Facilitating Parental Involvement in Therapy of the Disfluent Child

Abstract

This article reflects a behavioral orientation that assumes that people have the capacity to control, direct, and change their thoughts, feelings, and behaviors, and that change requires systematic, stepby-step action. The basic goals for parents, consistent with this assumption, are to identify and replace their thoughts, feelings, and behaviors that support the development of disfluency with those that are supportive of fluency. Although parents are typically not the "cause" of their child's disfluent speech, they are part of the environment that maintains it. Once parents know that they can do things that will help, it is their choice and responsibility to make any changes. Parents are viewed as powerful change agents at all stages of intervention in the management of the disfluent child. Three stages can be defined: managing the preschool age child from 2.5 to 5 years old; managing the school-aged child from 6 to 12 years old; and managing the adolescent from 13 to 17 years old. Although the needs of children and the roles parents will be called on to play within each group are similar, each child's personal environment is unique and must be seen as such. This article will focus on home intervention strategies for the preschool age child designed to prevent the development of a chronic stuttering problem. Speech pathologists working with disfluent children often feel uncertain about how to proceed. This is understandable when you consider the variety of conflicting theories and therapeutic methods that exist. It is even more understandable when you consider that there is a striking lack of research using children for the subject population. For example, in a review of the literature on stuttering from 1967 to 1977, Sommers and colleagues (1979) found that subjects 15 years old and younger comprised only 20 per cent of all who were studied when averaged over the 10-year period, whereas the average percentage of 5-yearolds and younger was only 3 per cent. Recently, Silverman published an exhaustive bibliography of clinical, experimental, and theoretic publications pertaining to children between the ages of 5 and 12 years (1978) and to children 5 years old and younger (1979). Altogether, 695 reports are listed. Considering that he took his literature search as far back as the 1890s and that he included Dissertation Abstracts, dsh Abstracts, Psychological Abstracts, and the ERIC and MEDLINE computer data bases, this number is surprisingly low. Moreover, the quality of this available information must be considered.