Question
I just began to work with an adult with a very strong stuttering (sometimes till 30 seconds before saying a word, with totally no eye contact and very contracted muscles). He was a short time with a speech therapist when he was a teenager but till now he
Answer
Many times, the challenge of working with adults who stutter is to help them overcome years of negative reactions to stuttering. In this case, you have several hurdles:
I would start by focusing on the reactions rather than the fluency. Teaching this man all the techniques in the world will not make him perfectly fluent. So, the first step has to be learning to deal with his stuttering. Maybe help him find a support group for adults who stutter. Also, have him confront his fears about speaking situations, if this is an issue.
It is important to understand that personality does not cause stuttering. Stuttering is a multi-factorial disorder, meaning it is "caused" by a number of variables. You can help him understand that, while is personality didn't cause him to begin stuttering, it can help make it better or worse. You describe him as being out of control. I'm not sure exactly what you mean by that, but stuttering is, essentially, a loss of control on many levels.
I would really ensure that this man and his family learn all they can about stuttering. If he is 60, and just seeking help now, my guess is that there has been a pretty fair amount of avoidance on his part. You'll have to work through that with him and help him face situations and face the fact that he is a person who stutters.
I would make sure he understands that even when he uses the speech modification (e.g. reduced speaking rate, easy onsets) and stuttering modification (e.g. cancellations, pull-outs) techniques, he is still going to stutter. Using these strategies can be very hard. He should view them as tools that he can use if he wants to, rather than tools that he has to use all the time.
Craig E. Coleman is a Clinical Coordinator at Children's Hospital of Pittsburgh and Co-Director of the Stuttering Center of Western Pennsylvania. He received his Bachelor's and Master's degrees at the University of Pittsburgh. Craig is a member of the National Insurance Advocacy Initiative and Chair of the National Stuttering Association's Insurance Advocacy Committee. In addition, Craig is an elected member of the ASHA Legislative Council.
Craig Coleman
Related Courses
1https://www.speechpathology.com/slp-ceus/course/ripple-effect-stuttering-community-based-9217The Ripple Effect of Stuttering: A Community-Based ApproachThis is Part 2 of a four-part series. The stuttering experience has a ripple effect that extends far beyond the child who stutters. Parents, teachers, peers, and others must possess both knowledge and skills to best support children who stutter. This course will highlight new clinical tools and resources to provide a community-based treatment approach for stuttering. (Part 1 - Course 9278, Part 3 - Course 9301, Part 4 - Course 9304)auditory, textual, visual
This is Part 2 of a four-part series. The stuttering experience has a ripple effect that extends far beyond the child who stutters. Parents, teachers, peers, and others must possess both knowledge and skills to best support children who stutter. This course will highlight new clinical tools and resources to provide a community-based treatment approach for stuttering. (Part 1 - Course 9278, Part 3 - Course 9301, Part 4 - Course 9304)
2https://www.speechpathology.com/slp-ceus/course/creating-allies-and-developing-advocacy-9223Creating Allies and Developing Advocacy Skills in Stuttering TherapyThis is Part 3 of a four-part series. This course will focus on specific strategies for involving parents/caregivers in stuttering therapy, and promoting self-advocacy skills among clients who stutter. Through the use of case studies, the speakers will problem-solve obstacles commonly faced by speech-language pathologists when addressing these important aspects of therapy. (Part 1 - Course 9278, Part 2 - Course 9286, Part 4 - Course 9304)auditory, textual, visual
This is Part 3 of a four-part series. This course will focus on specific strategies for involving parents/caregivers in stuttering therapy, and promoting self-advocacy skills among clients who stutter. Through the use of case studies, the speakers will problem-solve obstacles commonly faced by speech-language pathologists when addressing these important aspects of therapy. (Part 1 - Course 9278, Part 2 - Course 9286, Part 4 - Course 9304)
3https://www.speechpathology.com/slp-ceus/course/best-practices-for-stuttering-assessment-9225Best Practices for Stuttering Assessment and Treatment Including the Role of Support GroupsThis course is Part 4 in a four-part series. It will provide an overview of stuttering peer support communities and the clinical importance of incorporating community experience into therapy. Current research and practical application questions will address goal writing, SLP roles and responsibilities, and common challenges connecting therapy to the community. Case studies will be shared to highlight assessment and treatment across various age ranges. (Part 1 - Course 9278, Part 2 - Course 9286, Part 3 - Course 9301)auditory, textual, visual
This course is Part 4 in a four-part series. It will provide an overview of stuttering peer support communities and the clinical importance of incorporating community experience into therapy. Current research and practical application questions will address goal writing, SLP roles and responsibilities, and common challenges connecting therapy to the community. Case studies will be shared to highlight assessment and treatment across various age ranges. (Part 1 - Course 9278, Part 2 - Course 9286, Part 3 - Course 9301)
4https://www.speechpathology.com/slp-ceus/course/20q-early-childhood-stuttering-less-897820Q: Early Childhood Stuttering: Less-Direct and More-Direct TreatmentThis course addresses key issues in the treatment of early childhood stuttering, with a focus on less-direct and more-direct treatment approaches. The course will discuss ways that clinicians can draw upon various approaches to develop individualized treatment so that each child’s and family’s individual needs are addressed.textual, visual
This course addresses key issues in the treatment of early childhood stuttering, with a focus on less-direct and more-direct treatment approaches. The course will discuss ways that clinicians can draw upon various approaches to develop individualized treatment so that each child’s and family’s individual needs are addressed.
5https://www.speechpathology.com/slp-ceus/course/ethical-considerations-when-working-with-8991Ethical Considerations When Working with Those who StutterThis course will discuss how the stigma of stuttering, advocacy, empathy, caseload management, and the structure of various settings in which we work (e.g., schools, medical settings, university clinics) impact our work with people who stutter, across the lifespan. Case scenarios involving ethics and stuttering will be presented for participants' consideration.auditory, textual, visual
This course will discuss how the stigma of stuttering, advocacy, empathy, caseload management, and the structure of various settings in which we work (e.g., schools, medical settings, university clinics) impact our work with people who stutter, across the lifespan. Case scenarios involving ethics and stuttering will be presented for participants' consideration.
