STR Practical Thoughts

Why don't we write goals about fluency? Round 2

Recently, I presented a podcourse for Speech Therapy PD where I boldly stated that SLPs need to be moving away from writing goals for percentages of fluent speech. This is not a new concept, nor am I the only professional saying this out loud! Following this comment, one SLP Facebook group had a lively discussion about my quote. STR's Scott Yaruss has already posted a blog (see below) on this subject: 

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What Do I Do When...???

What do I do when…
“His teacher doesn’t notice, and he doesn’t seem to be bothered?”

This is a question I received recently - and one those of us who specialize in the area of fluency disorders receive (in various versions) all the time.

Before I launch into trying to answer this inquiry, let me first unpack the question as it is presented. Truly, there are at least two layers

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Why don’t we write goals about fluency?

A recent facebook post raised the question about goal-writing for stuttering, and it prompted me to put some thoughts into a blog post. (Sorry to have been away for a while!)

I’m always glad when I see people discussing goals for children who stutter, because I think it’s one of the key areas where we as a field can improve our clinical practice. Too often, I see goals that are

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How do I screen a preschooler or young school-age child who stutters?

Question: I’ve been asked to screen a preschool/young school-age child who stutters. What test should I use?!?

Answer: Often, clinicians are asked to look at a young child who stutters to see if he is stuttering. Parents, teachers, and others may observe disruptions in a child’s speech and wonder what should be done.

For preschool and young school-age children (between the ages of about 2 and 6), the question of

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International Stuttering Awareness Day: Did I miss it?

NO!  You didn't "miss it!" Don't think of ISAD as a "day." Think of it as an opportunity to make a difference - no matter what the calendar says! 

In the stuttering community, we take the whole week (truthfully the month of October) to spread awareness about stuttering! [Then we will do the same thing in May.]

So, if you haven't had the chance to "plan something" to celebrate 2018

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Students who Stutter: How can teachers help?

Following a recent professional development for SLPs, I was asked, “What can teachers do to help students who stutter?”

The answer to this question can vary depending on the age of the child who stutters, but I would like to provide a few general thoughts that help teachers of students of any age.

In brief, teachers can help students who stutter by:

  • Providing a classroom atmosphere of acceptance of all
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Answering SUMMIT questions

Welcome SUMMIT participants! I want to thank you for all your entusiasm and desire to learn more about stuttering during the SLP Summit, August 2018. There was an overwhelming response to my preesntation-both during the live session and during the weeks of replay opportunities! 

School has begun, and I am back at my desk feverishly trying to answer emails, Q & A questions and other requests. So many of you

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What does "homework" for school-age stuttering therapy look like?

Many SLPs provide practice opportunities for children with articulation disorders. Some provide home activities for social and general language skills. However, most SLPs report that they do not create carryover activities for children who stutter-because they do not always know what to do and how to help children move their skills into real-life communication situations.

Because we believe that effective real-world communication is an overarching goal for stuttering therapy, we

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The Top 3 Myths About Stuttering

As professionals who work with people who stutter, we realize that stuttering is one of the most misunderstood communication disorders. For example, how many times have you heard the any of the following comments?

  • “I hear stuttering is caused by (insert outdated or misleading cause here).”
  • “Oh, you work with stuttering? I stutter sometimes too!”
  • “If he just slows down his talking, then he won’t stutter.”

Most people who do not

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Connect ALL of your clients who stutter with self-help/support groups!

Imagine a place where people who stutter can come together and share their experiences in coping with stuttering, celebrate their successes, gain support in facing their challenges, and simply not have to worry about whether other people will listen to them when they talk.

Now imagine an event where more than 800 people who stutter (including both adults and children), family members, and speech-language pathologists dedicated to stuttering can all work

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Is it “stutterer” or “child who stutters?” What about “CWS?”

Today’s blog entry is adapted from School-Age Stuttering Therapy: A Practical Guide (Reardon-Reeves & Yaruss, 2013, p. 9).

Many of us have wondered whether we should refer to our students as stutterers or as children who stutter.

Clinicians from many professions struggle with the appropriate use of “person-first” language to highlight the value of the person, rather than focus on the person’s problem. The issue can evoke strong emotions

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What should we say to the parent of a young child who has recently started to stutter?

I often receive calls or emails from parents who are concerned about stuttering in their young child’s speech. Sometimes, the child has just started stuttering; other times, the child has been stuttering for a while but the parents have reached the point where they are concerned enough to take action.

What should we tell them? We want to set their minds at ease wherever possible – there’s no reason for parents

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What if my child doesn't recover?

One of the more common questions that clinicians are asked by parents of young children who stutter is, “What will happen if my child doesn’t recover?”

It is clear from the research that the likelihood of a complete recovery from stuttering behavior diminishes significantly the longer a child stutters. Recovery from the behavior after approximately age 7 (ish, or so) is less likely. This does not mean it's impossible, but

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When a school-age child stutters and exhibits a speech sound disorder, do we treat the speech sounds or the stuttering first?

There's actually been quite a lot written about children who stuttering and also exhibit other communication disorders (especially speech sound disorders), because it's a fairly common occurrence for children to experience more than one disorder. It's not always clear in what order the different conditions should be addressed, though.

The basic answer is that it will depend upon the individual student. There is no blanket recommendation (stuttering first or articulation

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Is stuttering neurological?

One of the more common question I receive from clinicians and parents is simply this: “Is stuttering neurological?”

Answering this question directly and clearly is important, not only because it is valuable for people to have an accurate understanding of what stuttering is (and what it is not) but also because we want to address the underlying anxiety that the question may convey. When parents and others ask if stuttering is

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Why no "continuous phonation?"

As many of you know, we are continuing to post “how to” videos for teaching speech handling strategies to children and adolescents who stutter. These videos complement discussions of speech strategies in our clinical manual, School Age Stuttering Therapy: A Practical Guide. Recently, we posted our newest video (find our pausing/phrasing video here), and subsequently received a Facebook request from a SLP for a video highlighting the

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What if a school-age child is not aware of stuttering?

A clinician recently asked about a 5th grade student who stutters. She indicated that he does not seem to be very aware of when he stutters. He will sometimes say that he hasn’t stuttered in a long time, even though his observable stuttering is quite noticeable to listeners.

Awareness is one of the biggest challenges we face in stuttering therapy. One the one hand, we want the child to be

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Even more thoughts about secondary characteristics...

I posted previously about addressing secondary characteristics, but this is a common question for clinicians. So, I thought I'd write a bit more....

Secondary characteristics, or accessory behaviors, include eye blinks, looking away from the listener, tensing muscles in the articulators or elsewhere in the body, moving ones hands, etc. These behaviors can be uncomfortable for speakers, because they can draw more attention to the stuttering itself. Still, they are

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Child is stuttering? Try this one weird trick!

I’ve been spending a bit of time on the various Facebook groups for speech-language pathologists, lately. These groups can be a great resource for clinicians seeking input and advice from their colleagues about how to handle challenging situations, and I’ve enjoyed the conversations I’ve had there. That said, there is one thing about the Facebook exchanges that really bothers me, and I feel the need to rant a bit about it,

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Measuring adverse impact in a child whose stuttering seems to be "mild"

A recent blog post asked about how we can measure educational impact for a child who appears to stutter only mildly. This is one of my favorite questions, because it's one of the topics my research has addressed over the past 20 years.

Educational and social impact of stuttering can be directly measured through tools such as the Overall Assessment of the Speaker's Experience of Stuttering (OASES; Yaruss & Quesal,

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“I want to dismiss him, but the parents are worried!”

A recent Facebook post raised an important question: what if you think a school-age child who stutters is doing well and is ready to be done with therapy, but the parents still want him to stay? What about the child who has learned how to use strategies, feels good about himself, and communicates freely? Can you justify dismissal if the child is still stuttering? What if the parents want you

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What percentage of stuttering behavior is normal?

A recent Facebook post asked what percent of disfluency was considered to be in the normal range.

Like so many questions surrounding stuttering, the answer turns out to be somewhat complicated! Historically, people have used various set values, such as 3% syllables stuttered or a 10% overall disfluency rate to indicate that a person’s speech fluency was above or below normal limits.

While these metrics may have their place, I want

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How young is too young for treatment?

I recently read of a mother who is seeing stuttering with signs of frustration in her 2 year old daughter. She was wondering if it’s too early to seek treatment…

It is true that some children can start stuttering a very young age, but it is also true that most young children who start to stutter ultimately recover and go on to develop typically fluent speech. Determining the right time

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Generalization is a challenge!

I am often asked about how to help children generalize their speaking strategies from the therapy room into real-world situations. Clinicians typically report that kids are good at using strategies in structured tasks like reading when they have a lot of clinician support but need reminders when using techniques in conversational speech.

Generalization in stuttering therapy is one of the most common challenges that speech-language pathologists (and their young clients)

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Timed Oral Reading Tests for Children Who Stutter?

I recently read about a child who stutters who was placed in an oral reading remediation in which the test was timing him on reading every day and marking how far he got in a passage during a minute. I thought I’d offer some thoughts…

It's really not ideal for a child who stutters to be forced to read under timed conditions like this, especially when he is being judged

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Addressing Secondary Characteristics in Children Who Stutter

A recent post on a facebook discussion group asked a great question: how do we reduce or eliminate secondary characteristics for children who stutter?

Addressing secondary characteristics is a common desire for speech-language pathologists, teachers, and family members alike, but I’d like to offer a different way of looking at how we might achieve this goal.  Specifically, it's not actually necessary in most cases to address secondary characteristics in their

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Support Resources for People Who Stutter, Their Families, and Their SLPs

I’ve received a few inquiries lately asking about support organizations for people who stutter. We are fortunate to have some great resources for helping to connect people who stutter to one another. This not only helps speakers; it also helps parents and others to understand the true nature of stuttering so they can see that people who stutter can do anything they want in their lives.

In particular, check out

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When do we recommend therapy for teens?

A recent post to the discussion list for the ASHA Special Interest Group for Fluency Disorders described a teenager who stutters. The question surrounded whether it was the right time for the teen to enter therapy. This sparked some thoughts, because I think this is a really important topic—one that many of us struggle with for school-age kids and adolescents who stutter. When is the right time for therapy?!?


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Not-so-famous people who stutter

Sorry to have been away...If you get the chance to get the flu or cold that's going around this year, I don't recommend it. A major thumbs-down review of this year's bug!

In any case, today's thought... People often talk about "famous people who stutter" and how it might be helpful for kids and others who stutter to recognize that people who stutter can be successful and famous. All of

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Increasing our confidence as stuttering therapists

A colleague mentioned that she wasn’t feeling confident about working with a new child who stutters on her caseload. This prompted me to think a bit… Actually, I spend quite a lot of time thinking and writing about the confidence challenges that speech-language pathologists face when working with children who stutter. I have long wondered about how we can help to increase clinicians' sense of self-confidence and self-efficacy surrounding stuttering,

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The Most Important Resolution

Yesterday, I was thinking about how exploring New Year's resolutions with our clients can give them the opportunity to talk about their goals--and that understanding their goals can help us to guide them toward greater success, both in and out of therapy.

Today, I am thinking a bit more about what we can do when we find that our clients are struggling. First, it's important to recognize that struggling during

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New Year's Resolutions

As we ring in the new year, many of us like to take a few moments to reflect on where we've been and plan for where we'd like to go in the year ahead. Setting New Year's resolutions may seem like a cliché, but it's always a good idea to take stock of progress and to make sure that we are headed in the right direction in therapy.

So, this week,

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How long do we wait?

Happy 2018!

I’m just sitting here watching some more snow fall while I archive my emails from 2017. The biggest folder in my mailbox is the one where I keep all of the questions that I receive from clinicians and families about stuttering. I am often struck by just how much uncertainty there is about stuttering, and I am pleased when I can offer some words of comfort or guidance

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Stuttering on the holidays

Sitting here on a lovely, snowy, Christmas morning in Michigan thinking about all of the excitement that goes with the holidays...

As wonderful as this is, it can sometimes cause some stress for parents, who may worry when they see their children stuttering more when they get worked up. We can help parents through this time by reminding them that this is normal and expected--and that their child's joy during

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Talk about stuttering with preschoolers?

A speech-language pathologist asked, "Is it appropriate to talk about stuttering with preschool children?"

This is actually one of the most common questions we are asked. For years, speech-language pathologists were hesitant to talk about stuttering with young children--even going so far as to avoid the word "stuttering" altogether! Much of the fear that clinicians have about discussing stuttering with children stems from an old theory (the so-called "diagnosogenic

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New! STR Practical Thoughts

To start 2018, Stuttering Therapy Resources is offering a new website feature: Practical Thoughts! These brief blog and video entries will include tidbits, musings, ideas, and advice about helping people who stutter.

We'll still publish our long-form Practical Tips and Practical Videos (look under Resources on our website), as well as our tweets and facebook content. Practical Thoughts are just one more way we seek to help speech-language pathologists help

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