The Internet has become a significant resource in communication disorders, and contains a wealth of information about stuttering. Leeper and Gotthoffer (2000) present a number of applications of the Internet in the field of speech pathology and audiology, including accessing therapy materials and consumer information for use during treatment. In the area of stuttering, much of the currently available information is geared toward the adult who stutters, speech-language pathologists, and parents of children who stutter. Until recently, there has been very little information on the Internet that is designed specifically for the school age child or young teenager. In 1996, Judy Kuster added two wonderful pages to her Stuttering Homepage Web site entitled "Just for Kids" and "Just for Teens" (Kuster, 2000a, b). Over the past few years, I have been including these resources, as well as a few others, as a part of my treatment tools in working with children and teens who stutter.
The purpose of this paper is to explain the ways in which I have incorporated the Internet into fluency treatment with children. Basically, I have used Internet resources in four ways: 1) to provide information about stuttering, 2) to generate discussion about stuttering, 3) to provide an outlet for children to express themselves about their stuttering, and, 4) to provide information for parents of children who stutter. I’ll briefly describe and give some examples of each of these, and then turn it over to you, the reader, to share additional ideas with me and the other conference participants. I'd like for this to be an exchange of ideas, as I am still learning how to best use Internet resources.
The Internet as a source of information about stuttering
It is important to include a component of education about stuttering for children who stutter, no matter how young or old they may be. In the past, I have made the mistake of assuming that a six-year-old is too young to need to know much about stuttering, or that a teenager already knows everything they need to know about stuttering if they have a long history of previous therapy. However, over the years, it has become apparent to me that a client who understands their disorder and its treatment, whatever their age, has a better grasp of what can be accomplished in therapy and can be involved more actively in their treatment. Having had prior therapy does not always mean that a client is informed about his or her stuttering, so it is helpful to do some checking to see what each client knows about stuttering.
With that said, I could simply give my clients and their parents a home assignment to go surfing the Internet for information about stuttering. I have one thing to say about this suggestion; it doesn’t typically work (believe me, I have tried it). An unguided search often leads to a frustrated client or a poorly informed one. It can be difficult to locate the useful information that is out on the World Wide Web. Sorting out helpful Web sites from the considerable amount of useless information or misinformation that is available may overwhelm some people. In some cases, a child or their parents may not even attempt to do the assignment, as it may seem too daunting a task. Hence, I have discovered that I get the best results by going online with clients during some of our therapy sessions, usually for five-to-ten minutes at a sitting for younger children, and longer periods for teens.
I am currently seeing two clients, boys in the fourth and fifth grades, who both enjoy going online. On Judy's page "Just for Kids" (Kuster, 2000a), they particularly enjoy reading from the selections "FAQ's" (frequently asked questions), "Teasing", "Good stuff by and for kids", and "Things to think about". We read the item(s) that either they or I have chosen for that session, and talk about it. They frequently choose to read about other children's experiences with stuttering. Neither of them knows many children their own age who stutter, and they have commented that it is neat to learn that other kids have similar experiences to theirs.
My teenaged clients have enjoyed reading on similar topics, as well as other topics including learning about famous people who stutter, books and movies that include characters who stutter, and different therapy techniques. In addition to the information available for teens on the Stuttering Homepage (Kuster, 2000b), there are some good articles for teens available at the British Stammering Association website (British Stammering Association, 2000). As clients become older teens and move into young adulthood, the resources available on the Internet expand to include many of the resources that are geared to the adult reader. Once introduced to stuttering information on the Internet, some teens will take off and explore stuttering sites independently, outside of therapy sessions. This is something I encourage, and I ask them to bring any interesting sites that they find to my attention, so that I can familiarize myself with any information that I may not have seen previously, and discuss it with the client.
Generating discussion about stuttering
Sometimes, reading a short selection from the Internet can get a good discussion going between the client and the SLP. These can range from talking about what the client thinks caused their stuttering to a lively discussion about how to react to teasing. While discussion on a variety of topics can be brought up during therapy without use of the Internet, information gained while online provides another healthy source for generating discussion. It can also reinforce discussions that have gone on previously in therapy. For example, one of my school-aged clients has experienced teasing at school and from friends on a regular basis. We had talked about this on a number of occasions during therapy sessions, and he had pretty well come to the conclusion that he really didn't know how best to react to the teasing. We went online and read what other children said about their experiences with teasing, and how they react to it. It gave him some new ideas about how to react, and brought some other perspectives into our discussions. Recently, he has decided to incorporate several of the suggestions from the Web page. He loves the response submitted by Eva, who wrote that she says "You no-no-no-no-no-no-no-ticed?" when someone teases her, as well as Doug H's retort, "That's just one of the differences between you and me" (Kuster, 2000a). Next week, we plan to videotape several one-act scenes that he wrote, to test out the responses that he has decided to try if any teasing occurs when he begins attending a new school this Fall. This technique of 'making a movie' about stuttering is one of many great ideas presented by Bill Murphy (1996), and it will be a good way for my client to practice responding to teasing in a way that allows him to feel good about himself. My client is excited about doing the activity, and at the idea that he really can make a response to children who tease him. Using the Internet as a source in this case seems to have helped us over a hurdle in treatment.
Providing a creative outlet for clients to express themselves
Having an audience can be a good catalyst to encourage a child to communicate his or her feelings about their stuttering. There are numerous opportunities on Judy Kuster's Web pages for children and teenagers to say what they think. One of my younger clients enjoyed reading the section on Judy's "Just for Kids" page entitled, "Good Stuff By Kids Who Stutter" (Kuster, 2000a). A page in this section contains submissions by children where they tell readers something about their stuttering. This boy loved to read and have me read to him from the entries, so we visited this Web page on several occasions. When asked whether he would like to submit comments himself, he was excited about having his opinion right up there on the Web. We worked on what he wanted to say and, when he was satisfied with his article, we submitted it to Judy. He was so pleased to read his entry when it appeared on the Web page. His family did not own a computer, so we printed out a copy for him to take home. The next week, his mother reported that she had taped it to the front of the refrigerator, and that her son showed the article to anyone who came to the house. The activity was a real source of pride for this child, who had previously experienced little about his stuttering to be proud of.
Teenaged clients have some similar options for submitting responses to Judy's teen Web pages on a variety of topics (Kuster, 2000b). In addition, the Web site contains opportunities for teens to go to chat rooms dedicated to teens and college students who stutter, and there are opportunities for connecting with teens and college students who want to correspond with others about stuttering. A college student with whom I have been working decided to join the Stutt-L listserv, an online discussion forum, last spring. A clinician participating with older teenaged clients on a discussion forum can provide some interesting topics for discussion. In addition, if a client decides to move from being a "lurker" (one who reads the discussions but does not participate) to being an active participant, it can be a wonderful avenue for self-expression outside of the clinic setting.
Provide information for parents of children who stutter
A final way in which I use the Internet in therapy is to provide additional resources for the parents of my clients. I typically give them brochures and booklets, and loan out videotapes concerning stuttering. When parents have home computers with Internet access, I also encourage them to go to the Web pages that their child and I have visited in therapy, so that they can become familiar with that aspect of therapy. I make available to them Web sites for stuttering support groups, where they can access information and materials. Some of the sites that I refer parents to include those for Friends: The Association of Young People Who Stutter, the National Stuttering Association, and the Stuttering Foundation of America (see the reference list for the Web addresses). For parents who are highly motivated to gain information about stuttering on the Internet, I encourage them to start with Judy's Stuttering Homepage and branch out from there.
It is almost certain that you will encounter parents who are not terribly Internet savvy, but who are interested in having a look at what information is available online. Including them in a therapy session to look at some of the online resources with their child can be a good way to introduce them to the Internet. If they would like to search further, meeting with them outside of therapy to get them started can give them the confidence to investigate later on their own, either at home or at their local library.
Summary
The Internet provides some wonderful resources for both children and teenagers. Using the Internet as a part of therapy can help to facilitate a child's treatment program, and encourage them to move outside of the clinical setting to gain information and interact with others in a safe realm. I hope that this short paper has provided you with some ideas about how to incorporate information available on the Internet into treatment for children who stutter. I am interested in hearing your opinions and experiences regarding the Internet as a treatment tool and hope that some of you will share with me via the threaded discussion.
References
British Stammering Association. (2000). Information for teenagers and young adults. British Stammering Association Main Index. http://www.stammer.demon.co.uk/Web_Site/teens%20index.htm (14 August 2000).
Friends (2000). Friends: The Association of Young People Who Stutter. http://www.friendswhostutter.org/, (22 August 2000).
Leeper, L. H., & Gotthoffer, D. (2000). Quick guide to the Internet for Speech-Language Pathology and Audiology, 2000 Edition. Boston: Allyn & Bacon.
Kuster, J. (2000a). Just for Kids. The Stuttering Homepage. http://www.mnsu.edu/comdis/kuster/kids/kids.html (15 Aug. 2000).
Kuster, J. (2000b). Just for Teens. The Stuttering Homepage. http://www.mnsu.edu/comdis/kuster/kids/teens.html (15 August 2000).
Murphy, B. (1996). Empowering children who stutter: Reducing shame, guilt, and anxiety. Originally presented at the annual convention of the American Speech-Hearing-Language Association, Seattle, Washington, November 20-24, 1996, http://www.mnsu.edu/comdis/kuster/TherapyWWW/murphy.html (22 August 2000).
National Stuttering Association. (2000). National Stuttering Association Homepage. http://www.nsastutter.org/ (16 August 2000).
Stuttering Foundation of America. (2000). The Stuttering Foundation of America Homepage. http://www.stuttersfa.org/index.html (16 August 2000).