Parents as Partners in Young Children's Stuttering Treatment

Re: Child awareness

From: Anne Bothe
Date: 10/17/00
Time: 6:46:30 PM
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Hi, Robin! Two interesting questions -- let's see.....

1. Do I think children who are not aware of their stuttering should be made aware? The short answer for the little ones is no, primarily because I don't think it's necessary -- We have plenty of other things to spend time teaching them, so I wouldn't bother spending time on teaching a preschooler to be "aware" of his stuttering because I'd rather spend my time in activities that I can relatively confidently predict will just reduce his stuttering. On the other hand -- if you'd like to consider a procedure that says "uh-oh" after every stutter to be one that's going to make the child "aware" that he stutters, then I suppose I could say that all we're doing is making children aware of two kinds of speech (nonstuttered and stuttered), the same way a tennis coach points out flaws in your serve until you become "aware" of when you're doing it right and when you're not. For older children (as young as 5 or 6, or older, depending on lots of variables), I would only spend time explicitly teaching them to be "aware" of their stuttering if I had some self-evaluation goals for them or something -- which I have done. I don't think there is anything wrong or dangerous about letting children be aware that they have a thing that adults call "stuttering," if that is part of what you're asking, and I don't think that preventing them from ever hearing the word or ever becoming aware that they stutter will be an effective treatment -- there have been a couple posts on the "Professor is In" section of this conference about this general idea, and I agree with those who say that not labeling it or not letting kids become "aware" of it is an older idea, based on some older theories, that might actually lead to worries about "Oh, no, I have something so awful that we aren't even allowed to TALK about it!"

Anyhow -- Long rambling, I hope that answered your first question. Your second question was about whether our study took spontaneous recovery and "childhood disfluency that never really becomes stuttering" into account. We did, in a couple ways -- mostly, these children had all been unquestionably diagnosed as stuttering several months, if not years, before we met them, by other people. It's possible, yes, that our entire results are just one big history/maturation threat, and that each child who showed decreased stuttering just happened to show it some time after we introduced the different conditions we were comparing -- but we also controlled for that by having fairly nice long baseline data before we introduced any of the experimental conditions. The point you raise, in general, is a very important one for designing good studies about treatments -- designs that only do one quick pretreatment measure and one quick posttreatment measure, for example, might be at risk of overinterpreting a natural change in children's fluency. That's part of why I like single-subject experimental procedures, with all their multiple measures and rules about stability and all.

Thanks for your questions!

Last changed: September 12, 2005