by Keri Spielvogle, M.C.D., CCC-SLP
Have you ever worked with a dysfluent child who refused to talk? This is not uncommon among children with fluency disorders, especially ones who are aware of the disorder. These children may already be feeling the shame and embarrassment sometimes associated with this speech disorder and are beginning to avoid speaking situations. Sometimes, the child holds an intense dislike for speech therapy, with negative feelings that "it won't help," especially if therapy was unsuccessful in the past.
This poses a significant challenge for a clinician trying to elicit smooth and easy speech from a dysfluent child. How do you get a child to talk when she/he dislikes or is embarrassed to speak? A lot of times the easiest way to get a child to talk is to find out what she/he likes and use this as a therapy tool. If you need some ideas, follow the suggestions below.
The child won't tell me what she/he likes.
Sometimes it is up to the clinician to find out what the child likes. The parents are always a valuable resource. Ask them for their advice, but also try other things to stimulate the child and to find out if she/he has interest in other areas.
Some children love to read, especially the younger ones. Avoid reading the text to the child. Elicit spontaneous speech by letting the child tell you what is happening on the page. Even if the child quickly goes through a book, talk about the book with the child when you are finished. Try to relate the book to the child's life. For example, in a book about a terrible, horrible, no good, very bad day, you could ask the child about a bad day she/he recently experienced. Encourage language development by incorporating different parts of speech, such as adjectives, adverbs, irregular verbs, etc.
Children who are visual learners sometimes respond well to CDs/DVDs. There are many different types of CDs/DVDs to choose from to engage the child in spontaneous speech.
Boys, especially, respond well to sports. The best way to incorporate this into fluency therapy is to find out what sport(s) the child likes to watch and his/her favorite team(s). Then, record the games on television and use them in therapy. Donít worry if the child has already watched the game; this presents a better opportunity to elicit spontaneous speech. Turn down the sound and allow the child to tell you what is happening, incorporating his/her speech techniques.
Television shows that incorporate music and dance often engage a child. Again, allow the child to tell you what is happening using smooth and easy speech.
Watch cartoons with the sound down. Let the child predict what will happen at the middle and end, and ask the child to retell the story to you using slow and easy speech.
Ask the parents to bring in family pictures, including those of siblings and pets. Look at the pictures with the child, allowing him/her to narrate the events in the pictures using slow and easy speech patterns.
Playing games with children often elicits spontaneous speech. There are many different games to choose from, those targeting fluency goals and those that are available to the general public.
Many games offer simulated speech, giving positive feedback or commands (similar to "Simon Says"). Allow the child to interact with this, giving you directions using slow and easy speech patterns.
Children usually like to play guessing games. Barrier games are a great way to elicit spontaneous speech, and have some fun too. Encourage slow and easy speech patterns when giving clues and answers.
Cards are great to use, but the game must encourage spontaneous speech. A great game to use is Old Maid, encouraging the child to describe the desired card using many describing words.
There are games available developed by professionals to target fluency goals. Use these according to the directions, but feel free to modify with accordance to the needs of your child.
Hopefully, you will be able to use some of these ideas in your therapy sessions to allow your child to practice smooth and easy speech techniques.