Purpose: The purposes of this tutorial are (a) to critically review the ways in which stuttering therapy and research are both constrained by and resistant to ableism and (b) to offer practical suggestions for further interrupting stuttering-related ableism in the discipline of speech-language pathology. Method: At the beginning of the tutorial, the concept of ableism is introduced and the effects of ableism on people who stutter are discussed. Following an overview of the discipline's current strengths in resisting ableism associated with stuttering, five practical suggestions for further interrupting ableism are provided. To illustrate how these suggestions might be enacted, real and hypothetical clinical and research scenarios are presented throughout. Although this tutorial draws heavily on the experiences of adults who stutter, many of the concepts are also relevant to kids and teens who stutter. Conclusion: Speech-language pathologists can be change agents in interrupting ableism associated with stuttering and powerful allies to people who stutter.
Purpose: The purpose of this study was to explore experiences with concealing stuttering in children and young people who stutter based on recollections from adults. In addition, we explored how school-based speech therapists can be helpful or unhelpful to children who are concealing stuttering from the perspective of adults who stutter. Method: Thirty adults who stutter, who previously or currently conceal stuttering, participated in semistructured interviews exploring their early experiences with hiding stuttering. Purposeful and random sampling was used to diversify experiences and opinions. Reflexive thematic analysis was used to develop themes and subthemes to describe participants' experiences. Results: All participants in the study reported beginning to conceal stuttering at 18 years of age or younger, with more than two thirds sharing that they began in elementary school. Participants reported that exposure to implicit and explicit ableist messaging about stuttering and traumatic social experiences at school contributed to their inclination to hide disfluencies. Many participants described concealment as a strategy for protecting themselves from stigma. Several participants condemned fluency shaping, calling it harmful and likening it to teaching concealment. Participants believed that speech therapists could be helpful by promoting safe and supportive school environments and by being responsive to the social and emotional challenges that can accompany speaking differently and navigating stigma at school. Conclusions: Some children who stutter may attempt to protect themselves from stigma by concealing their disfluencies, but doing so can feel isolating and confusing. Speech therapists can play an important role in making the school environment safer and more supportive for children who stutter.
Purpose: The aim of this study was to document the behaviors that adults who stutter (AWS) may engage in to make positive changes to living with stuttering. Method: We interviewed 23 key stakeholders, including 11 AWS and 12 speech-language pathologists who specialize in stuttering therapy. The semi-structured interviews began with the primary question, “If an adult who stutters was making positive changes to living with stuttering, what would they be doing?” Follow-up probing questions focused the interviews on identifying actionable behaviors that would suggest positive changes. The interviews were transcribed and qualitatively analyzed using applied and reflexive thematic analyses to develop multilevel themes. Results: Meaningful units extracted from the interviews contributed to three high-order global themes: (a) noticing and adjusting physical behaviors involved in speaking, to the extent that it is personally important to do so; (b) developing neutral or positive thoughts and feelings about stuttering; and (c) participating more fully in social and professional activities, even if the person stutters or thinks they might stutter. We developed 35 low-order basic themes, which we grouped into 11 mid-order organizing themes, to richly illustrate the three global themes. Conclusions: These findings extend the ongoing discussion regarding best practices for therapy targets in stuttering intervention. We identified measurable, multidimensional actions that clinicians can integrate in their therapy plans with AWS. While these actions represent a holistic approach to making positive changes, it grants clients and clinicians space to develop individualized intentions and outcomes.
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