Parents of children who stutter have a variety of options when seeking therapy. Their choices include:

• Private practices
• Hospitals
• School-based services
• University clinics

Although each setting has its pros and cons, the good news is that effective stuttering therapy is possible in all.

It is worth noting that the experience level of speech-language pathologists and their knowledge and comfort in working with people who stutter is more important than the actual speech therapy setting. The question left for the parent, then, is: How can I tell?

A good place to start is with the Specialty Board on Fluency Disorders. This Board is responsible for recognizing specialists in the area of stuttering and fluency disorders. Such specialists may have the designation BRS-FD (Board Recognized Specialist-Fluency Disorders) after their names.

Specialists have been recognized by peers for their expertise. Equally important, they are required to remain current on advances in treating stuttering in order to maintain their specialist status. Although this is not an absolute guarantee that your child will receive effective treatment, finding a specialist certainly increases the likelihood.

Private practices

Private speech-language pathology practices have several characteristics conducive to successful stuttering treatment.

Benefits

• Private practices allow for flexible scheduling, regardless of type of therapy (one-on-one vs. group) or preferred days and times.
• Treatment is given by a certified and licensed speech-language pathologist, and perhaps even by a specialist. In some areas, it is even possible to find entire clinics where all of the professionals specialize in the treatment of stuttering.
• Private practitioners make and receive numerous referrals to and from other professionals. Thus, if additional services are needed, a network for locating them may be available.
• Private practices can involve the entire family, an important consideration in stuttering management.

Drawbacks

• Private practices are often more expensive than other settings.
• Private practices may not work with insurance providers.
• Families often need to pay for services up front, regardless of whether their insurance provider will reimburse the costs.

Hospital settings

Benefits

• Clinics are relatively likely to employ a specialist and they tend to involve the whole family in therapy.
• Therapists in hospital settings often have access to more resources and better access to medical, counseling or other professional services.
• Therapists in hospital settings can offer more intense and thorough evaluations and treatment.
• Hospital settings are better equipped to accept insurance coverage (although such coverage is getting progressively more difficult to obtain) and to assist families when navigating through this often complex process.

Drawbacks

• There can be a relatively long waiting period for both evaluations and therapy.
• Scheduling can be an issue, particularly for parents hoping for after-school sessions.

School settings

Benefits

• Unlike hospitals and private practices, public school settings do not require extra time and money on the part of parents.
• Schools allow therapists to gain a broad educational perspective of their clients. In other words, by working with classroom teachers, school speech-language pathologists acquire different viewpoints of their clients. They find out what the children are learning in school and how their stuttering may be affecting that process.
• The abundance of rooms and people can make the school setting a great place for transfer and generalization of what has been learned.

Drawbacks

• Limited parent involvement since therapy does not typically involve the entire family.
• School-based speech-language pathologists typically have big caseloads, and, consequently, therapy may take place in large groups, sometimes with no other children who stutter.
• Interruptions of therapy due to breaks in the school schedule.
• Stuttering is generally a small portion of school therapists' caseloads, which can mean that their expertise lies elsewhere.
• Children are often pulled out of class for therapy which forces them to miss classroom instruction time and can be socially awkward.

University clinics

Universities often have their own speech and language clinics where students training to be speech-language pathologists can accumulate contact hours.

Benefits

• These training facilities typically offer reduced costs for their services.
• University clinics may include professors and researchers who are up to date with the most current research and cutting edge advances in the field.

Drawbacks

• Even though the student-clinicians are supervised by licensed professionals, they lack the experience of a well seasoned clinician.
• Student-clinicians tend to change with each new semester, so rapport must be re-established every few months.

Contributed by:
Dale F. Williams, PhD, CCC-SLP, BRS-FD
Communication Sciences & Disorders Department
Florida Atlantic University