Parent-Child Interaction therapy (PCI) is enough for many of the younger children. But for these older children, who may have been stammering for a longer time, additional therapy sessions are often necessary.
The first part of therapy uses a modified form of parent child interaction therapy which we call Family Interaction. As we have said before, we know that parents don't cause their child to stammer, but we also know that the family can have a really positive impact on helping the child who stammers.
So these sessions are aimed at getting a better understanding about the communication styles that are particularly helpful for enhancing a child's fluency and, conversely, those that may be affecting the stammering. Video tape feedback is a really concrete way of identifying different styles of interaction and of practising new ideas in a very safe environment.
Following the family sessions, some children will also be given some therapy which focuses directly on speech skills. This involves a step-by-step programme to help the child to learn how to manage his or her talking through games and activities with built-in targets and rewards.
Different activities and ideas are used depending on the child's age and abilities. For example, younger children are introduced to concepts about "slow and fast" tallking using puppets and stories. One programme that we use adapts the old fable about the tortoise and the hare and helps children to understand that "fast" is not neccessarily the "best" way. Parents are closely involved in therapy and will have "homework" tasks to carry out between sessions to ensure continuity.
Therapy sessions for older children also follow a structured programme. At first these are aimed at communication styles within the family setting and their effects on fluency and stammering; these are followed by direct work on speaking skills. Older children will also be given lots of help to understand the complexity of stammering and problem-solving skills to help them to help themselves in a variety of ways.
If necessary, we will offer extra help for the child who has additional speech or language problems or special educational needs.
If parents express any other concerns about their child's general behaviour, we would do some problem solving to see if we can help with alternative practical ideas for these.
School is often a worry for parents and it is important to liaise with class teachers or Special Educational Needs Coordinators (SENCOs) or Learning Support Assistants as necessary.
