334: Stop Guessing With Stuttering Therapy

Show Notes:

In this episode of SLP Coffee Talk, Hallie chats with Victoria Dertouzos—SLP and founder of Speech and Stuttering Therapy of New Jersey—about why stuttering therapy looks so different than it used to, and why that’s a good thing. Victoria breaks down what a modern, neurodiversity-affirming approach to stuttering actually looks like in practice, how to assess what you’ve been missing, and what to say to students who’ve never felt heard in a therapy room. If stuttering therapy isn’t your jam, this one’s for you.

Join me for FREE CF Bootcamp on Wednesday, July 1st, 2–3 PM ET.

Here's what we learned:

  • You can reduce the struggle around stuttering—but you can’t remove the stutter itself.
  • If you’re only counting disfluencies, you’re missing the whole picture.
  • A student who seems fine might be switching words, skipping answers, and falling behind without anyone noticing.
  • Say “stuttering”—not “bumpy speech.” Normalizing the word helps normalize the experience.
  • Ask the student what they think before you ask what they do. That’s where therapy actually starts.

RESOURCES

🎤✨ The Speech Retreat is Back! Learn more and register here!
https://www.speechretreat.com

🎉FREE CF Bootcamp on July 1st from 2:00 PM–3:00 PM!
https://speechtimefun.com/cfbootcamp2026

📘✨ Grab your copy of The Secondary SLP Roadmap here! https://www.speechtimefunpd.com/stf-book 

Learn more about Hallie Sherman  and SLP Elevate: 

Learn more about Victoria Dertouzos Chaney: 

JOKE OF THE WEEK:

Q: Why did the golfer bring two pairs of pants?

A: In case got a hole in one.

Where We Can Connect: 

Subscribe & Review on Apple Podcasts

Are you subscribed to the podcast? If you’re not, I want to encourage you to subscribe today so you don’t miss any future episodes! I already have so many amazing guests and topics lined up, I would hate for you to miss a single one!  Click here to subscribe on Apple Podcasts.

Could I ask a big favor? If you are loving the podcast, I would LOVE it if you would leave me a review on Apple Podcasts. I read each and every review.  Plus, you get to pay it forward because it will allow other teachers like you to find the podcast! Wondering how to leave a review? Click here to review, then select “Ratings and Reviews” and “Write a Review”.  So easy and so appreciated! 

Do you have a question you would like me to answer on the podcast?

GREAT! CLICK HERE TO FILL OUT THE FORM! 

TRANSCRIPT

TRANSCRIPT

00:00:00 Hallie: Quick break SLPs, The Speech Retreat is back. It's the virtual professional development event that is actually fun. Think about it. Raffles, laughs, a virtual photo booth, and real world ideas that you can use the very next day for preschool through high school. Six different speakers that actually get it and are talking about topics that are relevant to you. Earn CEUs live, join PDHs on replays, and connect with the community of SLPs who love what they do. Don't miss it. Learn about the next event, the date, the speakers, and more at thespeechretreat.com.

00:00:44 Hallie: Welcome to SLP Coffee Talk, the podcast designed exclusively for speech language pathologists who work with older students, grades 4 through 12. I am your host, Hallie Sherman, your SLP behind Speech Time Fun, the Speech Retreat Conference, and the SLP Elevate Membership. And I'm thrilled to bring you conversations, strategies, and insights that will give you the jolt of inspiration that you need. Whether you're tuning in during your morning commute, on a break in between sessions, or even during a well-deserved relaxation time. I am here for you each and every week. Let's do this SLPs.

00:01:25 Hallie: Hey, hey, and welcome to another episode of SLP Coffee Talk. Today I'm bringing to you an SLP that knows something more about something that I am… It is not my forte whatsoever. Guys, I will be the first one to say when it comes to stuttering therapy, it is not my jam. But Victoria, I believe it is yours. So welcome to the show.

00:01:47 Victoria: Thank you so much for having me. And I just want to say you're not alone in what you just said. I think a large majority of SLPs feel the same way.

00:01:55 Hallie: Awesome. Thank you so much for saying that. Tell everyone listening a little bit about yourself and your SLP journey to what you were doing these days and how you got so passionate about stuttering therapy. 

00:02:05 Victoria: Yeah. So my name is Victoria Dertouzos. I've been an SLP for almost 10 years now. And this actually began for me prior to going to graduate school. It's kind of strange, but I had to self-design a major in undergrad for speech pathology at the college that I went to. So that kind of forced me to look for internships and look for experiences to try to get, you know, knowledge and real life knowledge about speech therapy. So I happened upon a speech therapist who was a board certified specialist in stuttering. And that experience really… just I knew from then that I wanted to work with people who stutter. I saw what she did and I knew she was changing their quality of life. And that really hit me. So, it was kind of on my mind since then.

00:02:53 Hallie: Awesome. So you just went straight first, like into private practice afterwards and work primarily with stuttering clients? Like how that go?

00:03:01 Victoria: So, yeah, so I actually didn't have a stuttering client even in grad school until I graduated. I know it's funny, right? I started in the schools. I did some leave replacements and then I landed in a school based placement for about five years. And there I happened to have, I think, an abnormally large number of kids who stuttered for what my caseload was. And on the side, I kind built up private clients. Somehow they found me the kids who stuttered and I just built up my private practice enough to eventually leave the schools. And I've been doing this full time now in my practice for, I think, four years.

00:03:42 Hallie: Wow.

00:03:43 Victoria: Yeah.

00:03:44 Hallie: It's so amazing. Now, I know you see kids of all ages, do you have a preference on the preschoolers, school age, which is more your preference? We had to ask. And there's no wrong answer, I'm just curious.

00:03:55 Victoria: Yeah, I mean, I definitely, of course, love the niche in general, but I do really like working with the adults. I find that it's really fun to have these deeper cognitive intellectual conversations about their experiences with stuttering and how it has shaped who they become as a person. And if that's who they really feel like they are, or if stuttering is in the way of that and being able to kind of peel back those layers and help them really be their authentic selves. And I like working with the preschoolers too, because the parents are involved and you're really like, changing the dynamic of the family and helping everyone to feel supported. So, I would say those two are probably my favorite.

00:04:34 Hallie: I have questions for both ages. I'd love to hear from the older ones. I'm assuming you're not their first stop at speech therapy that they finally wanted to do it for themselves? Like, what are typically like their hopes and dreams when they seek you out?

00:04:52 Victoria: Yeah, so most adults who stutter are coming to me after… well, maybe it's like 70/30 when I say most. Most of them are coming to me after having many, many experiences in speech therapy, unfortunately, and most of that speech therapy has been focused on chasing fluency, using fluency shaping strategies and they're now in their 20s, 30s, 40s, 50s. Like, hey, I still need support. You know, unfortunately, the reason for that is because they've kind of been sold the wrong thing. And I think that starts with what we are sold in grad school a little bit. And I say sold loosely, of course, because I think the focus kind of got lost somewhere along the way or for stuttering therapy.

00:05:36 Hallie: And you know, from someone who is even older than you. Like, I agree. Like, that's how we were taught all… like how to “cure.” And air quotes. And now with neurodiversity affirming practices and approaches, how has your practice changed with, you know, this knowledge and this new approach?

00:06:00 Victoria: So I'll be honest, I've known that I wanted to work with people who stutter, right? So, through my own experience, I would say even before this really big, loud shifts with neuro-affirming therapy has started, naturally, I just noticed like, I'm not helping them. Something has to change here. And you know, I've kind of seeked out my own information. That was different from what I was taught and where I started because even like five, six, seven, eight years ago, like I made my own little cards I was trying to sell of like easy onset and the typical strategies and I'm not saying that, you know, I know there are people that still use them. But the shift really came from my clients and learning from them and noticing that there was something bigger that needed to be addressed and that was, you know, the impact that it was having on them.

00:06:53 Hallie: What does therapy look like now?

00:06:56 Victoria: Yeah, it's such a loaded question. Because it-

00:06:59 Hallie: You can’t give every single detail, but like the general gist.

00:07:03 Victoria: So the important piece is to look at for a child and an adult who stutters all kind of speak like school age and above, right? Like kids who know that they stutter, they know they're a person who stutter. Adults know that too, of course, right? We wanna not just be looking at what the stutter seems to sound like, right? Like there's word repetitions, there's blocks, like what's there, right? We don't really wanna be putting emphasis on what the listener is experiencing, right? And that's what we used to, because that's what we do as speech language pathologists, we listen. And we figure out like, was that an interdentalist? Was it a flatterer? Right? That's part of our job. 

00:07:40 Victoria: For stuttering, we actually can't get the full picture of stuttering without asking the person what's a part of it. So I'll just speak to what I just mentioned, right? Someone can be having a block and you might not hear it. You might not know. So you can't use your perception to clinically judge that accurately. Another thing that you can't judge just by listening is if the person is trying to avoid a stutter that they're feeling or not. So we want to be looking at, are there avoidance behaviors of switching words or trying to start a sentence over and trying to skirt around stuttering. And a person who is constantly doing that almost to the point where you don't even know that they are a person who stutters is called a covert stutterer. So that's a different ball game. 

00:08:23 Victoria: And then of course, there are secondary behaviors that can come with stuttering. What most people don't understand about those is that they are not actually concretely linked to stuttering, they're actually a conditioned response to the struggle that they're feeling, this neurologically based thing, which is stuttering that is happening to the person. So if you would imagine, you know, like you get stung by a bee, the next time a bee comes by you, you're going to move out of the way. And every single time you're going to do that. And that's kind of what it's like for stuttering. 

00:08:54 Victoria: If they're super uncomfortable or they don't want to be doing it, they're going to close their eyes or squeeze their face or make some kind of movement. So, the next piece is kind of figuring out why do they feel the need to avoid, why do they feel the need to, or have that physical response of feeling uncomfortable. And a lot of times that comes from their thoughts about stuttering, their underlying beliefs about it. It is part of their speech, you know, where they can try as hard as they can to not stutter and it's part of how they talk. So because of that, it's part of who they are. And if they don't feel good about that, they're not gonna feel good about themselves.

00:09:30 Victoria: So the next piece of therapy needs to be focusing on where that's intertwined, where that message kind of got sent, whether if it was from caregivers or past therapists or just from experiences that they've had from peers or teachers, wherever, and helping them to know that there's a community of people who stutter and just feel that they can be a part of that and they can be accepted. And I would say that's almost like the larger, harder part because we're kind of… we're fighting an uphill battle here with misinformation that there is about stuttering out there.

00:10:04 Hallie: So interesting. Oh, my goodness. It really is so involved. Now that said, since you said, you know, with their past perceptions, how does that change with those preschoolers who may not be aware? And typically the parents are coming in saying, fix my child.

00:10:22 Victoria: Yeah. So, the first place that we start is letting them know that we are not guaranteeing that we can make stuttering go away. And where we start is kind of figuring out, what are the indicators here that make it more likely that this child's gonna continue to stutter? And that's exactly the language that I would use because there is spontaneous recovery for kids who stutter. We don't really know if they're going to stop stuttering or not. Whenever I say spontaneous recovery, I use air quotes because I don't actually believe it's that spontaneous with the preschool. Or always, right? I can't say it as an absolute. 

00:10:58 Victoria: But with the preschool age, what we're looking at is who they are, basically their internal abilities, whether it's their language abilities, their emotional regulation abilities, their temperament, and their external environment. So how does the nurture of how they're being brought up affect how their stutter is basically being expressed? Right? So if you think about our genes and like epigenetics, if you understand that and how it's all coming out.

00:11:25 Victoria: What we do with the preschool age group is we modify whatever is not the best fit environment for them to try to help the neuroplasticity of their brain really feel the ease of communication more frequently and shape it that way. And within that is building a support system that is accepting of stuttering and accepting of how their speech sounds at the same time so that if they do continue to stutter, they understand that it's okay and they don't have to grow up thinking that they have to fix something about how they talk constantly when they really can't.

00:11:58 Hallie: Interesting, I remember always having that internal battle like they're unaware of it. How am I teaching this to them without them then learning? Like, really, I'm going to show them that there's something wrong with the way they're speaking if I'm trying to change them and they're not aware. It was very conflicting.

00:12:18 Victoria: Yes. And most SLPs feel that way. A lot of them do. And if they don't right away, they start to realize like, okay, we're talking about bumpy and smooth speech and this kid just wants to play and how am I… what am I doing here? And then honestly, a lot of times that leads to like, I don't have anything left to do with them and I'm going to discharge them now. And then the child continues to stutter and nobody knows how to support them really until they get the next therapist and the next therapist and the next therapist. And then they find me in their thirties and they're like, here I am.

00:12:50 Hallie: On that same page, in the schools, oftentimes it is if it's not the parent, it's the teachers coming to us saying, you know, pick up this kid. You need to fix him. Well, like you said, some strategies that you would give to the parent, what are some strategies you would give to the teacher to create that comfortable environment for that student?

00:13:15 Victoria: Yeah. So I want to start by saying this. There's a lot of people and caregivers that have opinions, right? And a lot of times it's exactly what you said, right? I hear this thing, it needs to be fixed. They need to go, like I know who they need to go to and it's speech, right? But if we're skipping over the part where we talk to the kid about it, then we're missing the entire point. So again, because stuttering is a part of how they talk, that kid, teen, whoever it is, may know that and understand that. And sometimes in the situation, they're the only person that knows that and understands that. 

00:13:50 Victoria: So when they're in speech and they're like, this isn't helping me or they go home and they say to the mom, like, I don't need speech anymore. And the mom's like, but you're still stuttering. Like, I'm going to get you in speech or the teacher. Same thing. Like he's answering. Maybe he's answering confidently in class and he's fine. And the teacher's like, I hear stuttering that comes from a place of just like misinformation a little bit. And again, if we're skipping over asking the person how they feel about it, then we're missing the whole point.

00:14:15 Victoria: So, personally, and I'm sure I'll talk more about this, but my part of my mission is to get SLPs to really understand this and know how to handle that situation so that, you know, we are the first line of defense so that we can really be the best first line of defense to spread this information to parents and teachers. And what we're spreading is like acceptance of stuttering. It's okay. It's part of them. This, again, neurodiversity-affirming idea that, you know, we're not fixing it because we can't. We can do things to help them reduce their struggle, reduce the negative impact on their life. But we can't remove the stutter.

00:14:50 Hallie: So often in the schools, like you're not seeing progress. It's not impacting them academically. It's very hard to justify keeping them on their caseload. And especially if they are participating in class, it's not stopping them socially. But so interesting, you said like you never thought to ask the student, they might be acting fine, but inside screaming like you never know.

00:15:12 Victoria: Yeah, or honestly the opposite. You might hear them stutter and then they feel fine. And you touched on a really huge piece that the interesting thing about it is that if you're assessing the wrong thing, then it is going to look like they're not eligible for speech, right? If you're just assessing how frequently they're stuttering, you may be missing the whole piece of they're not raising their hand in class because they're too embarrassed and nervous, but that's not allowing them to access their education. So helping SLPs to understand what they really need to be looking for is like the very first thing that can kind of prevent this entire domino effect.

00:15:49 Hallie: Especially if they are changing words and sentences, they can be getting things wrong in a presentation or whatever. It can have an impact.

00:15:57 Victoria: Yep, completely. Or like, “Oh, I forgot.” You know, and now they look like they don't know or they didn't study or whatever it was. So the advocacy piece is really important, too.

00:16:06 Hallie: How would you start this conversation with a student? Let's assume older since majority of my listeners are working with the older students. How would you have that conversation if a student was presented to you and you wanted to get to the bottom of how they're feeling about everything?

00:16:21 Victoria: Yeah, so I think knowing their history is important and asking them about it, right? Have you ever been in speech therapy before? And what did you do? Did it help you? Did you feel like it helped you? A lot of times I ask them, do you feel like you need to be here? Do you feel like you need speech therapy? And I like to see what they say. That age group is coming to me privately, but I have worked with them in the schools, too. But when they come privately, I'll even say like, whose idea was it to do this evaluation? Was it your idea or was it mom's idea? And it kind of makes them giggle, but it gives me insight into what they think.

00:16:56 Victoria: And sometimes that answer is, “Yeah, my mom made me do it.” And then we go through the evaluation and there's so many areas that they feel they need support on. But as we move through the evaluation, they start to realize like, oh, this person cares about what I think. They're not asking my mom. They're not analyzing how many blocks I have right now in real time and asking me to change it. They're asking me how much anxiety do you have when you speak with your teacher or how difficult is it for you to present in class or how much do you know about stuttering? Do you know anyone else who stutters? Right? And they start to realize that they have the ownership of it instead of maybe… like if it's different from a past experience, right? It starts to feel different.

00:17:41 Hallie: Interesting. How do you find… get more information about secondary behaviors? Like what kind of questions do you ask them to kind of elicit what could be?

00:17:51 Victoria: Yeah, you know, it's so interesting because SLPs ask this the same way a lot of the time. And like the question can just be, “Hey, do you ever do anything when you stutter?” Right? And I think it just encompasses how we feel about stuttering and parents feel the same way that it's like this elephant in the room. Like, how do you ask it? But you just ask it. Like, do you stutter or like-

00:18:12 Hallie: We're overthinkers. We're people who [inaudible] we want to make sure it's right.

00:18:16 Victoria: Yes. Exactly.

00:18:18 Hallie: You need a conversational script.

00:18:20 Victoria: Yeah, exactly. But what we want to move away from is making it taboo. We want to say stuttering, right? We don't need to say bumpy speech. It's stuttering. That's what it is. And the more that a person or a kid who stutters hears trusted caregivers and trusted professionals talk about it openly and like it's no big deal, they're going to feel like it's no big deal. So, yeah, you can just like, is there anything that you do when you stutter? Do you blink your eyes? Do you move your hands? Do you stomp your feet? And a lot of times to make them feel like it's not targeted, I'll be like, I know a lot of kids who stutter who X, Y, Z, or I know adults who stutter who used to look away when they were talking to other people or whatever it is. And sometimes the examples kind of help take the pressure off of like, do you do this? 

00:19:05 Hallie: It's so helpful. And then when you finally like get those answers and find out more about it, like, where do you go from there? Like, what would a session look like?

00:19:13 Victoria: Yeah. So of course, just like any evaluation we do, it depends on whatever you get, right? If you're doing the [inaudible] and you find out it's the S, you start working on the S. Same with a stuttering evaluation. If you, you know, you're evaluating them and they have so much tension and struggle when they're blocking because they're trying so hard to push the words out, you're going to want to work on that tension. 

00:19:34 Victoria: And I'll throw another thing in here that might blow your mind, right? We are actually reducing the amount that they're trying to get the word out. They, a lot of times, like that example, when they're stuck in a block and they're pushing as hard as they can to get the word out, they're actually like making it harder. So we help them to sit in that moment of the block and try to feel more comfortable in it and feel more comfortable letting it happen so that they don't have so much tension there, which is really the complete opposite of asking them to use anything, use an easy onset, use your stretchy speech, right? 

00:20:07 Victoria: We don't want them to do anything. We want them to get to a place where they can just stutter and it feels okay and it feels like safe in their body. So that's a good example. Tension, maybe you find that they are avoiding constantly. You want to be working on those avoidance behaviors and trying to reduce them so that they can have more spontaneous speech, they can say what they really want to say. Maybe it's really difficult for them to order food and that's really important for them. So you're going to work on getting them comfortable with that, things like that.

00:20:36 Hallie: Luckily now everything's online. You don't really have to talk to anyone, which is…

00:20:41 Victoria: Over ordering. Yeah. I would say even for me, like you just click and it's easy.

00:20:47 Hallie: Well, although… we realize it's a good way to practice. But in reality, how often are you picking up on… maybe making like a doctor's appointment? I think like when I really need to pick up the phone.

00:21:00 Victoria: Yeah, yeah. And I would argue even for me, if I don't do it a lot, then like I have to go do it. I'm like, oh, gosh, I have to do it. So it's the same thing. It's like the repetition helps you feel more comfortable.

00:21:11 Hallie: Love it. Any last bit of advice that, you know, for someone who is feeling just not confident working on stuttering, feeling unsure of our role now, what would you say to them? 

00:21:23 Victoria: I would say it's not your fault and you can start small. You can start with just reading an article about stuttering. It's probably going to change your view on one little piece of it, right? If you go to the National Stuttering Association website. Actually, I was going to say, “Next week is National Stuttering Awareness Week,” but that's not going to be… That's not going to… [crosstalk] Yeah, true. No, but there are tons of blogs, experiences of people who stutter, right? Just pick one thing and read it and it'll start to shift your mindset on how you look at stuttering and supporting kids and adults who stutter and then you can just take it from there.

00:22:08 Victoria: But it can be overwhelming. But like I said in the beginning, it's not your fault. Whatever information you've been given, that's what you're using. And you make your best decisions based on what you have at the time. But if you keep making those decisions, knowing that it's not leading you anywhere, it's not making the kid progress, or it's not really helping them, then that's where you're in trouble. So we never stop learning in every area. And this is the same as all of those. So I would just encourage continued learning and evidence-based learning because the evidence is out there. 

00:22:39 Hallie: I love that. Thank you so much. Where can everyone learn more about you and everything you have to offer?

00:22:45 Victoria: Yeah. So I'm on Instagram @stutteringtherapyslp and online as well, stutteringtherapynj.com. My practice is Speech and Stuttering Therapy of New Jersey. So we, you know, of course support kids and adults who stutter in our private practice. But I also have a program where I support SLPs myself in Stuttering Therapy Academy. It is a comprehensive live training program for SLPs where we walk through all of the stuff that I was just talking about tonight from the very beginning, the research, the assessment, writing goals, making a plan and treatment in all areas that really are effective for people who stutter.

00:23:24 Hallie: Awesome. Thank you so much. And we'll have links to everything in the show notes, everyone. Not to worry. I always end my episodes with a joke since jokes build rapport and are language based. I tried to find a fun one here. Why did the golfer bring two pairs of pants?

00:23:41 Victoria: Oh, gosh. This is for me to answer, right?

00:23:44 Hallie: Yeah. I mean, I would. [inaudible]

00:23:50 Victoria: Something about par.

00:23:51 Hallie: No. In case got a hole in one. 

00:23:54 Victoria: Oh, that was easy. I should have got that.

00:23:57 Hallie: He had a hole in his pants.

00:23:58 Victoria: So easy. My husband would be disappointed.

00:24:02 Hallie: You guys can steal the joke. Take credit for it if you want. ChatGPT wrote it, guys. I didn't write it. So thank you so much. Go check out all of our links over things. And until next week, everyone, stay out of trouble.

00:24:21 Hallie: Thanks so much for tuning in to another episode of SLP Coffee Talk. It means the world to me that you're tuning in each and every week and getting the jolt of inspiration you need. You can find all of the links and information mentioned in this episode at my website, speechtimefun.com. Don't forget to follow the show so you don't miss any future episodes. And while you're there, it would mean the world to me if you would take a few seconds and leave me an honest review. See you next week with another episode full of fun and inspiration from one SLP to another. Have fun guys.

Similar Posts