In Patrick Campbell’s previous blog, he talks about the “common language we hear in and around speech and language therapy” and the “language of childhood therapy.” As the parent of a now-23-year-old who stutters, I never questioned what a therapist meant when they talked of “speech therapy.” This is a topic now on my mind daily as the founder of Voice Unearthed, the largest parent-support Facebook group for children who stutter. My mantra often becomes, “what do you mean by that?” A review of posts over just the past few days reveals a common use of technical terms that few parents question the true meaning of:
- ‘I referred my 7 yr old to speech and language’
- ‘My son has had his stutter since he was 4 and we have been receiving treatment since he was 5’
- ‘I’ve read that early intervention is always best’
We, as parents, assume that there is a common and trusted understanding of these terms among the professionals we turn to for support. However, these concepts can play out in remarkably different ways. For example, the term early intervention has many potential meanings depending on which therapist you speak to and their approach to therapy. Early intervention can mean doing nothing, counseling the parents on how to create an environment that best supports fluency or advising the parents on how to create an environment that promotes joyful communication regardless of fluency. As well as this, it can involve training the parent to praise the child’s smooth speech and point out bumpy speech, or teaching the child speech tools.
For many of us (including me in my younger days), it didn’t cross our minds to ask, “What do you mean when you refer to “early intervention?” What does that look like?” I now realize that the array of early interventions can range from very helpful to strategies that may cause life-long limitations, pain and struggle.
The language used by speech and language therapists helps create a narrative that suggests we would rather they did not stutter, or at least stuttered less. Take for example the commonly used idea that speech therapy can help a child learn to ‘manage’ their speech. This language suggests their speech is mismanaged and its preferred that they learned to control the behavior. But, what does “managing” speech look like? Do they need to make it stop? Make it happen less often? Make it easier? Should they think about what they’re going to say before they say it? Should they not think about it at all? Or think about it a lot so they can use those speech tools? Or pretend it doesn’t bother them? Any and all of these options continue to be promoted by many therapists in an effort to get a child to “manage” their speech. Many children, especially those who continue to stutter beyond seven years of age, will choose the safest, least shameful route to managing their speech and simply speak far less rather than risk disappointing themselves and everyone around them. Imposing a goal of “managing” speech on children can backfire – and often does, an outcome we experienced with our son and often shared by many parents within the Voice Unearthed Facebook group.
The technical language used by speech therapists can also contribute to a power imbalance between therapist and client. For example, after one of Eli’s therapy sessions, the therapist came out into the waiting room and happily announced, “He did great – I didn’t hear any schwa sounds!” All I could think of was, “I’ve never heard him say schwa.” With my son standing there and other clients waiting their turn in therapy, I maintained my sidelined cheerleader role and exclaimed, “way to go Eli!”. I now know that ‘schwa’ means a special vowel sound but that day I walked away still having no clue what ‘schwa’ meant and why it was so important. This is an example of how a service provider can maintain control over decisions and processes when using technical language and jargon – intentionally or unintentionally. We can quickly be silenced by this imbalance of power and knowledge, in part legitimized by institutional certification. We assume that their idea of ‘speech therapy’ is the right one and not saying “schwa” is a good thing.
Parents must learn to recognize the broadly-accepted yet empty language and jargon that often surrounds therapy for children who stutter. Pay attention to language, ask questions and take your time when deciding on what type of support, if any, might be best for you and your child. We must be discerning consumers – our kids’ well-being depends on it.
By Doreen (Dori) Lenz Holte