OCD and stuttering

[Guest guest]

I will contact my son's apeech therapist and ask if she has any

advice re: finding a speech therapist who specializes in disfluency

and understands TS and OCD. I realize that there is a shortage of

disfluency specialists to begin with, and that the connection between

stuttering and OCD is only beginning to be understood. When she

responds, I'll post her advice here.

In the meanwhile, here is what has helped my son.

First, I identified the situations when he had the most trouble.

Naturally, it was at times of anxiety: for him, this was in the

grocery store when he was asking me to buy him something, and when he

was talking to adults that he didn't know well (interestingly, he

could be playing with a friend and being totally fluent, but when the

friend's mom or dad came to pick him up, he could hardly express

himself!).

Next, I did a little home-made ERP in the grocery store. I told him

that I wanted him to ask me for whatever struck his fancy, and that

if he asked fluently he would get it. (He said, " Mom, what if

someone overhears me?! What will they think of me?! " Cute, huh?)

But we did it, and it really helped. His speech therapist taught him

a technique where he was to say the first syllable of every statement

or sentence in a slow, drawn-out manner: " Mo-o-o-o-m, can I have some

pi-i-i-i-zza? " instead of " m-m-m-mom, can I have some p-p-p-pizza? "

Second, when he " gets stuck, " instead of waiting and not

interrupting, we use the code words " Go on? " if we're in company,

or " just say it " if we're alone. That cues him that he's compulsing

and tells him to stop it. We emphasize that the statement does not

need to be grammatically correct and that he doesn't need to chose

the very best vocabulary or phraseology: he does not need to edit and

revise when he speaks, he just needs to blurt it out.

Third, we used a little toy car to illustrate how talking was

supposed to go. We put the car on the table top, and as he talked,

we made the car go forward. When he stopped to revise, the car

stopped, and when he backtracked and repeated, the car went in

reverse or rocked back and forth. The was a very powerful image for

my son, and it helped him to visualize the problems with his speech

and correct them. pointed out to me once that this reflects

the imagery in the book Up and Down the Worry Hill by Aureen Pinto

Wagner. So we bought a copy of the book and had our son read it, and

pointed out how it applied to his speech compulsions.

As far as school being a form of therapy, I think it could go both

ways. For some kids, it could just be overwhelming and make the

problem worse. Being immersed in the situation that causes anxiety

could be too much for some kids. Homeschooling would allow you to

work on the ERP in tiny chunks, by gradually putting your son for

short times in situations where speaking is a challenge, and

rewarding him for doing his therapy there. On the other hand, if

homeschooling isolates a child and keeps him away from the anxiety-

provoking situation, it could amount to enabling. I guess it depends

on the kid. Homeschooling has worked very well for us, but every

family is different.

I don't know if stuttering could be a tic. My older son, who has TS,

did stutter for a while when he was around 5-6 years old, and outgrew

it naturally. You would have to talk to a doctor or therapist about

it, but I would expect that if a stutter were a tic, it would be

around for a few weeks or months, and then go away for a time. Also,

the urge to tic just gets stronger and stronger if the person puts

off doing it, while the urge to do a compulsion will peak and then

fade if it's put off. Maybe you could explore this with your son and

see which happens.

The cutting with scissors thing really reminded me of my son, too (I

think our sons are cut from the same cloth, if you'll pardon the

pun!). When my son was that age he took a pair of scissors and

carved his name in the piano seat! I was livid, but since we knew he

had OCD I brought it up with his therapist before I did anything

about it. I didn't know if it was impuslivity, OCD, a defiance

disorder or what. Interestingly, she didn't think it was OCD, and

just advised me to handle it with " consequences " the way one would do

with a NT child. So I had him use his hard-earned allowance money to

buy one of those furniture repair kits at the hardware store, and

taught him how to refinish gouges in wood furniture.