Reply – Re: Speech Therapy
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Re: Speech Therapy
— by Jack H. Jack H.
This discussion has been fascinating and I'm just now coming upon it. I have many thoughts to many points made but I'll just go for now with what it on the op of my head.

First off, a bit of back story: I am both a Person Who Stutters and a Speech-Language Pathologist. I have stuttered all my life and had good and bad experiences in speech therapy (which has run the gamut from fluency focused to avoidance, attitudes, and beliefs focused). I work as a SLP in a public school system in a rural school district. During my undergraduate and graduate studies I worked in a lab that asked questions about the connection between developmental stuttering, language, and emotions.

There are many SLP's who are also people who stutter. Some are very important figures in the field of stuttering. Any movement that seeks to re-frame or radically change the nature of how we treat stutering should have these voices heavily involved.

To look back at the opening question: "Is it possible to have speech therapy that doesn't also teach there is something wrong with your voice that needs to be fixed?" My short answer is a categorical yes. I think one of the foundations that make this possible is shifting the focus of your practice from a "medical" to a "solution focused" one. The medical approach sees a problem and attempts to fix it using varied strategies and tactics. Even more "inclusive" approaches like stuttering modification could be viewed as ways to fix a problem. Approaching therapy not with a problem to fix, but a solution to reach changes, in my opinion, a whole lot. Talking with your client about what they want to get out of therapy, seeing what their fears and hopes are can inform how you set your goals. During this whole process you can be both receptive to what they say, and frame it in a way that does not pit "wrong" speech against "right" speech. I agree that avoidance reduction and acceptance therapy are powerful tools are should be at the forefront of a SLP's agenda. I would also love to argue that incorporating some aspects of fluency shaping into therapy does not necessarily mean that we are attempting to "fix" broken speech. Robert Dellinger, on a StutterTalk podcast framed fluency shaping activities as a way of exploration. We pair it with voluntary stuttering, and education about the speech anatomy and physiology as a way of exploring what all we do when we talk. We should never as he puts it, "Impose fluency" on anyone.

I agree 100% with Brooke that there are a depressingly large number of our colleagues who treat therapy with PWS as working towards fluency and nothing else. I get mad as hell about it but I'm also glad at those moments I'm in this field as well so that I can try to change how they think about stuttering and working with those who stutter.

I could go one for a long time but I want to hear what others think.