COMPONENT 12. PARENTAL INVOLVEMENT
Rationale: As the child is in therapy only two-three times weekly,
the parents must involve themselves in the treatment process to
assure maximum progress. Parental communicative style and
communicative feelings of guilt, fear and anger must be dealt
with through the therapeutic process.
Research:
Conture (1990) - "All the good that is done in therapy can be offset,
in a relatively short time, by parents who cannot, or will not,
understand their role in their child's speech development. "
Gregory (1991) - feels strongly that parents need to understand the
stuttering problem, its variability, factors associated with this
variability, and how the child responds to fluency disruptions.
Gregory & Hill (1993) - success of the therapy depends to a great
extent on the commitment of parents.
Kelly and Conture(1991) - stuttering results from complex
interactions of constitutional and environmental factors.
Intervention with children who stutter should include attention
to these factors. Therefore, establishment of parent-child
fluency groups may provide an opportunity for clinicians to assist
parents in better understanding the disorder and ways they can
help their child.
Perkins (1992) - implies that parents are part of the environment
that maintains the child's disfluent speech; therefore, their
direct involvement in working with the child is critical to
effective treatment.
Ramig (1993) - "Involving parents in the intervention process is an
important step toward facilitating the changes for improvement in the
young child who stutters" (pg.226).
Botterill, Kelman & Rustin (1991) - stuttering arises out of a complex
interplay between the child's environment and the skills and abilities
the child brings to this environment. Intervention programs should
incorporate a dimension of environmental change that will facilitate
fluency development.
Van Riper (1973) - "parents feel a profound sense of guilt".
Wall and Meyers (1984) - "it's important to assure parents they did
not cause the stuttering; also, there are many things they can do
to enhance fluency".
Zebrowski and Schum (1993) - Discuss the counseling aspects involved
when working with children who stutter and their families.
Acknowledging the attitudes, beliefs, and feelings of the family
unit is an important component to the intervention process.
Activities/Techniques:
1. Several parent-clinician conferences should be scheduled. During
these conferences, parental fears, guilt and anger should be
assessed and managed appropriately. Parents must be given the
time and freedom to express their feelings.
2. Discuss normal disfluency and normal language development,
focusing upon the following developmental areas necessary for the
production of fluent speech:
a) motor coordination and timing
b) linguistic and cognitive knowledge
c) emotional maturity
3. View the film "Stuttering and Your Child" (Speech Foundation of
of America, 1977) with the parents, providing feedback and answers
to any questions which may result.
4. Ask parents to assess how they are responding to their child's
dysfluencies. Present Cooper's Parent Attitudes Toward Stuttering
Checklist (Cooper, 1986) or Zwitman's Child Management
Questionnaires and Checklist (Zwitman, 1978). These checklists
are helpful to facilitate parental awareness and change.
5. Explain the importance of parental involvement. Be sure to
provide concrete examples of how parents can become effectively
involved in the therapeutic process.
6. View the film "Prevention of Stuttering - Part II" (Speech
Foundation of America). When their child stutters, he/she can
detect the listener's reaction through both their words and their
non-verbal actions. If the child detects negative feelings, the
result may be a negative attitude about himself/herself, their
speech, or both. This may cause the child to stutter more
severely and more frequently. Therefore, it is important for the
parent to react the same for both fluent as well as dysfluent
utterances from the child. An increase in attentiveness when the
child stutters may reinforce the behavior.
7. The clinician can assist the parents in structuring a "talking time"
(Botterill, Kelman, & Rustin, 1991) in which the parents make a
commitment to spend three, four or five minutes: four, five or
six times per week playing with their child. This should be done
in a quiet room as to not allow for any interruptions. During
this "talking time", the parents do not make any demands or
comments on the child's speech. Listening to the content of
the child's message is the primary emphasis. If parents are
unable to complete this assignment (over a two week period), the
clinician should discuss with them their role in the therapy
process and factors which influence speech change.
8. Early in the intervention process, the parents should become
familiar with the speech model used with their child. Often,
the clinician will instruct the parents to slow their speaking
rate. However, this task is not as easy as it appears. Parents
also need to practice with the clinician as to ensure consistency
between the therapy model and home model. This inclusion, even if
brief or periodic, assists in increasing the parents understanding
of how difficult changing speech patterns can be and will aide in
the therapy program.
9. Establishing evening "Parent Support Group" meetings for parents of
children who stutter is one way to reach out to parents who cannot
attend in-school therapy sessions. Bennett (1990) discussed how
one school district organized such meetings, with baby-sitters
and translators, in order to train parents on issues around the
disorder of stuttering, environmental factors which influence
one's speech, and treatment considerations. This atmosphere
also provides parents with an opportunity to share their feelings
and attitudes with other parents in an accepting, warm environment.
10. Provide the parents with information they can take home. Booklets
and pamphlets are invaluable sources of information. The
following are suggested reading for parents and teachers:
(a) ÒIf Your Child Stutters: Speech Foundation of America
A Guide for ParentsÓ P.O. Box 11749
Memphis, TN 38111
(800) 992-9392
(b) "A Brochure for Parents John Ahlbach
of Children Who Stutter" National Stuttering Project
1269 Seventh Avenue
San Francisco, CA 94122
(415) 566-5324
(c) "The Stutterer in the Ellin S. Rind, M.S.
Classroom" Stuttering Resource Foundation
123 Oxford Road
New Rochelle, NY 10801
(914) 632-3925
(d) "To the Parents of the Peter R. Ramig, Ph.D
Nonfluent Child" Dept. of Communication
Disorders and Speech Science
University of Colorado
Campus Box 409
Boulder, CO 80309
(303) 492-3049
(e) "To the Teacher of the Peter R. Ramig, Ph.D - as above
Nonfluent Child"
(f) "Does Your Child Stutter?" Peter R. Ramig, Ph.D. - as above
(g) Stuttering and Your Stuttering Foundation of America
Child: Questions and P.O. Box 11749
Answers Memphis, Tennessee 38111
(800) 992-9392