Helping Children Develop Healthy Attitudes Toward Stuttering

Develop Healthy Attitudes Toward Stuttering A partnership between Children's Hospital of Pittsburgh and the Department of Communication Science and Disorders at the University of Pittsburgh S C W tuttering enter of J. Scott Yaruss, Ph.D. Stuttering Center of Western Pennsylvania University of Pittsburgh 1 estern P ennsylvania Wait a minute!!! What do you mean by, “Healthy Attitudes Toward Stuttering” 2 Attitude Matters  Stuttering can have a profound impact on children’s ability to succeed in life » But…it doesn’t have to be this way!  As NSP parents, you know that the most successful adult speakers are those who have been able to accept their stuttering 3 It is not stuttering that holds people back... It is how people react to their stuttering 4 How should we expect children to react to stuttering? 5 Feelings about Stuttering  It is normal for children to have emotions and feelings about their stuttering » It is also normal for you to have emotions about feelings about your child‟s stuttering  Children don‟t always understand their feelings…you can help! 6 The Traditional Role of Parents  In speech therapy, parents typically receive lots of advice about how to help children speak more fluently » “Slow down your own speech” » “Pause before speaking” » “Shorten and simply your sentences” » “Don‟t interrupt the child” 7 Helping children speak more fluently is good... …but it‟s not enough!!! 8 So…what else can parents do? 9 Parents Can Also Help Children...  Understand what they are doing when they stutter and how to change it Learn how to react to stuttering and how to deal with other people‟s reactions Interpret what it means to have a speech disorder and (for older   10 Parents Can…WHAT?!?  Many parents have their own issues and concerns about stuttering, making it difficult to react supportively parents are consistently told not to react to their children‟s stuttering… » “Do nothing at any time, by word or deed or posture or facial expression, that would 11  Plus, The Parent‟s Dilemma  Watching hard! children stutter is » It is nearly impossible to watch our children struggle with any difficulty without trying to do something--anything--to help them  So...the advice to “just ignore it” is in direct conflict with our 12 Is It Really Okay to Talk about Stuttering?  In a word…YES! » “There are no published reports of a relationship between discussing...stuttering and sustained increases in the frequency or severity of stuttering” » --Zebrowski & Schum (1993) » Children who stutter do not respond adversely when parents provide feedback 13 Keeping Talking in Perspective  Talking  It is just another motor skill young children need to develop is perfectly normal for young children to make mistakes when learning to talk » Children make mistakes when learning every other motor behavior and we accept it without concern 14 Why Talk about Stuttering? I felt isolated and frustrated…lik e stuttering was something to be ashamed of This problem is so awful that my parents can't bear to talk... about it. Some quotes from adults who stutter --Rustin & Cook (1995) 15 Why Talk about Stuttering?  Break  Help  Help (Starkweather & Givens-Ackerman, 1997) the “Conspiracy of Silence” children understand stuttering children feel more comfortable about their speaking abilities  Help children learn how to react to stuttering 16 Okay, So… What Should We Say? (It depends…) 17 Child Factors Determining When and How to Talk to Young Children about Stuttering  Child‟s awareness of stuttering Child‟s concern about stuttering 18  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 19 Some Signs of Awareness  Mild  Mild  Mild word substitution tension or struggle frustration during or after stuttering different ways to speak fluently such as “why can‟t I 20  Trying  Questions Guidelines for Talking with Children Who Are  Don‟t over-react…it‟s normal for children to be curious about their developing skills » Children learn how concerned to be from Aware you  Respond to questions in a matterof-fact way 21 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 22 Goals for Talking with Children Who Are  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 Concerned   23 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 24 Think about it this way… If your child were to continue stuttering… How would you like him to respond? 25 Stuttering can be very stubborn... …not every child will be able to overcome it If we continue to emphasize only fluency, we may end up contributing to the development of guilt and shame that affect many 26 General Guidelines for Achieving these Goals  Model… stuttering  Listen… …appropriate responses to …to children‟s concerns about talking 27  Talk… Modeling a Calm Response to Stuttering  Modeling a calm response to stuttering will help the child learn to do the same  To be aware of your own reactions to stuttering » Affective: How do you feel about stuttering? do this successfully, you need to 28 Modeling Different Ways 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 29 Modeling Effective Responses 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 30 Modeling Effective Responses To Adversity  Explanatory style Temporary Specific  Examples » “Sometimes learning takes a little while.” » “That word was kind of bumpy” (or tense) » “You sure have a lot of good Permanent Pervasive (Peterson, Buchanan, & Seligman, 1995) 31 Listening to Children  Content versus manner: Listen to what children say rather than how they say it 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  Affirm 32 Talking about Stuttering  Respond  Label to children‟s questions speech-related behaviors and feelings children and encourage concerned the child‟s experiences 33  Reassure  Reframe 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 34 Examples of Other Responses Type Labeling Informing Assuring Reframing Description Examples Factual statements about That word sounded bumpy. child’s behavior Explanations of child’s feelings Parent reassures child about acceptance Sometimes we feel frustrated when things are hard to do. It’s okay with Mom if you repeat words. Parent helps child see This is a good chance to behavior in positive light learn … 35 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 the 36 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?   37 Questions for Discussion  How does your child feel about stuttering? situations have you faced with your child‟s reactions to stuttering? roadblocks do you see to using these suggestions in your life?  What  What 38 Questions? Comments? Please contact me!  J. Scott Yaruss, Ph.D., CCC-SLP Assistant Professor, University of Pittsburgh Co-Director, Stuttering Center of Western Participation PA Communication Fluency  Address: 4033 Forbes Tower Treatment Pittsburgh, PA 15260 Education Research Support  Phone: Fax: (412) 647-1367 (412) 647-1370 Stuttering Pennsylvania Center of Western 39