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From: Woody Starkweather
Date: 10/18/01
Time: 2:45:40 PM
Remote Name: 155.247.229.88
Hi Viren:
This is, in my opinion, a very important question -- one that does not get asked enough by SLP's treating stuttering.
The answer is of course, yes, if a child lives in a home environment where there is violence or the threat of it, addiction, any form of mental illness, such as depression, or even physical illness, he or she can be chronically anxious over these problems, depressed himself, and in many other ways affected by them just as any child in such a house is affected. It may or may not be harder for the child who stutters, but home environments like these are so extremely difficult for children that it doesn't really matter. The stuttering is a relatively minor problem, compared to the home environment. One way in which such an environment is very important is its effect on treatment. A child who is being abused, who lives in a family with an addicted family member, or who is sexually abused, or who witnesses such events, is UNABLE to focus on anything else. Therapy will be very difficult for such a child, if not useless. I have seen several cases like this. In one case, we worked for a couple of years with a young child. He made progress with his speech in school, with his friends,and of course in the clinic, but at home he continued to stutter. Eventually, and more or less by accident, we discovered that the father in the family had a gambling addiction, as a result of which he committed crimes to get money for gambling, and generally left the family with no sense of financial security. When the child went home to this insecure atmosphere his stuttering returned completely. We got the father into rehab and the family into counseling and within a few months, his stuttering was also treatable in the home. Now he is speaking normally.
I think it is always important to try to find out about these things when the parents are interviewed. Of course, most families try to hide this kind of information, so it can be quite difficult to know if one of these things is present. But when it is clear (as for example with a parent who is drunk while accompanying a child to the clinic), it is, in my opinion, best to say "Sorry, the family is not in a place where therapy for stuttering can be of any help. Get help for the alcoholism (or whatever the other problem is) and then come back." This is difficult, but it tends to get the parent with the problem into treatment, which is what needs to happen before the stuttering can be addressed anyway.
Woody