parents do not cause stuttering! In fact parents can do a lot to help children who stutter by making changes to support their child who stutters. There are lots of ways which SLPs and parents can work together to prevent stuttering from becoming a problem.—Voon Pang, Auckland, New Zealand

I share a variety of appropriate resources with concerned parents. I provide a courtesy phone consultation and I also send them a basic communication index survey. I follow up with a telephone call to review the results of their survey.—Mark J. Witkind, Miami, Florida, USA

I understand you are concerned about your child speech--I would also be. You did very well coming in with your doubts so soon. With your help we’ll be able to work out your son’s speech dysfluencies.—Marina Llobera O’Brien, Palma de Mallorca, Spain

The first thing I tell a worried parent is, be calm. Your reaction to the way he or she speak matters a lot.—Grace Ademola-Sokoya, Lagos, Nigeria

First, I just listen to their fear and concern and validate their feelings as being understandable and normal. Then I share that a child who stutters can be an effective communicator and a happy, successful person; that therapy can guide them to stutter with less tension. I will often share the Famous People Who Stutter list with them.—Kathleen M. Chase, Centennial, Colorado, USA

It is important for me to interact and communicate with your child as he might have normal dysfluency which may occur during speech and language acquisition.—Ursula Zsilavecz, Pretoria, Bauteng, South Africa

It is important that the parents let their child know how much they love them. When they communicate with their child, do not focus on the stuttering too much but listen to what the child wants to communicate and respond to the things that they are interesting to them. The parents may tell their child that they recognize his/her struggles with their speech while their child stutters to let them know they understand them.—Ponjit Jithavech, Bangkok, Thailand

The first thing I tell a parent is that we will start on a path of teamwork together. I’ll be your guide, but you will do the job.—Mara Luque, Buenos Aires , Argentina

2. When should a parent seek out an SLP?

Parents should contact a speech-language therapist as soon as the parent or child is anxious about the child's speech.—Elaine Kelman, London, England

Seek out an SLP if your child is frustrated by their stuttering. If your child is happily stuttering away, without lots of tension or frustration, then watching/waiting is okay. If the stuttering lasts longer than a few months, or any time your child is frustrated, consulting with an SLP is a good idea.—Melissa Petersen, Seattle, Washington, USA

When a child has been presenting dysfluencies for the past six months, I wouldn’t wait anymore. If there are blocks, movements or he has started to avoid talking, don’t wait. We want to start working with parents immediately.—Marina Llobera O’Brien, Palma de Mallorca, Spain

Anytime parents are worried about their child's speech, they may not need to meet the SLT immediately, but they can get  information over the phone.—Katri Luhtalampi, Tampere, Finland

Parents should seek out an SLP as soon as they become very worried about their child's speech. The SLP will be able to counsel the parents appropriately or initiate therapy if necessary.—Grace Ademola-Sokoya, Lagos, Nigeria

A parent should seek out an SLP when he or she is worried or if the child demonstrates negative reactions to stuttering. Parents should also seek out an SLP if stuttering has been present for longer than 6 months since onset.—Voon Pang, Auckland, New Zealand

No matter the age of the child, if parents have a concern they should schedule an appointment with a therapist to meet with them and the child.—Ursula Zsilavecz, Pretoria, Bauteng, South Africa

Stuttering can best be addressed AS SOON AS it appears in a child’s speech. This is usually some time during the preschool years, between the ages of 2 and 4. A parent of a young child who notices stuttering blocks (in which a child’s speech seems to be “stuck”) or excessive repetitions of words or speech sounds should see a Speech Pathologist with the child as soon as possible. There are many things that can be done at this age to lessen the likelihood that this child will experience a lifetime of stuttering. There is a window of opportunity for this which often ends quite rapidly as stuttering becomes ingrained in the child’s speech patterns. Sometimes this process can take place over just a few weeks.—Leslie E. Lockwood, Riverside, California, USA 

It is important that parents of preschool children who are bilingual (for example; English/Spanish in Miami) obtain appropriate information involving their child's fluency development, as soon as they become concerned, to facilitate a process of normal fluency development. Unfortunately, over the years, I've spoken to many parents who have been advised to "wait and see" for too long a period because they attributed their child's atypical disfluencies to bilingualism.—Lisette M. Betancourt, Miami, Florida, USA

I always share with parents that they should seek the advice of an SLP as early as possible. Many parents also share that they have been encouraged by a teacher or a physician to contact an SLP as well.—Mark J. Witkind, Miami, Florida, USA

If you are concerned about your child's stuttering, contact an SLP who has experience working with those who stutter. Don't wait!  She can provide you with information, suggestions, and advice about next steps to take.—Ellen M. Kelly, Nashville, Tennessee, USA

Whenever they have concerns about their child’s communication, even if the pediatrician advises them to wait another year and see how things go.—Kathleen M. Chase, Centennial, Colorado, USA

The parents should seek out an SLP within 6 to 12 months of when they start to notice their child’s stutter.—Ponjit Jithavech, Bangkok, Thailand

A parent should seek out an SLP as soon as possible. The sooner you start working, the better.— Mara Luque, Buenos Aires , Argentina

3. When a child gets frustrated with his/her stuttering, what do you tell them?

 “It is hard when you can't get the words out, but you will get there, so keep trying and I will keep listening.—Elaine Kelman, London, England

"I can see that you struggle with your speech, but I'm glad you said it! I want to hear what you want to say. I don't care how you say it."—Katri Luhtalampi, Tampere, Finland

I tell the child that it is okay to feel frustrated. It is not their fault, and I can see how much they want to tell me something. I tell them that I will listen as long as it takes for them to tell me. I work hard to not interrupt the child, even if it takes a long time.—Melissa Petersen, Seattle, Washington, USA

I listen and tell children that it’s okay to feel frustrated, that sometimes they may feel that way; we all do from time to time about various things.—Kathleen M. Chase, Centennial, Colorado, USA

“It's hard when you want to share something and you just can't say it!  I want to hear what you have to say no matter what!”—Ellen M. Kelly, Nashville, Tennessee, USA

I wait until the child can calm himself down. Then I talk to him or her about the frustration and feelings about stuttering. Later, I help him or her to set goals to overcome their struggles.—Ponjit Jithavech, Bangkok, Thailand

“It’s OK to have bumpy speech and to find talking hard sometimes… You’re just learning to talk, and sometimes we make mistakes when we’re learning.”—Voon Pang, Auckland, New Zealand

I share with children that I am here to help them to understand their stuttering. I also encourage the child and his family to start a communication inventory journal.—Mark J. Witkind, Miami, Florida, USA

I let children know that learning a new skill does not come easy. You don't give up learning to walk because you fell at the first attempt. Keep on trying, and you will succeed. Then I draw their attention to a quality they have displayed or an important skill they possess.—Grace Ademola-Sokoya, Lagos, Nigeria

Get the child to talk about the frustration; try to find out what  he is really angry about. Try brainstorming with the child and problem solving on how we can manage the stuttering or manage the environment that may be causing the frustration.—Ursula Zsilavecz, Pretoria, Bauteng, South Africa

I tell children, “I would also be frustrated…it’s horrible not to be able to talk”. But you know something,it’s not your fault, and I’m going to teach you how to play with the words and enjoy pulling them out!—Marina Llobera O’Brien, Palma de Mallorca, Spain

 When children get frustrated with stuttering, the first thing I tell them is to focus on the task, the activity, and the message rather than the stuttering. DO NOT put energy into stuttering.— Mara Luque, Buenos Aires, Argentina

4. What advice would you give to an adult who has tried therapy previously and not found it helpful?

Therapy won't be the right fit for everyone. Do what works for you. Working on self-acceptance or self-help can be amazing for some people, and other people like having a therapist to support them through the process. If you do decide to try therapy again, it is okay to "try out" a few different therapists until you find someone that you click with.—Melissa Petersen, Seattle, Washington, USA

There are lots of new approaches available these days and you might want to give it another try. It's really important that you have a good relationship with your therapist, so shop around!—Elaine Kelman, London, England

There are different kinds of approaches, don't give up seeking help!—Katri Luhtalampi, Tampere, Finland

There are lots of reasons why therapy might not be helpful at a particular point in time. Sometimes the therapy and/or the therapist aren’t right. Sometimes the timing just doesn't work in a person's life. Each person who stutters is unique. Finding a therapist who has experience working with those who stutter and will help you discern your personal goals for communication and how to achieve them may give you the help you didn't experience before.—Ellen M. Kelly, Nashville, Tennessee, USA 

Need to understand that there are different approaches to therapy and SLP's also very different in their therapy style. We all need to understand that learning a new "speaking style" is like changing a lifestyle and takes time and hard work.—Ursula Zsilavecz, Pretoria, Bauteng, South Africa

First, I would ask for the person expectation of therapy and explore more about what were his/her experiences on previous therapy. I believe that getting a chance to be in therapy it helpful in some ways. Although, the person does not found that the previous therapy was helpful, I would ask him to evaluate the change that happens after he went to the therapy. I also would help the person set the realistic goal and support him to achieve the goals.—Ponjit Jithavech, Bangkok, Thailand

It’s never too late to build effective communication skills… Sometimes it is about making sure that the SLP you are working with is tailoring his/her therapy to suit you and that there’s a good fit between you and the SLP.—Voon Pang, Auckland, New Zealand

I advise adults to arrange a brief interview a potential SLP. This gives them an opportunity to discuss their potential concerns. They can then decide if they would like to make an appointment with the SLP. I also provide them with appropriate resources via email.—Mark J. Witkind, Miami, Florida, USA

Don't give up on trying something new. Stuttering therapy is hard work, cooperate with your therapist to work out new methods that will be helpful to you and build your confidence.—Grace Ademola-Sokoya, Lagos, Nigeria

I would ask them what their goal for therapy is, which would likely lead to my explaining that there isn’t a cure for stuttering, but that therapy can assist them in becoming a more open, confident, successful communicator who actually enjoys talking. I would ask them if they know any other PWS? I would be sure they know about good websites to get more information and connect them with the NSA in case they would be interested in meeting others who stutter.—Kathleen M. Chase, Centennial, Colorado, USA

We need to find out what’s the best for you. I’m here to listen, and then help you. Explain to me what you have been doing up until now and tell me what helps you.—Marina Llobera O’Brien, Palma de Mallorca, Spain

I’d say this is a new opportunity. Stuttering is a huge puzzle and as we move each piece, the other pieces will start moving.—Mara Luque, Buenos Aires, Argentina

5. Is there anything unique, special, different or powerful you say to clients that seems to resonate, connect or help effectively?

With kids, I use a picture of a road with different lanes. I tell them that their destination is saying what they want, and they get to choose which lane to take. Each lane represents a different "way" to talk - stuttering openly, using fluency shaping, using strategies - and all of the lanes are ok. We talk about the differences between the lanes - some are faster, some are more work - and the child who stutters is always in charge of deciding how to travel.—Melissa Petersen, Seattle, Washington, USA

Clients and parents both benefit from hearing that "It's not your fault!" Even if they know this, it bears repeating and reinforcing. Knowing that the things a PWS does to avoid stuttering are natural ways of coping until they have new, better ways, resonates with clients. They feel guilty, embarrassed or ashamed about their coping strategies, at times, and that's natural when that's "all they've got". When clients or parents understand that stuttering - and communication, for that matter, is complex, they better understand that the solution is complex - and takes time. This helps decrease some of the confusion, uncertainty, and impatience with self, stuttering, variability, and progress. Clients are often encouraged when the SLP asks "What's going well?" in addition to, or instead of, "What's not working?" Drawing from a client's successes helps them know they "can" and when they believe they "can," they will! —Ellen M. Kelly, Nashville, Tennessee, USA

Firstly I would like my client to know that he must feel free to tell me if he does not like or agree with what I want him to do. He needs to know that "Rome wasn't built in a day" and working on his speech is a bit like putting the pieces of a puzzle together. At first there are small patches of the picture but with perseverance we eventually have the greater picture. —Ursula Zsilavecz, Pretoria, Bauteng, South Africa

With adult clients, I spend more time to listen and guide them to see value in themselves and encourage them to face their fears, and things that they tend to avoid. —Ponjit Jithavech, Bangkok, Thailand

Children and adults who stutter can achieve their dreams just like anyone else, and being perfectly fluent is not a necessary ingredient in that happening. —Elaine Kelman, London, England

Stuttering is one small part of who you are. It doesn’t need to define you and there are many people who stutter who lead successful and happy lives. —Voon Pang, Auckland, New Zealand

This is so important. I always encourage clients to openly discuss their concerns and their issues. I further encourage clients to ask a family member, significant other, or a close friend to participate in their therapy program. —Mark J. Witkind, Miami, Florida, USA

Stuttering is not your fault—it’s nobody’s fault. You are not alone. What you have to say is worth saying and deserves to be heard. You have a right to speak out. People talk to communicate thoughts and feelings, not to show how fluent they are. That stuttering is what happens when we try not to stutter (I can’t remember who first said this last statement, but I’ve always thought it was great and it resonates with many of my clients who stutter). —Kathleen M. Chase, Centennial, Colorado, USA

One of my goals is for the person who stutters to be as fluent verbally as they are mentally, to be able to say what they want with their own words. —Mara Luque, Buenos Aires , Argentina

Posted Oct. 17, 2016