A team approach works best when customizing an intervention plan to the specific needs of each child and family. The three primary team members are:

• Speech language pathologist
• Parent
• Child

This team can be expanded as needed. For example, teachers, family members, friends and a variety of other professionals who interact with your child regularly can be invaluable in the therapeutic process.

Here is how each team member will contribute to your child's stuttering therapy.

Speech language pathologist

Stuttering evaluation

The speech language pathologist will conduct a thorough evaluation to determine the presence and severity of a stuttering or fluency disorder. During the evaluation, he will:

• Interact with and observe your preschool child to assess your child's fluency within the context of overall communication skills
• Ask questions about risk factors which may predict the nature and course of the stuttering
• Formulate recommendations for home programming and/or speech therapy
• Make referrals to other professionals if concerns arise which go beyond the scope of communication

The therapist’s role in home programming is to help create an environment that will support fluency and reduce any demands that may be contributing to the problem. During the initial evaluation, if environmental shaping is recommended, the therapist will review and model strategies that you can use during daily activities.

Stuttering therapy

If therapy is initiated, the therapist will meet with your family on a weekly basis to:

• Discuss home programming
• Determine therapy goals
• Implement practice activities that you can incorporate into your daily routines

While therapy visits are important, the home programming you practice each week will be crucial to your child's progress. As a result, the therapist’s primary job is to ensure that you understand and are able to carry out therapy goals and activities in your child’s everyday environment.

Parent

You and your child's therapist need to work together as a team to identify and address your family's specific needs.

Stuttering evaluation

During the evaluation, the therapist relies on your input to better understand how your child functions in real life settings and how stuttering impacts your child’s life. Home monitoring and programming may require that you:

• Participate in recommended activities
• Monitor your child’s responses
• Track stuttering severity at home

Stuttering therapy

Within therapy, you will participate in natural games and conversations with your child using identified strategies. These are designed to:

• Increase your child's self confidence
• Improve communication skills
• Enhance fluency

Your feedback about the benefit and effectiveness of therapy will help the speech language therapist to develop goals and activities that will help your family progress. The therapist will also encourage you to ask any questions you may have and to provide any information you feel is important about you child and his progress.

Child

Preschool children in home monitoring programs are not asked to do anything directly relating to their speech. They engage in fun activities led by their parents to promote a fluency enhancing environment.

Stuttering therapy

For children engaged in more direct home programming or speech therapy, the focus is on preventing and reducing fear, embarrassment or shame that can be associated with stuttering. Examples may include:

• Watching videos
• Learning about the talking process
• Discussing feelings that can surround stuttering

In addition, your child will are participate in speech activities based upon her needs to increase smoother speech output.

The systematic practice that you and your child's therapist lead will be essential to improving your child's skills in everyday communication. Examples may include stretching initial sounds in words or pausing at natural phrase boundaries. Between therapy sessions, your child will participate in activities that you lead to promote the goals and lessons suggested for the week. Your child’s input and feedback regarding therapy and its benefits will always be considered.

Contributed by:
Sarah Vogel, MA, CCC-SLP
Speech language pathologist
Voorhees Specialty Care Center
The Children's Hospital of Philadelphia