Question
Should I do traditional treatment for a student who says his stuttering is not bothering him?
Answer
If you have a child who is not experiencing adverse impact in his life, in my opinion, he does not belong on your caseload. I know the parents want him on the caseload. The parents want him to work on it, but in my opinion, there is a risk of putting a child who has no problems on your caseload. He is going to be in therapy, but he is not actually going to be doing anything. Why would he work on his speech if his speech does not cause him a problem? What I would do personally, and I have been in this situation many times and work with other clinicians who are, is administer the OASES. I document the fact that the child is not experiencing any adverse impact. If you are in the schools, if there is no adverse impact, then you will not be able to treat him. Of course, the parents can force you to treat him. Unnecessary treatment is always cheaper than due process. I would document that there is minimal adverse impact. The OASES may actually help uncover areas where stuttering is affecting him that he might not have fully understood were associated with his stuttering. That helps me target my treatment to those issues and to focus on that. Then I will say to the child, “I can see your stuttering is not affecting you here, here, and here, but I notice you are doing a little avoidance. Why don’t we just focus on that in treatment?” Once the child sees that he has a reason to work on his speech, you get much greater compliance, much greater motivation in therapy. Targeting the therapy to what is important from the child's perspective, from the adult’s perspective, from the speaker’s perspective, makes our treatment more focused and much more effective. I might treat them, but I also might not. I just want to make sure that I am treating the right thing.
J. Scott Yaruss, PhD, CCC-SLP, BRS-FD, ASHA Fellow, is an associate professor of Speech-Language Pathology at the University of Pittsburgh. He is author, co-author, or editor of several booklets, books, and brochures on stuttering, including the Overall Assessment of the Speaker’s Experience of Stuttering (OASES; Pearson), as well as School-age Stuttering Therapy: A Practical Guide and Minimizing Bullying: A Guide for SLPs (Stuttering Therapy Resources, Inc.).
