My approach to working with adults who stammer is client focused and holistic. 

I draw upon my lengthy experience as a Speech and Language Therapist alongside the other modalities I have studied across the years.

Each client presents with their own personal history of stammering and reasons for engaging with therapy, including specific communication aims e.g. confidence building for an interview or public speaking event. Some clients wish to understand their stammer behaviours more fully and explore how stammering has affected their lives. 

In general, I am able to offer a safe space for clients to discuss their concerns, agree individual aims and work together to achieve them. Therapy often includes education, fluency shaping techniques and confidence building around self advocacy and is very much a collaborative process. 

Developmental Language Disorder (DLD) is the term given to children and adults who experience difficulties understanding spoken language and/or using spoken language. DLD is a neurodevelopmental condition.

DLD has been known by various different names over the years, most recently Specific Language Impairment. The word ‘specific’ serves to describe language processing difficulties in the absence of any other developmental concerns e.g. autism, learning needs, sensory impairment. It is still unclear why people do not develop language typically when no other developmental needs are evident.

DLD is thought to affect between 7% and 8% of children and is a lifelong condition. Unfortunately many children with DLD go undiagnosed and can struggle throughout their education as a result of not having received appropriate support in school. DLD can cause difficulties acquiring literacy skills and with the development of social communication skills, and can therefore impact significantly on people’s lives.

In recent years due to campaigns by various organisations, including RADLD in the UK, there is a growing awareness of the indicators of DLD in children and adults.  As a result more adults are self referring to services for diagnosis and support for their language processing needs.   

At present there is no one diagnostic process or tool to diagnose DLD in adults.  There are some objective standardised assessments that Speech and Language Therapists can use alongside a robust developmental case history and discussion about historical and current impact of communication difficulties.  The University of Bath are hosting an in-depth research programme about DLD and are inviting volunteers to participate in the project: engage-dld.com

In many cases, adults have masked their difficulties and developed various coping strategies to aid daily functioning, and these are also explored during the assessment process.  Often clients experience great relief when their reports of lifelong difficulties are affirmed by a therapist who understands the impact of DLD upon their lives.

For those clients who already have a diagnosis of DLD, they may choose to access therapy for support with specific events e.g. a work interview or presentation.  Often adults who have been diagnosed as children are seeking a more in depth understanding of the likely impact of DLD over time and how this can change.

For clients who suspect they may have undiagnosed DLD, speech and language therapy can help with assessment of specific communication needs and offer support via education and confidence building around self-advocacy. Once clients have a good understanding about the nature of their difficulties, it’s not uncommon that solutions to their day-to-day communication issues arise organically. A therapist can help a client explore other possible strategies where solutions are not as obvious.   

This will depend on the individual needs of the client and will be discussed during initial consultation once the client’s therapy requirements have been identified.

Broadly, the aim of therapy is to empower clients to address their communication needs with confidence and usually weekly sessions are recommended initially. The client may then move to fortnightly or monthly sessions to allow for practice and consolidation of new skills between appointments as confidence improves over time. 

Many aspects of a supervisee’s working life may be addressed in professional supervision, including clinical case discussion, ethics, competency, professional relationships with colleagues, physical, mental and emotional health.  It may also be appropriate to discuss personal issues that impact working life if this is a cause for concern.

Less experienced therapists may tend to focus more upon consolidation of clinical skills as they build confidence in this area and more experienced therapists may use supervision time to explore bigger picture concerns e.g. career goals and progression.

My fundamental ethos is centred on the wellbeing of practitioners as a baseline, and I tend to view everything that is brought to supervision through this lens. Having worked with many professionals in the caring professions over many years, I have found that a common pattern of their behaviour is to put the needs of others, including their clients, ahead of their own. This invariably leads to burnout and a repetitive cycle of unhealthy working practices.

While working as Clinical Lead for a private organisation in recent times, I led the complete restructure of service delivery based upon practitioner wellbeing, which ensured much healthier and effective outcomes for therapists and service users alike. 

In my experience, many of the issues that arise in supervision are rooted in lack of awareness of unhealthy patterns of behaviour, which, once illuminated, can be changed to the benefit of all concerned.