Class Visits for Children Who Stutter

by Bill Murphy
Purdue University

Having the school aged client and the SLP discuss the disorder of stuttering with the client's class is a powerful technique that can have many positive consequences. When classmates are informed about the nature of stuttering, teasing in the classroom is almost always reduced or eliminated. Classmates also become advocates for the child who stutters and will come to his rescue on the playground if other children ridicule him. A class presentation is another way to normalize, " deawfulize" stuttering. When done correctly, stuttering is a less "loaded" topic, an issue that can, on occasion, be openly discussed. It is possible for an SLP to come directly into the classroom and work openly with the child on transfer and maintenance skills. Teachers can now more easily signal a child to use his management tools ( if appropriate and acceptable to the client and SLP ). Most important, the child has a powerful experience during which there is opportunity to self disclose stuttering in a supportive and accepting environment. The child feels more comfortable while attempting to implement therapy strategies in class without the worry about the misunderstanding and ridicule by others. Foundation is laid to learn pragmatically correct ways to use self disclosure as a stuttering management tool. The child learns that talking openly about stuttering puts both him and his audience at ease.

Procedures For Making A Classroom Visit

A classroom visit to help a child discuss his stuttering with his classmates should be done only if the child is in agreement. For some children this is an easy task. They want their classmates to know about stuttering. For others who have been teased about stuttering or who already have negative emotions strongly attached to the disorder, desensitization work must come first. Strategies to reduce or eliminate anxiety, shame, and guilt must be implemented both in and outside the therapy room.

Teachers and parents must understand the rationale for this experience. Even if a child has not been teased about stuttering by classmates, important skills are acquired by the child in this exercise. During a conference with the teacher the general mood of the classroom is ascertained to determine whether the teacher expects interference from any particular child.

The client should be included in the planning. Does the child want to inform the class regarding specific issues? How much does the child want to actually say versus what the SLP should tell? the child is still at a point where speech management skills are not consistent, the SLP may want to limit the child's verbal participation to speaking parts that are short and well rehearsed.

What and how issues are discussed will vary according to each child's needs and age level. Kindergarten children can understand concepts of bumpy or sticky speech and that it feels bad to be teased. They can learn that the speech teacher will teach how to have smoother speech, but that sometimes bumpy speech will still happen. Third and fourth graders can understand more complex explanations about stuttering, speech therapy techniques, their inconsistent success, and
the ramifications of teasing. Following is a sample outline of a class visit that would be appropriate for third and fourth graders. This is only a guide and each SLP must adapt it to their own style and the developmental level of the class.

Introduction
The SLP can introduce herself as the speech teacher and briefly explain her job.
Classroom participation
To normalize the concept of receiving speech therapy in the classroom, ask the children how many of them have been to speech before and what they worked on. Many times a child will mention that your client is currently in speech. Acknowledge that this is true and that you'll soon be discussing it.
Other speech problems and rationale for coming to the class
Briefly indicate there are many types of speech difficulties, e.g. how to pronounce speech sounds, hoarse voices, etc., but today you and the client are going to focus on a problem called stuttering. Let the class know that you and the client want to teach them some interesting things about stuttering, and to educate them, because we all know how important it is to be educated people. If the SLP also stutterers, this is a good time to give this information.
Define stuttering and it's causation.
Give a brief definition, age appropriate for the class. When speaking to this age level, I like to ask the kids if they know what stuttering is and summarize the discussion with something like, "stuttering is a speech problem where some people's speech system doesn't work very well all the time. It doesn't seem to be as coordinated as it should. It gets tripped up or stuck on sounds. We're not sure what causes this but we think maybe some people are just born this way."
Famous people who stutter
I like to ask the class if they know that many famous and successful people have stuttered and then briefly tell them about some of these people. As visual aids, one can use some of the posters depicting famous people produced by the Stuttering Foundation of America or the National Stuttering Project.
It's no one's fault.
It's very important to stress that no one is responsible for stuttering. People don't stutter because the are dumb or sick. Mom's and Dad's did not cause it and it's not a disease that you can catch.
Different ways to stutter.
Most clients, no matter what degree of speech management skill, can be verbally involved with the class in this task. The clinician and client can demonstrate different forms of stuttering behavior ( repetitions, blocks ). Ask for volunteers to imitate the various patterns. It can be fun, if done in a friendly manner, the client can grade attempts by classmates, e.g. A, A- etc. The SLP should indicate this type of imitation is for learning purposes only and should not be done at other times. A class discussion should follow in which the children are asked how they would feel and
act if they had to talk this way all of the time.
Tools that facilitate smoother speech.
Using the linguistic level at which the child is most comfortable, the SLP and client together demonstrate the speech management techniques the child is trying to incorporate, e.g. pullouts, stretched speech etc. It may also be helpful to ask a few of the other children in the class if the can do some of the fluency enhancing techniques, such as prolonged speech. Here the class may also begin to appreciate the level of difficulty involved in such management techniques.
We can't have 100% success. Change is hard.
It's important that both the teacher and the class recognize that speech management in conversation is difficult and the client will continue to have some hard stuttering. Change will come, but it takes time and practice. Influences that make changes difficult can be discussed.
Items may vary for each child but usually include the following: being tired, competing messages (many people trying to compete at once) and fear of being teased or ridiculed.
Why people make fun of others and how this affects us.
Here the SLP asks the class to share what they have been teased about. Most elementary aged children are willing to disclose this information and doing so actually creates a stronger bond among the children. I always emphasis that anyone who is willing to share something they have been teased about is very brave. It is also helpful to ask the children how teasing makes them feel and behave. Parallels can then be drawn to teasing someone about stuttering.
How the client wants his classmates to respond to stuttering.
The SLP and client can talk to the class about how they can react to stuttering in a helpful manner. I have found that many elementary children actually welcome their classmate filling in words on which they are stuttering. Of course others want the listener to be patient and wait until they are able to say the word.

added with permission September 27, 1998