Contact your local service when your child is stammering as soon as possible after you have noticed it happening regularly. The BSA can supply the contact details of your local service.

Recovery from stammering for a primary school child

This is always difficult to judge, but we do know that Early Intervention gives the best chance of recovery and that the longer the child has been stammering a complete recovery is less likely. Parents may understandably find this upsetting and worry about their child's future. Anxiety about fluency can be transferred to a child from a parent and make it more difficult for him to manage his speech, so it is important to discuss these fears with the therapist and people who understand, such as the BSA:Helpline.

Stammering need not hold you back

Parents can be reassured that stammering need not hold back a child's academic, personal and social development as long as he receives the support he needs from therapy, parents and teachers. The BSA knows of people who stammer who have succeeded in every walk of life.

Finding a therapist

The National Health Service (NHS)

Speech and language therapy for children who stammer is available under the NHS. In most parts of the UK, you can refer your child to the local speech and language therapy department yourself (the BSA can provide contact details). In some areas you will need your GP or Health Visitor to make the referral.

Private therapy

Rates for private therapy vary widely depending on the service offered. However, the average fee for an initial, straightforward assessment is in the region of £85 to £120 per session. On-going therapy sessions are likely to be in the region of £50 to £70 per session. When family members have private medical insurance it is worth contacting the company to enquire whether speech and language therapy may be funded. The Association of Speech and Language Therapists in Independent Practice (ASLTIP) provides information about independent speech and language therapists throughout the UK.

Whether you see an NHS or a private therapist, it is entirely acceptable for you to ask if the therapist specialises in stammering and what you can expect from therapy. It is important, if possible, to see a specialist who works regularly with stammering and keeps up to date with the latest approaches to therapy.

The Michael Palin Centre for Stammering Children (MPC)

Once you have made contact with a local NHS speech and language therapist, they may be able to refer your child to this specialist service in London. This may be appropriate either if there is no specialist service available in your area, or if a local therapist feels your child could benefit from extra help.

Before your appointment with the speech and language therapist

If you have the time it is useful to collect some information about your child's stammering and either send this to the therapist with a covering letter in advance of the appointment, or bring it along with you. This will give the therapist a good starting point for the discussion with you. It will also help you be clear about what you want to say.

What happens when you meet the speech and language therapist

All therapists will have their own way of working but generally common features occur in their approach. Your first appointment is often an initial screening session where the therapist will consider your child's needs to make sure that the referral is the correct one for him. If you have collected information, that could be offered to support a referral for stammering. You may be asked if you are able to keep appointments regularly, should they be needed. The next step will then be an appointment for a full speech and language therapy assessment. Additionally, if you bring a small notebook with you in which you have written down any questions or concerns that you have, you are less likely to forget what you would like to ask or say.

The Assessment

If possible when both parents are involved with the child, they should go to this with their child. For part of the session, the therapist may need to speak to the parent(s) without the child. You should explain this in advance to your child so he does not get concerned.

Your child's case history

The therapist will take a detailed case history about your child's life so far by talking with both parents, if they both attend the appointment. This will include the child's medical details, family background and history and information about his development and progress. This discussion will be quite lengthy and may involve questions about the family situation that some parents have told the BSA they could not see the necessity for. However, it is important to remember that therapists are bound by the same rules of patient confidentiality as any other medical professional, such as a doctor.

Parents who still worry that in some way they have caused the child to stammer should be reassured after talking with the therapist that parents do not cause stammering. However they do have a vital role in helping their child manage the stammer more successfully.

What happens next?

The therapist will compile a summary of all the information gained from the parental interview and child assessment and share this with the parent(s) so that they are able to understand why their child is vulnerable to stammering and can work collaboratively with the therapist to support their child's speech.

After the assessment, a confidential report is prepared that summarises the assessment findings and the action that the therapist is initiating. A copy of this is sent to the parents and routinely to the child's GP and any other health professional involved in the child's care. If the referral was made by the primary school, then a copy would be sent there and usually filed with the child's SEN records. However, when parents make the referral they may provide a copy of this report at their own discretion to their child's Early Years setting, or ask the therapist to do so. The BSA would advise parents to ensure that their child's primary school receive a copy of the therapist's report so they are informed about the management of the child's stammer and able to collaborate with the therapist if required. Usually this report would be then sent to the Special Educational Needs Co-ordinator (SENCO) at the school.

What therapy involves

The amount and type of therapy offered to young children will depend on the outcome of the assessment and the judgement of the therapist as to what level of support is required. Most therapists nowadays will endeavour to work closely with parents so they can become skilled supporters of their child's speech needs. The therapist would also try to use the lowest level of intervention in the first instance and this may involve one or more of the following levels of care:

1. Advice and information

2. Indirect therapy

3. Direct therapy

For younger children, both indirect and direct therapy techniques can be equally successful, and different approaches suit different children.

Support from a therapist in primary school provides the best opportunity for managing stammering.

The BSA-Schoolchildren leaflets are available to give information.

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