7 Steps to Stuttering Desensitization

As high school SLPs, it is rare for a student who stutters to appear on our caseloads. As a result, it is a common feeling to doubt our abilities as an SLP when treating stutterers. A few years ago, we attended a PD and our entire view of stuttering therapy changed from what we learned in graduate school. This PD opened our eyes to the fact that stuttering therapy can be so much more than just aiming to decrease dysfluencies. Because the fact is, stuttering is more than just dysfluent speech. There are cognitive (thoughts and attitudes) and affective (feelings) components to stuttering and our therapy should also take these into account. Once we started working to change our students’ thoughts, attitudes, and feelings surrounding their, we noticed improvements in our students overall self-confidence and willingness to participate in academic settings. We started incorporating many different activities to improve the cognitive and affective components of stuttering, all of which are included in our fluency digital notebook. This is a great resource that we pull out whenever we work with a student who stutters. 

Desensitization to different speaking situations is one of the most effective non-speech stuttering therapy strategies we use and love with our students. Research has shown that programs which focus more on social-emotional topics and desensitization improved the attitudes of school-age children who stutter toward communication and their perceived ability to make friends. Desensitization strategies help speakers systematically desensitize themselves to their fears about speaking and stuttering by facing those fears in structured, supportive environments. We have seen a lot of success when we help our students desensitize to various speaking situations. The absolute best part is that the students feel a sense of empowerment when they conquer their fear. 

Here are the 7 steps you can follow to help your student desensitize to a speaking situation:

1. Create a list of every speaking situation  – Have your students brainstorm a list of every speaking situation and speaking partner they encounter in their lives. Some common speaking situations that could cause fear might be ordering at a restaurant, making an appointment over the phone, or speaking in class. Some common speaking partners that may cause stress could be talking to teachers, unknown people, or the principal. 
2. Rank the speaking situations– Have your students then think about which situations cause the most stress and fear. Write them in a new list in order from easy to hard. 
3. Choose a situation and write a script – Students look at their list and eliminate situations where they communicate with ease. As they get to the situations that cause them more stress, choose one to start working on. Help your students write a script to help prepare for the situation. They will write down everything they will anticipate saying as well as possible responses from the other speaking partner. 
4. Practice role playing the script in the therapy room – You and your students then practice reading through the script together. Practice until your student feels confident and self-assured in their ability to engage in a conversation.
5. Engage in real speaking situation – This might mean making a phone call, taking a walk to visit an unfamiliar teacher, or speaking in a classroom environment and reporting back. Of course, there are some situations in which you will not be able to be there with your student (i.e. a restaurant or store), but you can still have them engage in the situation and report back the next therapy session.
6. Debrief – This is essential!! Have your student reflect on their behaviors and emotions before, during, and after speaking. How did they feel? What was the outcome? You may even choose to have them journal this or write it down so you can refer to it later. 
7. Create a plan for more practice – choose a new situation (move to another situation on the list that is harder) or re-do the same one for more practice. For example, if your student doesn’t like making phone calls and they called a nail salon to ask some questions, have them call a different salon for more practice.

Desensitizing to speaking situations is just one of the many ways you can help support your students who stutter. By following these steps, you will feel confident in your ability to work with stutterers. If you’re looking for more activities for stuttering therapy, check out our fluency digital notebook here.