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Screening and Progress Monitoring for Stuttering: In-Person versus Teletherapy

Stuttering therapy is about more than just learning Fluency Shaping Strategies and Stuttering Modification Techniques. It also requires us to check in with our students and their families about feelings, attitudes and addressing fears and for some students limiting thoughts. I think that is one reason that Stuttering therapy is an area that so many of us feel the least prepared for or competent in. Another reason is that there is no quick-fix. It isn’t like articulation or phonology where with enough therapy, a student’s speech can be easily cleared up. Stuttering therapy requires us to help our students face fears and teach them to advocate for themselves so that they can have the power over their speech and not the other way around.

To do so, we have to start with an informal screening to identify our students that may need extra tools to help them communicate their message.

OBSERVATIONAL SCREENING:

IN PERSON: Once a teacher or parent brings the student to my attention, I schedule various times that I can see the student. I observe them in the classroom, at lunch, and during lunch. I listen as they talk to their teacher, peers, and friends. I also look to see if I see any secondary concomitants while they are speaking. I also take note of any other worthy information such as do they appear to have friends, do they speak often or do they tend to let others speak for them, and how is their overall emotional presence during those snapshot moments?

TELETHERAPY: It is obviously more difficult to do this during teletherapy. During remote learning, I could still observe them in their video classroom. However, I could not observe them in natural settings with their peers and friends such as during lunch recess. I contact the parent, let them know that the teacher is concerned, and ask if they share the same concerns. I also asked parents for any additional information they would like to share with me regarding concerns with their child’s communication skills. Some parents were even willing to send me small video clips of their child engaging with their siblings during play, etc…

INFORMAL SCREENING:

IN PERSON: When I am screening a student, I obtain several different speech samples using my Fluency Screening and Progress Monitoring Kit and when possible, I try to observe them in different settings again. Depending upon their age, I use different tasks to get the sample.

  • PRESCHOOL: I engage them in conversation during play activities. I also ask them about their favorite toy(s), possible pets, and/or tv show (Paw Patrol? Sesame Street?). I also ask them about their feelings about their speech. Is it difficult to talk? Do they like talking? How do they feel about talking?
  • SCHOOL-AGE (Elementary-High School): I have them read passages, tell narratives using picture prompts and personal experiences, and engage them in conversation. I ask them about their feelings about talking too. Obviously, I use more age-appropriate context by asking about social situations, how they feel if anyone interrupts them, and asking if there are any times when they may feel most uncomfortable talking, overall feelings about their speech, etc…

When I am screening a student in person, I use my phone to audio-record them so that I can observe them while they are speaking. Are they looking away? Difficulty maintaining eye contact? Any facial groping? Do they have any other physical concomitants? By audio-recording their speech samples, I am also able to go back and get accurate data regarding what disfluent speech patterns are present and the frequency and duration of the stuttering events.

TELETHERAPY: Everything I would do in-person, I do during teletherapy. I ask them to complete the same type of tasks using screen sharing and audio-record for the same reasons mentioned above. If I want to see the students in different environments or situations, I may also ask parents again if they would be comfortable video-recording and sharing it with me.

PROGRESS MONITORING:

IN PERSON: I complete the same type of tasks as those mentioned in the informal screening; however, I change it up by using different conversational starters, narrative picture scenes, and reading passages. If I have progress monitored the specific student multiple times and I have run out of reading passages or picture scenes, I will ask them to bring in a book that they are reading and/or favorite magazine. I put the data from their speech sample and responses to the social/emotional component on their previous data sheet so that I can look at the patterns to get a whole picture of the student’s progress.

TELETHERAPY: Again, the same is true for teletherapy. I use screen sharing to obtain the speech samples, audio-record with my phone, and use the hard copy data sheets to write the new data next to the older data. It also works if the student needs to show me their magazine. They typically just hold it up for me to see the picture before they talk about it and/or I have them read a passage aloud and then tell me what about the passage they thought was interesting and why.

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