The School Age Child Who Stutters
Stuttering Foundation of America, 1997-8

This 38 minute video is said, on its sleeve, to be an excellent resource and teaching tool for Speech and Language Therapists as well as teachers, parents and physicians However, its content is specifically directed at therapists working with dysfluent children.

The presentation is a mix of "live action" of prominent American therapists working with dysfluent children, and explanations and narration of these therapy session snippets to demonstrate points throughout the video.

Examples are shown of four different dysfluency types: repetition of words, repetition of sounds/syllables, sound prolongation and blocks. These are shown by excerpts from therapy sessions where children are dysfluent in these ways. Each excerpt is repeated and the dysfluent word is shown on screen. A few examples of each dysfluency type are shown. Similarly we see sessions with children where feelings about their dysfluency are expressed and therapists are encouraged to "listen, reflect and clarify". This section acknowledges, among other issues, a common feeling of frustration at not being able to say what they want to say when they want to say it. It is suggested that feelings can change as children modify speech and become more open about their dysfluency.

Then the "treatment" section, by far the bulk of the video (approximately 25 minutes), is introduced. The importance of considering individual differences in children and tailoring therapy to meet individual needs and abilities is stated, and also that the video can only show some of the fundamental aspects of therapy.

Therapy is described in three "different but inter-related parts" - exploring and identifying speech and stuttering; changing or modifying speech and stuttering; and transferring changes to everyday speech situations.

The session excerpts give a number of ideas of how to work through therapy, e.g. recognising smooth versus bumpy speech in the therapist and then in the child, varying the stuttering, experimenting with different modification ideas, and transferring skills to other situations. Breaking these down and giving examples and descriptions is a useful learning tool. However, there seemed to me to be quite a jump from the modification ideas within therapy to the transfer situations. This is the period of potential breakdown in any fluency shaping or modification programme and could perhaps have been addressed in more detail.

I was also aware that throughout the "treatment" there was no reference to any ongoing exploration of the child's feelings, nor about differences and potential avoidances in different speaking situations. This would also seem to me to be crucial in the transfer of modification ideas in any functional way. It was stated that the transfer phase was ongoing when regular sessions cease. Communication with parents and the importance of them being an active part of the therapy process is commented upon but not shown in session excerpts.

The goal of therapy is said to be to give children strategies to enable them to be more comfortable talking and to communicate well in everyday life.

The video is generally well presented and informative.

Applying the ideas to the individual needs of dysfluent children requires a knowledge of the therapy rationale and of all the issues involved. However, this video could be useful for therapists to view and discuss with colleagues and could also be a positive resource in the training of student Speech and Language Therapists

Reviewed in the Spring 1998 issue of 'Speaking Out' by Melanie Wilson, Specialist Speech and Language Therapist, Sunderland, UK.

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