Monday, January 4, 2010

Can we make a 9 year old go for stuttering therapy?-Part 1

About 4 years ago I was treating a wonderful nine year old girl I will call Dori. (not her real name).  Dori was discharged from speech therapy in school because her SLP said she hadn't noticed any dysfluencies in the speech room.  Dori was thrilled to not be pulled out of class anymore for speech therapy.  Her parents brought her to me because she was stuttering significantly at home. Dori later admitted that she became a pro at hiding her stuttering in speech in school.  She was bright and could easily subsitute words.

Dori was approximately 33% dysfluent in my speech sessions (this was an average over 5 sessions).
She presented with whole word repetitions, part word repeitions and laryngeal blocks. She also displayed lip tremors.  At the end of 4 months, Dori's fluency had increased dramatically as did her eye contact and communication skills (we worked on these too).  She was giving oral presentations in front of the class and tried out for the school play.  One day, Dori asked me why she still had to come to speech therapy .  She was adorable and trying not to hurt my feelings. She explained that she enjoyed our sessions and the fact they were fun, but she was happy how she spoke.  She said her friends didn't care that she stuttered and she spoke all the time. In fact, her teacher called her parents reporting that she was disrupting the class by talking to her friends often.  (This was actually music to all of our ears). I brought her parents in for the next session to talk about progress and whether she should continue. Dori's parents were torn.  They thought she had progressed and was doing great, but they could not let go of the dream of total fluency.  I think we resolved this conflict in a positive and healthyy way.  This blog post will be continued at week's end, but I would love to hear how other parents, grad students or speech paths. have resolved this issue.  What do we do as professionals when a family wants perfect fluency and the child is happy with the progress made? Please share your thoughts with me. tks Lori


Pam said...

I am not a speech path, grad student or parent, but have heard of this struggle when interacting with parents. An an adult pws, I have had the privilege of working with parent groups, and hearing parents talk of their desire to keep kids in therapy, even if the child doesn't want to.

I remember a powerful moment at the friends conference in Tampa this summer. A 16yr old told us, and his parents, in a group, that he really wished his parents would NOT constantly tell him to use his his fluency targets. That is made him feel like a failure. That he wished people, and his parents, could walk in his shoes. He wanted to make the decision about how he would approach his speech. He was after all, the one living with stuttering. Every person in the room heard that young man, and was moved by his ability to speak up and lets his wishes be known.

So, I guess its a tough call. We want the best for the kids, but we also need to hear from the kids what they think best is.

Just wanted to share this!

Lori Melnitsky said...

Tks Pam. I appreciate you sharing this. I look forward to hearing from others. I am glad that teen had the courage and strength to express his true feelings.

Manan said...

Hi!! Lori, I'm 36 yrs old and with PWS. Very good information and almost looks like you are sharing my story with exception of age group and some family involvement. I'll like to write you my background and explain my feelings in this respect. I have also gone through SLP about one year back and felt little bit lift in confidence, but now want to learn how to sustain the techniques learned through SLP. My contact e-mail is

Lori Melnitsky said...

Hi Manan-
Please feel free to e-mail me directly or on my blog. My e-mail is
Tks again for following me.