Stuttering can become a lifelong part of talking for some people. However, it does not have to interfere with your child’s ability to make friends, participate in the classroom, make good grades, form lasting relationships, or achieve career goals.
Deciding whether to take your child to speech therapy can be a difficult decision, however. Many parents are concerned that taking a child to therapy will increase his or her awareness of the stuttering and thus have a negative effect, or are unsure about the best time to start their child in therapy especially when they get conflicting advice about whether to “wait and see” versus take action. Adding to the confusion, research suggests that as many as 70% of all children who start stuttering will outgrow it on their own with no speech therapy. But, research also indicates that if a child has been stuttering longer than one year, the likelihood that he or she will outgrow it without any speech therapy is reduced.
Unfortunately, there are no firm guidelines about the best time to start therapy although most speech-language pathologists will recommend starting therapy within 6-12 months after you have first noticed the stuttering. One thing we do know, though, is that all children can benefit from therapy, although the outcomes are different for different children.
As a result of speech therapy, some children are able to eliminate stuttering completely. Others learn strategies that help them stutter less, while yet other children learn to talk in a way that is easier and less tense even though some stuttering is still noticeable. Most importantly, all children can learn to become more confident in their speaking skills no matter how much stuttering they may still have.
Deciding to take your child to stuttering therapy is an important step in helping your child. Once you have made this decision, getting information about stuttering and stuttering therapy will help you decide:
- The speech-language pathologist who is right for you and your child;
- The amount, length, and cost of treatment;
- Possible goals for speech therapy; and,
- The amount of success to be expected.
Special Education Law & Children Who Stutter
A child who stutters may be eligible to receive speech therapy for free from the local school district. A federal law, the Individuals with Disabilities Education Act Amendments of 1997 (IDEA, P.L. 105-17) mandates that state education agencies and local school districts provide special education services to children ages 3-21 who need them in order to receive a free, appropriate public education (FAPE). Speech therapy is considered to be special education. Even though IDEA is designed to provide a free, appropriate public education, children attending private schools are covered under the law too. There are several differences in how the services are provided but even if your child attends a private school, he or she may be eligible to receive free speech therapy from your local school district.
To help you better understand special education law, we provide a basic explanation on how children are identified, screened, evaluated, determined to be eligible for services, and how speech therapy plans are developed for each child. Other considerations are briefly addressed such as parental consent and your rights. Differences in these processes for children who are enrolled in private schools are discussed. Then, speech therapy options are presented for children who are ineligible for services from the schools.
The first step in the special education process is to identify children who need services. IDEA requires that school districts locate, identify, and evaluate children with disabilities. This process begins by screening children for potential disabilities. If your child attends elementary school, his or her teacher may recommend your child be screened if there are concerns about the way he or she talks. You may also ask the teacher to have your child screened.
If your child is in preschool, you can contact your local school district and ask that your preschooler be screened for stuttering. In the phone book, look under “Special Education” in the listings for the school district’s administrative offices or superintendent’s office. Second, your pediatrician may make a referral to the local school district because of concerns about your child’s talking. Third, under IDEA, each school district has to have a specific plan for finding children who have disabilities so that they may receive appropriate services early. Some school districts meet this requirement by advertising in the local paper a regularly scheduled screening day once a month that you and your child can attend.
Screening for a child who may stutter usually includes a few key steps. Your child may be screened by one person who will collect information and report back to a team of professionals. Or, if you take your child to a local screening day, several professionals may see your child. You will be asked about your child’s general development, your current concerns about your child, and general information about your family. Then, the person or team will spend time playing with your child, listening to his talking, observing how he plays with toys, and how he interacts with others. They may use a checklist that lists specific behaviors for observation to guide the screening.
After the screening, a team of professionals such as a speech-language pathologist, a school psychologist, a special education teacher, or a school nurse will meet to discuss your child’s screening results. If the team decides that further evaluation is necessary, you will be contacted and the team will share the screening results with you. They will request your permission to schedule a comprehensive evaluation. Your child cannot be evaluated without your written consent.
IDEA requires that the school district conduct a comprehensive evaluation that is tailored to determine whether your child’s stuttering makes her eligible for speech therapy. This means that the school district will have a speech-language pathologist evaluate your child’s overall communication skills. The law also requires that school districts get input from parents and that parents be on the team that makes the final decision regarding eligibility. Plan on telling the speech-language pathologist when your child first started to talk, when you first noticed her stuttering, whether it has changed over time, how her talking changes in different speaking situations or with different listeners, and whether there is a history of stuttering in your family. Also be prepared to tell the SLP about your child’s interests, hobbies, and other activities outside of school.
Is My Child Eligible For Speech Therapy?
After the evaluation, a team will meet to determine whether your child is eligible for speech therapy. This is decided by comparing your child’s evaluation results to guidelines developed by your local school district. The team making this decision consists of you, the speech-language pathologist who evaluated your child, and someone from your local school (either a preschool teacher, your child’s classroom teacher, or an administrator). Other individuals may be involved as necessary and appropriate.
The eligibility decision is based on (1) the testing results from the evaluation, (2) how these results compare to the eligibility guidelines used by the school district, (3) your input, (4) how your child’s stuttering affects him in school, and (5) the team’s opinions regarding whether your child would benefit from therapy.
If your child is eligible, an Individual Education Plan (IEP) will be written within 30 days. If your child is not eligible, you must be notified why in writing. You must also be given information about what to do if you disagree with the team’s decision.
The Individualized Education Plan (IEP)
The IEP is a document developed by you and the school to lay out the therapy plan for your child. It also specifically states what services your child will be receiving. It is developed with your input, input from your child’s teacher, and from the special education team member(s) who will be working with your child. For stuttering, this is typically a speech-language pathologist.
Certain types of information must be included on every IEP: (1) a statement about your child’s present level of educational performance, (2) your child’s annual speech therapy goals, (3) what services will be provided and who is responsible for providing them, (4)the amount of time your child will receive services each week, and (5) how progress will be measured.
The IEP is written one year at a time and is developed at a meeting that you attend with the school personnel. You must also give consent for the IEP to be used – your child cannot be placed in speech therapy without your consent. At least once a year, a meeting will be scheduled to review your child’s progress towards his goals and to determine whether new goals need to be written or services need to be changed. The IEP is a flexible document. If your child’s needs change before a year has passed, the current IEP should be modified at a new meeting.
If you do not agree with the team’s recommendations regarding eligibility or placement, there are certain steps you can take to have the recommendations reviewed by an outside person or have your child independently evaluated by another professional. You can also bring an advocate with you to any meeting. For example, if you are paying a speech-language pathologist in private practice to treat your child, you can bring her to school meetings to help plan your child’s public school therapy.
Children attending private school
If your child attends a private school but needs speech therapy, the local public school district is still required by IDEA to identify, evaluate, and provide services that are provided to children attending public schools. The main differences for children attending private schools vs. those attending public schools are in how services are delivered and the replacement of the IEP with a “Service Plan.” For example, instead of a speech-language pathologist coming to your child’s school to provide stuttering therapy, your child may have to walk to the closest elementary school for therapy. The Service Plan is similar to the IEP in many ways in that it will establish annual goals for your child and specify the kinds of services your child will receive. Personnel from your child’s school are invited to help determine your child’s eligibility for services and to help develop your child’s Service Plan.
If My Child Is Ineligible
Sometimes even if your child is stuttering, he or she may not be eligible for free speech therapy through the public schools. This does not mean that you cannot get therapy for your child; instead, you will have to find a speech-language pathologist who works in a clinic or private practice to see your child. You will also have to either pay for therapy yourself or have it billed through your health insurance. For information on finding a speech-language pathologist who specializes in stuttering, click here. You can also look in the yellow pages under “Speech Therapy,” or under your local hospital’s “Outpatient Services” department. For guidelines on obtaining insurance coverage for stuttering treatment, click here.
Choosing a Speech-Language Pathologist
The key to success with any kind of treatment is finding someone who is knowledgeable about that particular treatment. This is especially true of stuttering.
How do you find a speech-language pathologist (SLP) who is right for you and your child? First, learn as much as you can about stuttering so you will know whether the SLP you choose is also knowledgable about childhood stuttering. You may even want to read more about stuttering therapy. This website offers information about stuttering and stuttering therapy, as do many of the products we offer to families.
Also, use a referral source. Our list of therapists has names of people who specialize in treating stuttering. If one is not located near you, contact a local university, hospital, or speech and hearing clinic. Universities that have training programs in speech pathology often have a speech clinic that will provide therapy for stuttering.
Your local school district is required by federal law (IDEA) to offer speech therapy to children who are eligible. Contact your local school district’s special education department to find out more about having your child screened and evaluated for stuttering.
Once you’ve contacted a speech pathologist, interview them. There are many important questions you will want to ask, but a few in particular are very important.
- How comfortable are you with evaluating and treating stuttering? This is important because some speech pathologists are not comfortable working with stuttering.
- How many children who stutter have you worked with? This will help you determine whether the speech pathologist has the kind of experience you need.
- What do you think the primary goals of stuttering therapy should be for a child? This will help you decide whether the speech pathologist’s ideas about goals match your own.
- What approaches do you use in speech therapy? How often is therapy scheduled? It’s important that the therapy be scheduled at a time that will work well for you, your child, and the SLP. Sometimes the therapy schedule the speech pathologist offers will not work for you because of your job, your child’s naptime, or other family commitments. Getting to therapy should not be extremely inconvenient or stressful.
- What do you believe the parents’ role should be in speech therapy? For most children, the degree of success they will experience in therapy is directly related to the amount of support they receive from their families in making necessary changes. Finding a speech-language pathologist who believes that you have a crucial role in therapy and is willing to help you learn how to best help your child is an important part of this process.
Therapy Amount, Length, and Cost
The amount of stuttering therapy needed and length of time involved are related to each other and are usually different for each child. The decision about how much therapy is needed and how often it should be scheduled is usually made following a stuttering evaluation.
If you seek services through your local school district and your child is found eligible, the evaluation and any needed therapy will be free. However, if you seek services from a speech pathologist in private practice or working in a clinic, you will have to pay yourself or have services billed through your insurance. A thorough evaluation usually ranges from two to four hours and may cost between $300 and $500, depending on your location and the speech pathologist’s charges. These charges can vary greatly, so be sure to ask about costs when making the initial call to the speech pathologist. Also, check to see if your health insurance covers the cost of the evaluation. (You may want to read SFA’s Guide to Obtaining Reimbursement for Stuttering Treatment.)
Once you’ve completed the evaluation process, the speech pathologist will explain your results to you and together the two of you will begin thinking about the length of time that you can expect your child to be in therapy and how often it should be scheduled. Therapy length and amount needed depend on your child’s needs, the type of therapy itself, and the severity of the stuttering problem.
Hourly therapy charges generally range from $50.00 to $125.00 dollars. Again, these charges will depend on your location and the speech pathologist’s charges per hour; local university speech and hearing clinics often charge less because of their training mission. At many university programs, it is possible to get an evaluation and therapy at lower rates than those listed here. However, if your child is receiving therapy through your school district, there will be no charge.
If you take your child to speech therapy with a speech-language pathologist working in private practice or through a local clinic, contact your insurance company before you get an evaluation or go for therapy to find out whether they cover stuttering therapy. It’s important to ask about stuttering therapy in particular because many insurance companies will pay for speech therapy that is restorative (i.e., after a stroke or brain injury), but may not pay for stuttering therapy when it’s viewed as a chronic speech disability.
Expectations for Success
We hear from many parents who are concerned that stuttering therapy may not help their child. If your child has stuttered longer than a year, it is less likely that the stuttering will ever go away completely. However, a speech pathologist who is knowledgeable about stuttering can almost always help children who stutter make positive changes in how they talk.
As you work with the speech pathologist to meet your child’s goals, you will also set your criteria for success. Becoming an effective communicator and living successfully with stuttering should be among the most important of these criteria.
Goals for Therapy
Stuttering therapy for children usually means learning to talk in an easier manner, and to build positive emotions, and attitudes about talking. As a result, length and type of therapy can vary greatly depending on your child’s needs. A list of sample therapy goals for children includes:
- Reducing the frequency of stuttering;
- Decreasing the tension and struggle of stuttering moments;
- Working to decrease word or situation avoidances;
- Learning more about stuttering; and,
- Using effective communication skills such as eye contact or phrasing.
Working together with a speech pathologist who is knowledgeable about stuttering will help your child learn to talk successfully and well.
source : http://www.stutteringhelp.org/
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