When to Introduce Fluency Therapy into Your Articulation Treatment Plan

Question

If an SLP has been seeing a preschooler for articulation therapy and notices some disfluencies arising what is the best way to introduce the topic to the parents if they have not indicated any concern? 

Answer

I think that I would just be really direct with the parents about it.  I think that I would say, “As we have been going through therapy I have been seeing some disfluencies in your child’s speech.   Sometimes children exhibit normal developmental disfluencies.  At other times, the disfluencies make us a little more concerned about possible stuttering.  If we see phrase repetitions or interjections without any tension or secondary behaviors, we would be less concerned about that.  If we see any disfluency with tension or negative reactions, we would want to target those more quickly, especially if there is a family history of stuttering.  I would ask the parent to please monitor the disfluencies at home and let me know if they are seeing any signs of increased stuttering.  It is really important, too, if you have a child that you're working on articulation or language abilities and they start to stutter, you have to change your approach a little bit because doing a lot of direct drill therapy all the time isn't a great thing.  We have to create a lot of opportunities for them to use the strategies and techniques and respond and use the sound targets and language targets without doing a lot of drill work.

Craig Coleman received his Bachelor's and Master's degrees at the University of Pittsburgh. He has served as President of the Pennsylvania Speech-Language-Hearing Association (PSHA) and on the Legislative Council of the American Speech-Language-Hearing Association (ASHA). Craig currently serves as a Clinical Coordinator in the Department of Audiology and Speech-Language Pathology at Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center.