School-Based Speech Therapy: Treating ‘Me’

Perspective Disclaimer

I am not a speech-language pathologist, nor do I play one on the internet. There are many fantastic SLPs already doing wonderful work. This three-part series has already analyzed my journey through school-based speech therapy and unveiled a soul-cleansing repentance to the SLPs of my past. In this article, you will find that I will lean forward into being prescriptive—and sometimes jump all the way in—on recommendations that may be applicable beyond what I know would have been better for me. And, with even more emphasis this time, these reflections come from many years of making sense of my experiences, and are by no means a replacement for rigorous academic study, professional experience, or on-the-job training. The walk-in-my-shoes perspective aims to inform and complement actual speech therapy and other complementary healing practices. 

Treating Me

It is unhealthy to analyze your own stuttering journey, alone, similarly to how unhealthy it was to navigate it, alone. My memories are vivid. I’m still working through some that have lasted, imprinted during my childhood. The work that follows flows from this deeply felt experience. Please know that I didn’t know how much writing out the many truths of my journey would change my relationship with stuttering as much as it has thus far. However, this is only the case because I chose to face down what I couldn’t as a child. 

“Understanding is the antidote to shame,” claims Dr. Paul Conti, a leading behavioral psychiatrist who specializes in trauma. I heard him say these words last month, and if I hadn’t been driving, they would have stopped me dead in my tracks. This truth was ultimately why I began the analysis of my journey nearly 10 years go. Why did I have to travel such a perilous course through speech therapy to get to such a deep understanding of how to live in cooperative terms with my stutter? Shame, storm-cloud heavy shame, accumulating endlessly over the years, delayed my entrance into life, until I acknowledged its presence at 27 years old. 

Since then, I have sought to answer the “why me?” once and for all. Why did I have to go through all that I did if all it took was more life experience instead of fluency to cultivate lasting self-acceptance? What had actually worked, for me? While laying that out here would be nice, I have done that in my upcoming book and that is not the aim of this reflective exercise.

Instead, in this article, I will set up the scaffolding for a holistic approach to treating my stuttering through my school-age years. If you have not read A History yet, it unveils my school-based speech therapy journey. Here, I will answer the following three questions:

• What would have worked for me in school-based speech therapy? 
• Why these specific measures would have worked? 
• What was never going to work?

First, it goes without saying that the pursuit of fluency was never going to work for me, and that is all I’ll say about that.

Second, me is me but much of what follows could be applicable to a large percentage of the stuttering population. 

Descending Profile

Before I begin unveiling a holistic approach, it is important to baseline my cognitive and behavioral profile as I grew into my stutter and descended into affliction. The following is a profile of myself assessed by myself using anecdotes and examples from my journey.  There are three snapshots, to include grade school, middle school, and high school, that outline my mental health and chronologically lived experience of stuttering. When viewed on a continuum, they offer the baseline that underpins the recommendations. 

• Grade School: I was an outgoing, happy child who grew up with wonderful parents and an older brother. We were free-range kids, and I always had friends, went to sleepovers, and birthday parties. However, at six years old, stuttering made me start to isolate myself. I had wild mood swings, hyperventilation fits, and preferred to be alone. The descent into stuttering is blurry, though I can still feel the dis-ease of my moments of stuttering and time in speech therapy. As I progressed in school, there was less and less of a distinction between my outer and inner life. An observer could guess how I felt inside. 

• Middle School: By my pre- and early teens, I was forced to mature more quickly than my peers because of my experience at the Starbuck clinic and the need to become my own advocate in school. I did fall in with a good group of friends and played sports all year long, though I still struggled with loneliness and self-isolation. I increasingly suffered from undulating mood swings, which at times caused a supercharged hypervigilance and an energized exhaustion that kept me from sleeping. This was also when my anger started, causing me to snap at my SLPs when I’d begin to block on every word. 

Mind-Body Synergy: A Turning Point

The defining example of my psycho-social state came in middle school while playing baseball, not while stuttering. Baseball had been my escape from stuttering since I was five years old. I was called up to play for the high school team because of my success as a pitcher. In my third game, I lost the ability to throw the ball over home plate, walking four batters and blowing the lead. My inner turmoil from stuttering had consumed my only happy place and manifested in a case of the yips, a sudden unexplained loss of coordination in athletes caused by anxiety or some other psychological condition. I was finally paying for my failures to fix my stuttering. This occurred only months before my confrontation with it.  

• High School: S*icidal ideation suffices to explain my state of affairs as I began what were supposed to be some of the best years of my life. I was a ‘cool’ kid and part of the in-crowd, but no one knew how lonely my days felt. There were many social opportunities that I turned down, choosing to self-isolate and be alone. I opted for the library during study halls and lunch, and went straight home after practices or big games. I wrestled with a conflicting desire to be social and alone, an existence that was more difficult to handle than the physical act of stuttering. Between 15 and 18 years old, I was stuck in a state of inescapable wonder of when and how it would all end. 

It never seems possible that I—who I have become since—arose out of that. I cannot deny that there were many happy and fun times during my childhood, but the fault of affliction only allows its victims to store away the trauma. Even so, those who grew up alongside me will never fully understand what was happening within me. 

Please carry that reality, and the preceding behavioral snapshots, forward into the holistic approach because one could not fully grasp all of the options needed to alleviate some of my struggle without it. 

The Approach

I know more than anything in this world that there is not one approach that works for every person who stutters. And, whatworks for one may not work for another. However, at the same time, it is also true that we who stutter have more options to choose from to help overcome—yes, overcome—the afflicted state of stuttering than at any other point in the history of attempting to alleviate our struggle and to soften our stuttering. 

This fundamental understanding, then, is that they were also available when I was a child because the options aren’t new or unique to the present. It is from this hilltop that we begin to recreate a holistic approach for my school-based speech therapy experience. A ‘holistic approach’ accounts for the variability and complexity of what works in different circumstances, and considers the different phases of my stuttering journey while I was in school. Some options are age dependent and several may have been best used in conjunction with one or more of the others, which I will note. 

The primary assumption—I am not a speech-language pathologist. This means that I have intentionally left the stuttering modification efforts to the professionals, emphasizing that modifying my pattern rather than shaping it towards fluency would have been the most applicable pursuit.  

Lastly, as a self-taught student of speech-language pathology, psychology, sociology, philosophy, learning and mastery, leadership, decision-making, marketing, communication, and the human condition, I make the following recommendations presuming that others can learn more about their meaning and implement them in their own lives and therapy practice through a similar journey of continuous education.

The Buffet

The toolbox is stigmatizing in and of itself, offering an additional impediment that we who stutter must confront while we try to make change. Instead, the buffet—or any similar analogy where one has options and the choices—is more applicable to what must occur in school-based speech therapy for kids who stutter. One combination of foods is appetizing one day but not another. And, if we eat the same tool every day and we don’t enjoy it, then odds are we’ll stop eating before too long and, eventually, stop eating it altogether. 

The point is tools will be tools, applied differently depending on the situation and my maturity level. Stigma or not, use of the stuttering modification tools have to be learned with all of the other options on the buffet. Tools going forward, then, refers to speech and non-speech tools.  

Further, I accounted for the biases of memory that could have skewed this backward-looking analysis. I have spent years identifying the faults in my story and have worked hard to challenge the inconvenient truths. While memories are stories that we tell ourselves about our experiences over time, my story is filled with visceral snapshots of how I thought and felt during the different stages of my journey through stuttering. 

This is the case because I could only talk to myself about them, replaying, reinforcing, and re-experiencing each one over and over in my head, some of which retain the same or similar trauma as I felt when I first experienced them 10, 20, and 30 years later. A memory fueled by stuttering can be a powerful impediment if left to its own devices. However, when properly inventoried, understanding can fuel healing, and through healing I found freedom. It was worth the pain and effort.

Nonetheless, I recognize that some of the following tools are already in use in school-based speech therapy around the world. For the purposes of this exercise, though, let’s rethink their application with the through-life perspective that I previewed with the descending profile. This allows you to observe how what I began doing early in school set the foundation for each successive year. 

Before we begin, here are three truths, then a lie. I was a difficult child. I was not a willing participant. I didn’t know when, how, or where to begin [to use the tools]. I didn’t want help.

The Right Tools

It is now time to take a new inventory and retain the right tools for beginning my pursuit of change as a child into adolescence. 

How to use the following tools: read each summary, conduct your own research on it, and find others who already using or have implemented them. This is about me and my journey, but anyone who stutters can find themselves in mine. (And, I will write full, in-depth articles on each of the tools in the future, so stay tuned for those!) 

Also, keep in mind the perspective disclaimer for this article. I repeat I am not an SLP or a psychologist, I do not play either on the internet, and many are already practicing the tools that follow, though I offer them as a case study to show how they can be applied to a severe stuttering case. 

                        

[1] The Tools: They always had a mysterious aura. How were the fluency shaping tools meant to work? How would they become natural? What was their intended long-term use? To modify my stuttering pattern towards efficient communication, with frequent and repetitive use, and to soften my stutter, never fluency. I never learned these truths, only how to perform the tools. I became a subject matter expert in the tools by 10 or 11 years old, in the therapy rooms. In time, I would teach all of my SLPs the tools and model their complexities. 

• Start: Make clear what I’m working towards, easing and not eliminating all struggle. Show me or provide examples of safe places in school to start practicing them in real life. Give me homework with some kind of incentive for doing it (even make it a competition). Provide perspective on how much I would have to face to make some progress; find someone who would push me along faster. Encourage and empower me to try, with a stern pressure until I do it, without giving into my insubordinate anger. 

• Stop: Asking if I used them—let me show you with you. (More about this as you read.) 

Understand: All I heard was that I’d stutter forever if I didn’t use the tools. My SLPs were afraid to push me. I understand that I wasn’t a willing participant, and willingness is vital to success in therapy. But, I needed constructive urgency to help me build some momentum, any at all, and to unseat my defiance. In every other aspect of my life, I followed the rules, listened to my elders, had manners, and did what I was told. Therapy was different. It is clear now that, at every age, I needed to be pushed. Every SLP I saw was unwilling to break rank, grab me by the heart-strings, and show me a way out. 

[2] Fear Setting: This was the missing link that I found when I chose therapy as an adult. I have to wonder, why not as a child? The practice helps identify and rank the social situations that we fear, from lowest to highest, and gradually, repeatedly, and frequently you start doing those you fear the least until you have climbed the hierarchy.

• Start: Facing fear in real situations. If I worked on these fears in speech each year, I could have ever so slowly chipped away at my social anxiety. Leverage my defiant and competitive nature from playing sports was the foothold to build upon. Incremental challenges to confront my fears would have resonated with my I’ll show them mentality.

• Stop: Watching me flail and flounder in a maximum controlled setting. Normal fluent children learn social communication skills in public. Let me fail in public from trying.

Remember: Struggle persists because of social anxiety, not stuttered speech. Fear fuels anxiety, anxiety fuels struggle. I was not mature enough to understand this dynamic as a child, but I sure would tell you what I hated doing. Listen for those times when I don’t want to do something because that is exactly what I needed to be doing.   

[3] Home Base: Create a home base for me at school from which to launch into my fears, retreat from, and recover in safety. It is a private, physical, and safe place—to just be when I didn’t want to be seen, to process my emotions and feelings, and to be reassured that it will get easier. This can be the speech room or anywhere else than where I faced my fears. 

• Start: Using home base to discuss a plan of attack, physically leave from it to do the planned assignment together, and then immediately return together upon completion to recover in private. After this becomes a routine, begin to elicit and document feedback in whatever form I’m offering—body language or verbal—and the adjust accordingly, increase or decrease fear and frequency. 

• Stop: Assuming that the speech room is already a home base. Yes, it was safer than everywhere else, but never one I felt comfortable enough to use in my favor (see where it ranked on my fear hierarchy).

Understand: Real life is the speech room. To make this a reality, I needed to start from somewhere, a position of strength, not fear. Privacy allows the traumatic energy to release naturally without inhibiting it. Launching was the hardest part to overcome. I never did. Returning to normal after a moment of stuttering was even harder, which I never did by choice. And, recovery always took place in public—on the school bus, in busy hallways, the lunch room, or my next class. 

[4] Language of Immensity: I never learned how to describe what it felt like to stutter. Only one person ever asked me that in a way that I knew how to answer, with a look of desperation, and, in response, their look conveyed, “I understand how you are feeling?” To counter what becomes a default to numb the painful aspects of the stuttering experience, I needed to be taught how to articulate what I was trying to hide.

• Start: Identifying and discussing different feelings and emotions, as early and often as possible. Read my cues. It wouldn’t have been hard to determine whether or not I was in the mood to learn.

• Stop: Asking me how I feel without using specificity. For example, “what was going on inside you before, during, and after you [didn’t raised your hand in class, ordered what you didn’t want for lunch, or asked your teacher to opt out of the presentation]?” Start from where the immensity begins.

Understand: It took 10 years as an adult to finally put into words what I felt. It wouldn’t have been possible to do as a child without the guidance of someone who stutters, who knows the full experience. Nurturing spoken emotional agility early in a child’s development is an important step to ensuring their future mental health. Immensity was a word used also by Dr. Paul Conti, but call it whatever captures the totality of the felt experience. 

[5] Become an Ally: An ally is someone who willingly bears any part of the burden and stigma we who stutter face alongside of us while we are actively working to confront our fears. An ally is not someone who solely works to combat discrimination—that is an advocate. 

• Start: Accompanying me while I launch into, retreat, and recover from facing my fears. Walk in my shoes, feel what I feel, and show up again next time. 

• Stop: Thinking that advocacy is being an ally—it is but it isn’t. And, please end the proactive sensitization of my teachers about stuttering and my needs when I’m not alongside of you to communicate our plan of attack. Otherwise, you are an enabler who makes it easier to opt out of life, rather than an ally, opting into it. A bit blunt, but only because this very dynamic was what kept me from gaining any momentum towards change.  

Understand: Serving as an ally is a deeply personal relationship, one that takes time to establish. Anyone can advocate on behalf of stuttering in general and not really learn anything about the lived or through-life experience. The former is shared, felt, and lasting, the latter is impersonal, a dopamine boost, and fleeting, though sometimes frequent. Get in the trenches with me and watch how fast I change with you. (The methods and options for becoming an ally are endless, and warrant a detailed analysis on how to implement them with unwilling participants like I was as a child.)

Recruit Allies: My Support Network

In school, an ally is not only reserved for SLPs. Teachers, classmates, friends, or coaches are available to recruit and can serve as trusted supporters. While I could have certainly identified people who might be willing to accompany me into different school-based situations, I would have needed my SLPs to broker the alliances and coordinate them through to execution. For example, after some repeated exposures to a feared situation, imagine that I choose to keep doing it but do so with one or more of my classmates there for support and have my SLP observing should they have to run constructive interference if I receive negative feedback. As I did this several more times, the thoughts of “just maybe I could try it on my own” make it more possible than ever before.

[6] Social Fluency: The actual fluency I needed to chase—social skills to counter my debilitating social anxiety. Building self-confidence through learning communication and interpersonal skills is the antidote to this anxiety that perpetuates the struggle of stuttering. 

• Start: Creating opportunities for me to learn the social skills that stuttering denied in early childhood and let me slowly figure them out. Eye contact, spontaneous and routine greetings, expressions of gratitude, verbal and non-verbal cues, small talk, the give and take of conversations, entering and exiting group discussions—all without prioritizing fluent communication.

• Stop: Viewing speech work in the speech room as having my best future interests in mind. 

Understand: Young kids have the opportunity to naturally develop social skills, whereas we who stutter learn to fear these same opportunities and avoid them altogether, thereby stunting our social growth. I became socially fluent at 30 years old, 30! Social development is ingrained during pre-teen years and early adolescence, or the school age years. Knowing this alone should unseat a strict focus on solely stuttering modification to where the two align to work together towards change.

[7] Habit Building: How to build, change, and reinforce new, healthier habits is the most important skill to learn for any therapeutic endeavor, regardless of the age. To do so is to trust the process of learning, and then apply it to all aspects of life rather than only speech work. 

• Start: Identifying what the process is, what habits to develop, and a plan to implement change. Once the process is understood, transition from healthy, easy to form habits, such as reading one page a day or drinking five glasses of water, to more challenging efforts that are closely associated with stuttering, to include doing one target speech assignment per day in school. Seek to keep a streak of daily habits going.

• Stop: Trying to cultivate new healthier habits through speech work. Start smaller and elsewhere before working up to my fears and the tools.

Understand: The process. The first step is the hardest, but soon it becomes two, then three, and before you know it you’re at step 36 and it feels like change happened all at once. I don’t know how my SLPs would have fared in attempting to teach me healthy habit building skills, but I do know the desire was there at every age. I learned the value of this by training for endurance sports paired with avoidance reduction therapy for stuttering as an adult, and have since applied to the process to creating many other habits. For more information on the power of habit development, I prefer the books Tiny Habits by Stanford psychologist BJ Fogg and Atomic Habits by best-selling author James Clear.

[8] Walking Therapy Sessions: Speech and the speech room became added triggers to my already supercharged state from navigating the stuttering minefield all day. “Why don’t you go take a walk?” There is a reason people say this to us when we’re stressed or upset. Why not try it with a kid who is struggling with extreme tension in mind and body?

• Start: Sessions with a walk to somewhere safe outside of the routine triggering environments in school. Assess based on each walk and adjust over time, whether part of or the whole session is spent in active movement. 

• Stop: Starting therapy sessions from a supercharged state. 

Understand: Physical movement focuses you on your surroundings, disengages you from your thoughts, and can reset your energy. As an active and athletic student, I’m convinced this would have disrupted the cycle of frustration from session to session. 

[9] Control/Agency: The emotional turbulence of stuttering stems from what little, if any, control we who stutter have over what we do in our daily lives. The opposite of the chaos felt is agency, the sense that I am the one influences my actions. 

• Start: Introducing agency building exercises that slowly transfer some control over to me for what is done in speech and how stuttering is addressed in school writ large. Small and infrequent wins over 12 years of school would have been life changing.

• Stop: Making decisions on my behalf without my consent, within reason and less and less as I come of age. 

Understand: The control I exerted manifested in anger and self-isolation because, while maladaptive, it protected me from further struggle and was what I chose to do beginning at five years old. It would have been a delicate balance given my degree of frustration. However, the slightest bit of agency at every step in school could have gradually changed my perspective from hopeless to hopeful. 

[10] Self-Confidence Building: Stuttering therapy is really about building self-confidence (which is different than control or agency). However, self-confidence is not solely a result of therapy or eventual success with it. Self-confidence in children grows out of anythingthey enjoy doing, have some success with, and choose to keep doing, even in failure.

• Start: Blending speech work with activities I enjoy doing. This was attempted by having me read sentences from Sports Illustratedmagazines. Instead, try walking therapy sessions, anything active and outside of the speech room which would have helped build some momentum and offset my insubordinate attitude. 

• Stop: Attempting to build self-confidence through speech work alone.  

Understand: Self-confidence accumulated outside of speech has more of an impact than what is done in speech. I generated just enough of it from playing sports. The intense, fun, and competitive alternative propped me up through some difficult years and provided a distraction from my struggle to speak. In fact, many years later, this process of pairing activities I desired to do while moving through avoidance reduction therapy was how I finally climbed out of the traumatic state of stuttering. Each child will have their own interests, as I did, but the process applies to all who stutter.

[11] Self-Disclosure (also known as Advertising): Intention matters. Why are we disclosing our stuttering to others? If it’s to opt out of public stuttering, to apologize for when we stutter, or to help hide it, then it will only further your struggle. If it’s to give yourself permission to stutter, to opt in to difficult situations that you have avoided in the past, or to alleviate your thoughts of what others are thinking while you stutter, then it will only make it easier to openly stutter. The former is for others, the latter is for you, keep the focus on you. 

• Start: Modeling the following disclosure with me alongside of you until I am ready to do it on my own. “I am a person who stutters…” or “I stutter…” in conjunction with “…I know what I want to say, when and how I want to say it, but it may just take a little longer. Thank you.”

• Stop: Disclosing on my behalf without me there, period. 

Understand: Disclosing to opt out of stuttering in public was one of the most trauma-inducing acts I had to do as a child. I can still feel the many moments when I did as if they just happened, even while fully blacking out during most of them until I was safely out of the classrooms. Arming me with examples of how to disclose for my benefit and then modeling them until I was ready to take the reins would have provided an alternative to further potentiating my struggle and could have begun my effort to work on facing my greatest fears. (Continued in Opting In and pairs well with Become an Ally.)

[12] Opting In: The intent of disclosing that you stutter is to opt into instead of out of your life. Giving yourself permission to try, or even just attempt, to do that which is avoided because of stuttering is progress. The afflicted state of stuttering is the absence of trying and the preference for comfort.

• Start: Forcing me into my discomfort zone. Using fear setting, climb the hierarchy together, SLP and child who stutters. Identify a safefear to tackle first, and build from there. 

• Stop: Accepting that I truly want to opt out. In reality, it was the opposite. Conflicting desires yield to what is known, comfortable, and easy. 

Understand: My problem was that I didn’t even try. The only option was no, and my default disclosure was to opt out. I would have benefitted from being forced out of my comfort zone and shown how to do so. Before you say, “Well, that’s all well and good that you’re recommending this nearly 20 years later, but I don’t believe you would have taken to that direct of an approach.” Maybe not. But, I never even tried until I was in college and no one ever really pushed me.

[13] Stuttering 101: What is stuttering, and why and how do I stutter? These questions must be thoroughly addressed before all attempts to modify stuttering. Stuttering needed to be explained as a complex interplay of psycho-social reactions, such as anxiety, trauma, and shame, and identity, rather than merely as a disorder of speech. Simply, age appropriate emotional and social agility skills should be learned before stuttering modification tools, not simultaneously. 

• Start: Stocking my toolbox with entry-level emotional and social intelligence building activities, such as the language of immensitytraining. Direct questions, creative arts and crafts projects, or videos of other people stuttering would have been a few options to help me put words to my experience. 

• Stop: Thinking that because I stutter I must know what stuttering is and why and how I do it. I numbed all efforts to learn that from the start.

Understand: Stuttering is not a disorder of speech. Stuttering is not a disorder of speech. Stuttering is not a disorder of speech. 

[14] Creative Expression: I needed a place to start. If verbal communication was difficult and caused me to get frustrated, why not try another means. I have been writing in some form or another since I was in fourth grade because of what stuttering didn’t allow me to say. 

• Start: Observing the child’s creative leanings and driving them towards an outlet that enables them to express what they cannot say at first. Try multiple options like drawing, arts and crafts, music, journaling, dancing, sports, or any form of self-expression. 

• Stop: Relying only on speech work to counter my frustrated existence. 

Understand: Discover the child’s early passions and run with them. My creative expression came in the form of writing love letters to girls and running my own fantasy sports leagues where I managed all of the teams, along with playing real life sports. I had a knack for writing what I felt, being honest, and memorizing all of the baseball, basketball, and football players’ names. It was a unique combination from which my love for writing grew. More importantly, however, writing helped me find the right words to accelerate self-acceptance and to achieve a fulfilling life with stuttering. 

[15] Become Your Own Therapist: A question and a vital choice are the keys. Laying a foundation from which to build on each year in therapy requires that you start, so the question pertains to how to get in touch with the felt emotions and feelings, and the vital choice is learning how to take care of my mental health. Getting in touch with the day-to-day vicissitudes of stuttering could have saved me at any age, but I know learning how to manage my self-care in early childhood was impossible. This is another one of the tools that I achieved as an adult and was a goal my SLP began to explain from my very first session. 

• Start: Asking “how are you feeling today?” This question forces me to at least engage some of my inner life instead of continuing to numb it. Then teach me how to turn off and embrace when I am having a hard day, forming new constructive behavioral responses. 

• Stop: Failing to address the underlying side effects of stuttering that derail productive and lasting learning. I needed a fighting chance to keep starting when all I experienced was failure.

Understand: Adolescence requires a stronger emphasis on processing emotions and feelings than stuttering modification, particularly since the window for spontaneous recovery slams shut in the pre-teen years. Practicing self-care activities such as napping, reading, rest days, exercise, walking, and scheduled breaks could have disrupted my supercharged mind and body. The key here—doing all of the above during speech, when necessary. It would not have been easy, but the effort to do so could have exposed me to the options available until I found an outlet outside of school to begin cultivating a mindful existence. 

[16] Parents: My parents wanted the best for me. They were engaged in my life in every possible way and gave me the support I needed until I could stand on my own. However, I’ll admit—their endless pursuit of fluency came at my expense, even if that was the popular system-wide pursuit. What would I have wanted them to do? If it is not clear yet, it should be obvious. 

• Start: Pursuing professional psycho-social help to calm my inner struggle. Stuttering modification therapy can come later but my hidden reality nearly claimed my life at 15 years old. The urgency could not have been greater. 

• Stop: Working with my parents to fix my speech with the wrong tools. If they want fluency and my SLP just wants to improve the quality of my life, I will fall through the cracks.

Understand: Unpopular opinion—societal acceptance of differences, like stuttering, has improved drastically since I was a child in the 1990s and early 2000s. If you don’t have that long of a view of how it has changed, just take a look around and observe the booming self-acceptance and stuttering pride movements that are gaining momentum, and the widely agreed upon eradication of fluency as the goal for stuttering therapy. I cannot deny that there is still a long way to go for parents of children who stutter. But, there are many more choices to develop a holistic effort to alleviate your child’s struggle with stuttering and to set them up for a healthier journey than how I experienced it. School-based SLPs need to be the point of contact for parents in their search for help, even if that means prioritizing other more urgent therapeutic efforts ahead of or in conjunction with speech therapy. 

[17] Home Environment: One of—if not—the most differentiating parts of the lived experience of stuttering is how it is addressed, or not, in the child’s home environment. Sometimes loving, sometimes traumatizing, sometimes denial, and sometimes outright silence. The home environment sets the tone for a child’s eventual ability to climb out of the traumatic state of stuttering and into a life in which they can freely stutter. 

• Start: Incorporating the dynamics of home life into therapy sessions. If you don’t know them, investigate and assess during parent-teacher meetings. If it is borderline abuse (ie. denial or silence), please get help. 

• Stop: Thinking your influence and support is bounded by the school’s walls. 

Understand: I made stuttering a taboo and confrontational subject in my house. I wish I would have known how to foster a healthy environment in which we could have talked about it. Instead, I immediately shutdown and stormed off when my parents tried to discuss anything related to stuttering. And, once those parameters were set as a pre-teen, that was it, without any opportunity for renegotiation until the last few years. Having a safe space in which I could have openly stuttered and shared the details of my difficult moments, without fear of being pressured to use my tools—that would have been the ideal. I know I was lucky for the environment I grew up in because I know many who stutter who have experienced verbal and psychological abuse at home for their stuttering. 

For Speech-Language Pathologists…

There are many opportunities for SLPs to hone their skillsets and improve the resonance of their instruction. As I have revealed above, the things I did and was exposed to in school-based therapy stuck with me for years, leaving a significant trail of frustration to roll back once I re-started speech therapy in adulthood. The chance to change the trajectories of many children who stutter is handed to SLPs in schools. This great responsibility necessitates an overview of some unconventional and applicable tools that will ensure a positive, foundational, and overwhelmingly lasting experience is had by all who pass through your doors.   

Synthesizing the above tools with those below sets everyone up for progress. 

[1] Broadening Continuing Education: Of course, stay up to date with the almighty CEUs, certifications, and the latest stuttering research for application. Check the boxes, but then vault yourself into experiential learning. Continuing is the key here, meaning you never stop pursuing new knowledge and skills. 

• Start: Exploring your preferred learning style and methods. Read, listen to podcasts, take local college courses, take online courses, find a mentor, work as an apprentice with an expert in your field or desired area of study, create your own free degrees (read Ultralearning by Scott H. Young), or, even better, become a self-taught and driven expert in stuttering. 
• Stop: Being satisfied with an academic degree and education.

Remember: Mastery of your craft is not attained by staying in your lane (Dr. Joseph Sheehan, anyone?). Finding the intersections with and between related fields accelerates your learning potential, which will only benefit the children you are trying to help. Look no further than having to treat me, who would have required an SLP with cognitive-child-social-behavioral-trauma psychology baseline knowledge to crack my affliction. The best bet is to expand into the psychology field and grow from there because, without question, stuttering therapy does not last without the principles of cognitive-behavioral therapy.

[2] Hard Conversations: I live by the quote, “You are the sum of your hard conversations.” We grow and learn from situations that are faced head on. You feel the uneasiness bubble up into your chest in these moments, uncertain of how they will go. This is where we—children who stutter, SLPs, parents, and teachers—need to become comfortable operating because the lives and futures of we who stutter depend on the sum of our choosing to do so with courage. 

• Start: With me, and work up to my parents and teachers. I know I wouldn’t have been a willing participant at first and the conversations certainly would have been hard, but, as with everything else, the more they were had the sooner some movement could have begun. For example, collaborative meetings between me, my SLP, and teachers (without my parents) to develop a plan for my incremental integration into class participation. The same facilitation could have been beneficial with my parents to help me bring stuttering out from the shadows and learn how to let them into my daily struggle.

• Stop: Thinking I will buy into decisions that were made about me without me. 

Remember: From a young age, I was attuned to all of the conversations surrounding my lack of progress that were had in my absence. Being cut out made me feel helpless. I’m not talking about 5-10 year old me, but pre-teen through early adolescent me—my formative years—when I was really struggling. And I get it, my mom was unnecessarily difficult for my SLPs to deal with, though that is where the opportunity lies—seeing the situation from the perspective of a frustrated mother at her wits end and being willing to sit in that fire to find ways, from all angles, to extinguish it. Hard conversations like these lend themselves to “I must side with the children” or the right versus wrong dynamic, but neither of those leads with openness or an understanding of the give-and-take of compassion-driven outcomes. 

[3] Resources: Where do you turn first to get the latest resources on stuttering to update and continue your education? Who are the leaders and trusted voices in the SLP (or stuttering) community who you could learn from? These two questions should be at the top of your list to answer. 

• Start: By learning from and mastering the institutional knowledge—from acclaimed SLPs, professors, researchers, and scientists. And if you can, serve with them through a literal or pseudo apprenticeship. However, concurrently begin your experiential immersion into the stuttering community as soon as possible (more to follow on this accelerant in Go Native).

• Stop: Limiting yourself to institutional knowledge. 

Remember: The information age and social media has brought stuttering to your fingertips for you to see, hear, and connect with we who stutter. Many of us elders can share stories of feeling like we were the only ones to ever stutter, and could go years without meeting someone else who stuttered too. Blog posts, Tweets, TikTok, YouTube, Facebook, and Instagram videos, podcasts, books, music, interviews, support groups, conventions and conferences, summer camps, virtual learning, virtual reality, and many other socially transferable experiences that can more than supply the high demand for learning. 

[4] Support Groups: For SLPs. I have no idea if these already exist or not, they probably do in some way, though they are certainly not accessible to all SLPs, particularly for those in school districts with either few SLPs or children who stutter. If unavailable, start one, but being in contact with other SLPs and those who work with we who stutter is a start.

• Start: Building your community of support and belong to it, to build the camaraderie and exuberance between you and other SLPs akin to what is found within the stuttering community. I know SLPs are members of the stuttering community, but this is more like the requirement that psychiatrists must see their own therapists while they themselves are actively seeing clients. It’s support for the difficult journey.

• Stop: Going at it alone. 

Remember: This is not networking, which is too transactional and fake for the intimate nature of working with we who stutter. It is community building, where your peers are friends, sounding boards, cheerleaders, coaches, and, perhaps most importantly, allies. I overused the word alongside in the “Become an Ally” section for a reason. It defines what I mean here, community requires proximity, whether physical or trust, in which you know others are there to support you. Actively nurture proximity and trust in your community and it won’t be long before you have a flourishing support network. 

[5] Mentor/Apprenticeship: You are probably thinking about needing a mentor to serve under in a pseudo-apprentice type role. While that is always a good idea and is part of what I mean here, it is not the only option. Skip the line. Find a mentor who stutters. And, better yet, an SLP who stutters. If you’ve lived a full life as an ever evolving SLP, setup an active apprenticeship program and mentor the next generation. 

• Start: Opening your mind to learning opportunities alongside we who stutter. The roles of professional SLP and we who experience stuttering are vastly different. Exploit the differences, and combine the teachings from each to move you closer to refining your perspectives on what it’s like to stutter. 

• Stop: Thinking you need a thoroughbred when an introspective person who stutters will suffice. 

Remember: Mentor and apprentice relationships are a two-way learning exchange, which many don’t take the time to utilize. Stuttering is one of the most challenging lived experiences to replicate. Unless you are an SLP married to one of us who stutters—which is an interesting subculture—or are lucky enough to be around stuttering every day, you will need to develop a deep understanding of the affliction-inducing parts of stuttering to lead us to change. (More on how to do this in the following Go Native entry.)

[6] Go Native: Like learning a language, immerse yourself in the stuttering community. As I just explained, this is dual-use—a SLP and a person who stutters who join forces can mutually accelerate their learning when they live alongside one another in a mentor-apprentice-like relationship. Whether in real life or from afar, the immersive connection will have no choice but to turn you into a native speaker. 

• Start: As early as possible, and participate. There are no seats along the wall in our community.

• Stop: Wondering how the power of the stuttering community will change you—experience it for yourself!

Remember: We are living in the golden age of accessibility to the stuttering community, whether via in person or virtual support groups and workshops in various cities, countries, and platforms, audio and video podcasts, blogs, and worldwide awareness campaigns. Some of the leading communities and resources are: the National Stuttering Association (NSA), Stuttering Foundation, British Stammering Association or Stamma, Friends, Stuttering Association for the Young (SAY), Stuttering Scholarship Alliance, StutterTalk, and, the up and comers, Proud Stutter and Stammer Stories, among many others. Each has a different focus and vibe, but all have the same mission, stuttering awareness, to display unadulterated stuttering, and support for we who stutter. 

[7] Child Behavioral Psychology: You are not one—unless you went to school to be one—so humbly collaborate with those in your school and district, or others through private practice referrals.

• Start: Piecing together a therapeutic plan that prioritizes speech and mental health in which a child psychologist is intimately involved in its implementation. 

• Stop: Baselining speech disfluency without first addressing “why the struggle?”

Understand: During my 12 years in the system, I saw a school psychologist maybe twice for routine evaluations. Twice. No more words are needed here. 

Watch His Hands: The Missing Link

It was my plea for help—the sign of my inner suffering. My mom pointed it out to every SLP who tried to help me yet nothing was done to address it. The tension from my struggle to speak was fighting to escape by any means possible. Why could no one help me? I can still hear the desperation in my mom’s voice. No one else thought it might have been in my best interest to address that first, or at least in conjunction with my stutter. I understand the counterargument—alleviate the struggle to speak and the tension will dissipate. [Insert profanity], I don’t agree. Children who stutter experiencing this degree of inner turmoil must see a child psychologist more often than an SLP. 

[8] Counseling Skills: Intuitive, right? Wrong. If there is anything I learned after finding and graduating from therapy as an adult, it was that an SLP must develop counseling skills. Essentially, an SLP needs to be a coach who knows their players inside and out, their idiosyncrasies, favorite plays, how they perform under pressure, and which types of motivation they need to perform at their highest potential. 

• Start: Experimenting with talk therapy methods, curating interpersonal awareness to adapt quickly during sessions, determining how the child reacts to different forms of encouragement, and cultivating a strategic perspective on the ways in which the side effects of stuttering are influencing the child’s participation levels from session to session. Acquire skills that allow you to adapt to what each session might bring.

• Stop: Assuming these skills will come naturally. You are changed by what you do.

Remember: I sensed that every SLP was too afraid to go against my wishes, and dared not challenge them. While I could get angry, I was far from aggressive and would have cracked at the first compassionate attempt to do something different. “Okay, we don’t have to do that anymore.” This is not a sufficient response and pairs well with the need to have the hard conversations. 

[9] The System: Be the change you wish to see in it. It is not enough to simply know the system is still healing its own wounds and has been since I left it nearly 15 years ago. Change takes time. 

• Start: Standing up, doing your part, joining forces with the stuttering community, and putting the most urgent needs of each child first. Then work on stuttering.

• Stop: Believing it is someone else’s responsibility and there is nothing you can do. 

Remember: But, resources, funding, case-loads, policies, CEUs, limited exposure to children who stutter, etc. I hear you. Change is hard. Look no further than the millions of people who stutter facing down self-acceptance and stigma. It is not impossible. Grassroots and boot-strap it until we make it. (More on this in the future…)

[10] Trauma: Every moment of stuttering generates a traumatic reaction within we who stutter. Sit quietly with that fact for a moment. This needs to be the focal point of attack, learning, and therapy. 

Start: Studying the work of Dr. Bessel Van der Kolk, Dr. Bruce Perry, Dr. Peter Levine, Dr. Gabor Mate, Dr. Paul Conti, and Dr. Hans Selye, among many others. While these scientists and doctors say nothing about stuttering, you will be left in awe and wondering how what they describe as trauma is not a direct correlation with the lived experience of stuttering. 

• Stop: Underutilizing a fundamental skill already in use by SLPs. While most SLPs are not trained psycho-therapists, they are trained in making observations, assessing for care, and ensuring the needs of those they support are met. If the default becomes observing for indicators of an inner struggle instead of solely what is heard and seen, it could alter the lives of many who might otherwise take years to figure their way out of the traumatic state of stuttering. 

Remember: While you may be thinking, “I treat children.” Adults don’t outgrow the trauma that stuttering reinforced in childhood. Chronic exposure to anxiety, fear, and shame through my formative years, however, is the part about trauma that is unique to stuttering. Trauma is supposed to have a beginning and an end, according to the renowned practitioners above. But, the vibrations persist long after each moment of stuttering, regardless of severity or if we numb the felt experience. I have yet to uncover any specific research about the long-term effects of repetitively experienced trauma, though it likely also applies to many other seen or hidden disabilities. This is a personal mission of mine—how to treat actual chronic, repetitive, and daily trauma inflicted by the holistic experience of stuttering. (More on this in the future as well…)

A Meditation on Willingness

I am conflicted about how willing I would have been. The part of the younger me that impacts this was my stubbornness. It would have taken many attempts at any one of the tools for me to begin to feel that maybe, just maybe, I would be okay if I tried and then tried again, and again. Could it have went differently had I been given this toolbox instead? I do believe so. It could have saved at least some of my wasted years stuck in the shadow of stuttering. 

Conclusion: Trajectory of Experience

You had the power to change the trajectory of my relationship and experience with speech therapy. You are the tip of the spear, often the first one in to assess and shape much of what follows. 

This is a heavy burden to carry, a responsibility that ripples through the lives of we who stutter. My experience is but one, though not so unlike those of others who will experience speech therapy in school this year. 

Remember, the things I repeated in childhood speech therapy hung with me, ever-present, for the rest of my life. The fear, anger, failure, severity, anxiety, and frustration tempered my entire being as I grew older. I was resilient and hung on for long enough to make it to where I was meant to go, but I could’ve arrived there much sooner, with your persistence and desire to help me. 

Remember also, then, that trying different approaches changes the trajectory of trauma—combining several tools, sequencing them in a flexibly-ordered manner, and applauding attempts to implement them, by the child and the SLP, forces a momentum to build that was nonexistent in my journey. It should be clear by now that I walked through the same door over and over and over hoping that one day something different would await me on the other side. 

I know that my responsiveness to this varied and holistic approach would have been uneven. At first. Once I tasted success and tapped into my competitive nature that was right below the surface, I would have taken off. Tell me it’s okay to stutter, yes please. “Let’s take a walk today,” yes please. Teach me to how to build healthy habits, yes please. Help me to identify and work up to facing my fears, of course! The absence of any sort of strategy or long-term awareness of what I needed for the journey ahead is within the control of all SLPs to learn, understand, and deploy. 

It is no longer and never should have been one-sided. As much as I want to denounce the system and its past love for chasing fluency, I know that the stuttering community has already endured enough of that, which hurts us more than it helps. 

Instead, I ask that you do something different. Find something that sparks a chain reaction of momentum and self-confidence in a child that otherwise probably only knows the uncertainty of their immediate future. I will never forget the 7 words that taught me how to make an effort to try in the face of nearly insurmountable fear—you are changed by what you do.

And, while I’m saying it to my younger self, it is also for the SLPs who are on the frontlines of stuttering. Go on the offensive because you are the tip of the spear with the power and opportunity to change lives forever. If you need help, reach out your hand…we who stutter are here.