The following case study about a little girl who stuttered, shared by her mother with a speech-language pathologist, Maxine Johnson, and added below with permission.



Tomorrow is Jane's fourth birthday. Naturally, she is looking forward with great joy and anticipation to her party. Although I am happy for her joy, the thought of a birthday party brings back unpleasant memories of her party last year because it was on that day that my husband, Dick, and I realized that Jane had begun to stutter. To many parents this may not bring great alarm because, after all, most young children go through a period of some hesitancy in their speech. But to us, although we never said it aloud, we knew that our children would have a better than average chance of stuttering because my husband has stuttered most of his life and we knew that this speech problem does tend to run in families with histories of stuttering.

My husband and I are both college graduates and he is currently working toward his Ph.D. Also, Dick has had extensive speech therapy for his stuttering at a well known university clinic and he has developed a good level of fluency with very little stuttering remaining. With this background of sensitivity we felt that we could guide our children toward normal, fluent speech.

We are a happy family with very little quarreling and unrest. Dick is an affectionate father and I am a conscientious and loving mother. Jane is happy and content and is well adjusted to everything in her life. She is a normal, healthy child. Jane developed good speech early with quite a large vocabulary by the time she was three years old. Also, she is very precocious and loves people and the world around her. But, even with this seemingly good life, she began to stutter.

Perhaps it was because Jane was just presented with a baby brother that she began to feel insecure. But we did not feel this was a traumatic experience for her because she had been well prepared for his arrival. When he did arrive we made no big issue of it and we gave her the extra love and attention required to make her feel that we still loved her as much as ever and that she was still very important to us.

The first stuttering we noticed in Jane's speech were the natural repetitions of syllables and words. At first they were few and seemed to appear when she was excited or distressed. Gradually the stuttering repetitions began to occur more frequently and they became much more severe. Her easy, non-forcing type of stuttering on words changed to a hard, struggle type of forcing.

Dick and I reacted very emotionally to Jane's stuttering in the beginning. Because she was OUR daughter we didn't immediately look at the problem rationally. Dick would often go into our bedroom and cry in disbelief and pain about what was happening to our daughter. I would frequently do the same. We knew better, but, like most parents of stuttering children, we hoped that somehow the stuttering would just disappear. But this did not happen. We agreed that something had to be done! There was a reason for Jane's stuttering and, although we couldn't put our finger on the cause, we knew that we would have to re-evaluate our way of living and to do some changing in our behavior with Jane.

We finally decided to make a list of what might be wrong in our lives with Jane and to attempt to correct the situation. We resolved that we would make a special attempt to relieve Jane of all pressure situations such as having her tell something to one of us, to correct any negative behavior she might have, and to have her hurry up to meet our adult time schedules. We avoided telling her "no" and "don't" and to "grow up and stop acting like a baby" (isn't one baby in a family enough?). We also stopped spanking her for misbehaving. We would make her feel that we, as adults, could accept her for what she was and not for what we thought she should be.

At Jane's age speech becomes more complex, demanding, and at times frustrating for the child. We decided to use simple three and four word sentences with Jane. We made our speech as simple as possible, thereby giving her a simple adult model to follow. In addition, we decided to give her an extra amount of love and attention and to let her know and feel that we would always be there when she needed us.

We knew that we could not ignore her brother Sam so we would try to give him his cuddling and attention when Jane was napping or not around. However, this was not very practical because, although Sam was just a baby, he would soon come to realize that he was only loved and attended to when Jane wasn't around. So we decided to make him a part of our playtimes with Jane, but to still make Jane feel important. We would praise her feats and encourage anything she did or was proud of. Also, one important thing that we did from the very beginning without even mentioning it to each other was to NOT say anything to her about her stuttering or to each other when she was within hearing range. This also included not reacting to her speech through the expressions on our faces or by any sign of impatience. The first things our friends would tell us to do were to tell Jane to "slow down," "think about what you want to say," "take a deep breath," or to "stop and start over." We knew that this advice was not good because it would only make Jane more aware of the fact that she was doing something "wrong" when she talked to us and she would soon get the impression that we didn't like her when she talked that way. We decided to do nothing. We thought that by doing nothing we were really doing something-we were not calling attention to Jane's stuttering and therefore we were doing no harm to her desire to speak spontaneously without concern and worry.

Having developed our own list of do's and don'ts we hoped to make some progress with Jane. However, although some days were better for her than others she still seemed to make no noticeable gains. In fact, Jane's stuttering became worse. Her stuttering became so acute that she could hardly say a sentence without becoming completely bottled-up in her efforts to just get words out. Jane would do anything to try to say words: she would talk in a higher and higher pitch until she sounded like some weird creature, or she would jump up and down or stamp her foot while stuttering on a word-all to no avail. When the words wouldn't come Jane would run to a pillow and hide her head, or cry, or a sickly grin would spread across her face. Jane was truly a child to be pitied, but also to be intensely loved. Needless to say, at this time Dick and I were at an emotional breaking point. We knew that if a young stutterer is helped early enough and the stuttering handled properly the child can overcome it. Knowing first hand the ridicule and unhappiness a person who stutters goes through we could not bear the thought that our child would have to go through life with this handicap.

Finally, Dick decided that he would seek the direction of the university speech clinic. In conference with the director of the clinic, he suggested to Dick that I call his wife and ask her for suggestions to help Jane because she had successfully taken charge when their children had gone through a period of stuttering.

In conference with the director's wife, I learned that we were headed in the right direction, but we had not extended ourselves enough to help Jane. At that time, Jane was enrolled in a parent-cooperative nursery school two mornings a week for two hours. I was told to take Jane out of nursery school as well as Sunday school. We were to literally isolate her from other people. In addition, we were to give her much more freedom in her actions, eliminate any form of discipline, and to give in to most of Jane's wishes. We also were told to remove stimulating activities from her life such as rough play, TV, and new toys and experiences. Jane was to live in a stable, constant, unemotional environment where she could feel completely secure with no pressures or excitement to overly stimulate her. There would be no demands for eating, sleeping, good manners, and the other usual adult behaviors that we expect children to emulate.

I was instructed to do self-talk. This simply means to talk aloud about what I was doing. For example, I might say "Mommie get broom," "sweep sweep," "dust all gone." The reason for this was so that Jane would pick up on the idea and begin to do some self-talking in her play activates where there would be no speech pressures and to be able to experience speech fluency by herself. We were told that people who stutter often do not stutter when they are alone and this would provide her with a time that she could hear herself talk fluently-which was a change from all the other times when she would stutter. Lastly, I was told to see to it that Jane got plenty of rest, but not to pressure Jane to do this.

When I arrived home from this conference my head was in a whirl. How could I possibley manage to do all these things without Jane suspecting something? And, could I meet up to the challenge to comply with all these do's and don'ts without losing my good spirits and patience. But I decided that we were headed in the right direction and that this had to be done without regard for our own comfort, especially mine. So, as soon as Jane was in bed that evening, I called my friends and explained to them not to come over for awhile. I also called the teacher of the nursery school and told her why I was temporarily taking Jane out of school.

Fortunately, there were few children in our neighborhood and all of these were of school age. However, if any of the children came over to play with Jane I would have to try to entice her into staying in the house because I couldn't monitor the outside activity and I didn't want any of the children making fun of her stuttering. Kids can pick up on differences and I had remembered that at her birthday party a couple of the kids had laughed at her stuttering and told her "you talk funny!" Sometimes, although I had other things to do, I would ask Jane if she wouldn't rather stay in the house and help me bake a cake or some cookies. This worked to keep her in sometimes, but other times no type of luring would change her mind and she would run off with the children. At these times I became an unobtrusive observer to protect Jane from any unpleasantness that might arise. Finally, I talked to the parents and explained the situation so they would keep their children from coming over. Also, the over-stimulation of play might be detrimental to the progress in this type of therapy. The competition in children's play can sometimes be quite acute which could place a threat to Jane's sense of security.

Our whole way of life changed. We did nothing different from day to day except to go for a short ride occasionally. It took every ounce of determination and faith I had to make each day pleasant, cheery and "right" for Jane. I had no one to spill out my feelings and emotions to because I wanted to spare Dick from additional worry and concern and my feelings of frustration. However, Dick knew that I was going through a very trying experience and he would urge me to get out in the evening when Jane was in bed and asleep. We had no baby sitters because we didn't want Jane to feel that we were deserting her to a stranger it she would happen to awaken from her sleep.

Several months had passed since Jane began to stutter. We lived this day to day, calm, quiet and restful existence for some time before we began to notice any improvement in Jane. But, little by little, her stuttering seemed to ease considerably. She was not doing as much forcing or struggling for speech and she seemed much more at ease and confident with us and her environment. During this time I came to know my daughter the way every mother should come to know her child. When Jane began to echo our simple, unhurried, three to four word sentences we knew that we were on the right road. This gave us the incentive to try even harder what we were already doing. Also, being able to "get away with anything," Jane would play a little game of testing us to see just how far she could go. Fortunately, she knew right from wrong and she didn't go too far in abusing her new found power. Even so, in private, Dick and I called her "King Kong" because she was indeed the ruler of our home.

After eight months of this type of home therapy, Jane began to make very noticeable gains with her speech. Each day brought less stuttering and more fluent speech. When this took place we found ourselves subconsciously letting up somewhat on the therapy so we would have to remind ourselves to get back on track. Then the time finally came when she wasn't stuttering at all. I don't remember when that day occurred because it was so gradual, but each day brought more and more fluent speech until finally she was as fluent as ever. Her speech was more relaxed and she was much more confident of herself. About nine months had past and we felt almost as if a re-birth had occurred for Jane.

When Jane's fluent speech seemed to be on firm ground we gradually re-exposed her to the life she knew before her stuttering began. We took one small step at a time and waited for her reaction. When there was none we would take another step and then another. Finally, we decided to see how she would do in nursery school. I took her with me the day it would have been my turn to help the teacher so I could be close at hand to observe her. Jane joined the children as though she hadn't been away at all and she was more confident in herself than ever.

Permitting Jane to go to nursery school again was the crowning point in the success of our therapy. Every now and then Jane would seem to have a little trouble on a word, but it did not bother her and she kept right on talking. Dick and I now had tears of joy.

Out of our frustration, stress, heartache, and emotional pain emerged a most rewarding experience. We were able to avoid future trouble with Jane's stuttering because of our dedication to see to it that Jane regained her fluency. We were glad that we sought professional help and that we were determined to follow through with the guidelines offered to us. I wish other parents the good fortune we have experienced and would remind them that therapy takes time to work and to be patient and consistent with the application of the home therapy.

added to the Stuttering Home Page October 26, 1998