About the presenter: Judy Butler is a graduate of Brown University (1979) and the University of Connecticut (1981). She published Becoming a Friend: Thoughts from a Stuttering Specialist which can be purchased from the Friends website at www.friendswhostutter.org She co-authored Making My Own Way: Empowering Children and Teens Who Stutter which is available free at www.mnsu.edu/comdis/kuster/TherapyWWW/butler.pdf. Judy is an ASHA Board Recognized Specialist in Fluency and Fluency Disorders with a private practice in Massachusetts, USA.

You can post Questions/comments about the following paper to the author before October 22, 2007.

Conversations About Stuttering

by Judy Butler
from Massachusetts, USA

One of the many possible goals of stuttering treatment is helping clients make "decisions about how to handle speech and social situations in everyday living." A process for achieving this goal is to, "Identify, with the client's help, attainable behavioral goals..." (Starkweather and Givens-Ackerman, 1997). A clinician may choose to identify a client's concerns using a routine questionnaire. The recent emphasis on evidence based practice has certainly increased my use of such questionnaires to quantify client input. But, my preference remains eliciting information in the context of relaxed conversation. I especially like this approach when treating children because they often respond to direct questioning with "I don't know." Conversation with children is more productive and fun.

Uncovering a client's personal preferences helps a clinician design meaningful treatment. Even when using a commercially available treatment program, "it is vital that clinicians modify its components to fit each specific child's needs" ((Shields and Kuster, 2003). One way I elicit information about a child, is to expand upon incidental comments they make while playing a variety of question/answer activities. Especially fruitful are games that involve playing cards. There is something about shuffling, sorting, flipping, selecting and otherwise manipulating cards that seems to be engaging. After employing one particular therapy program for adolescents that provides numerous questions about fluency, (Blood, 2003) I began making my own simple playing cards. Here is my clinical nugget: to help with initiating conversations about stuttering, take any questionnaire related to fluency and place each question on a separate index card. Use these cards to create a simple game. Note: this is a singular kind of game because stuttering can be a sensitive topic. The clinician's empathic listening skills are important to the success of this activity. Clinical judgment and client responses will guide the conversation and the development of clinical goals. One example of a questionnaire that the clinician can modify the wording of questions as appropriate to the needs of the client is available from Floyd, J., Zebrowski, P.M., Flamme, G.A. (2007) Stages of change and stuttering: A preliminary view. Journal of Fluency Disorders, 32, p. 113-117


  • Blood, Gordon W., Ph. D. (2003) The POWERR Game, Memphis TN; The Stuttering Foundation, www.stutteringhelp.org
  • Bray, M.A., Kehle, T.J., Lawless, K.A., Theodore, L.A. (2003) The Relationship of Self-Efficacy and Depression to Stuttering. American Journal of Speech-Language Pathology, 12, p.431.
  • Moore, L.A. (2006, Aug.15) Empathy: A clinician's perspective. The ASHA Leader, 11 (10), 16-17, 34-35.
  • Shields, L. W. & Kuster, J. M. (2003) Finding Good Resources for Children Who Stutter. Facing the Challenge of Treating Stuttering in the Schools, Part 2: Selecting Goals and Strategies for Success. Editors in Chief, Nancy Helm Estabrooks, Sc.D., and Nan Bernstein Ratner, Ed.D; Guest Editor J. Scott Yaruss, Ph.D. Seminars in Speech and Language, 24, number 1, p. 11.
  • Starkweather, CW, & J. Givens-Ackerman, (1997) Stuttering. Austin, TX: PRO-ED, Inc., p. 188, 195.

    You can post Questions/comments about the above paper to the author before October 22, 2007.

    August 16, 2007
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