The first thing I noticed was his mum: the concerned way she looked at him as they entered my room and took their seats, the way she shifted uncomfortably when I, a speech and language therapist, asked Brian* if he knew why he was here, the way her shoulders tensed as I smiled expectantly at her teenage son.
Then, as he attempted to answer, his whole body suddenly jerked forward until his head was almost banging against his knees. I heard no words. I checked the referral information discreetly, shuffling quickly through papers and thinking angrily that the GP who’d referred him was completely off the mark. Is this a child with Tourette’s or a neurological disorder?
The letter stated “boy has a mild stammer – please advise”. After a few painful seconds, Brian finally managed to force out a “No!” and I realised that the GP was both right and wrong: yes, he had a stammer, but it wasn’t mild.
During that emotionally-charged first session, I learned that Brian had developed the stammer as a young child. At first his parents didn’t really notice; their health visitor and well-meaning relatives reassured them it would probably disappear over time. After a year, however, they noticed that Brian would sometimes blink repeatedly, as well as stammer. Then other movements began, some of which disappeared only to be replaced by others.
Now a teenager, almost every word was a struggle for Brian, but more distressing were the secondary movements I had just seen. He was doing well in school but had always refused to talk about his stammer. His mum said, heartbreakingly, that it was like his stammer didn’t exist if nobody mentioned it, so nobody did. As she shared all this with me, Brian sat silently, his eyes focused on the nursery rhymes poster on the wall. Occasionally he’d glance in my direction, looking for a reaction. I tried desperately not to give the wrong one.
The only other response I saw from Brian during that first session was a halfhearted nod, confirming that he would come back the following week.
I felt intrigued and daunted at the same time. What had brought Brian to this point and what was the best way to help him?
He came back to see me many times over the next few years, and gradually the wall of silence around his speaking difficulties began to crumble. A large part of therapy sessions for teenagers who stammer is to be more open about the fact that the stammer exists, and this was the most difficult part for Brian and his family. We did some work on his breathing and technique, but by far the biggest challenge was enabling Brian to accept his stammer.
Having worked in the NHS for more than 20 years, I know there are some moments that stay with you long after they happen, moments you remember to remind yourself of why you do what you do. One such moment was the day Brian came for his session, now aged almost 16, smiling and clearly itching to tell me something. His mum was with him, unusually. He told me (with a stammer, but no secondary movements) that he had spoken in front of his year group and teachers about his stammer, as part of his GCSE English oral examination.
Then I noticed his mum again; she had an air of optimism about her, a sense that everything was finally going to be ok. Gone was the anxiety that can only be seen in the eyes of a worried mother as she told me that Brian had also got himself a weekend job; he’d started at one end of the street and asked, with his stammer, in all the local shops until one agreed to give him a chance.
What courage. I was so proud of him and so grateful to that shop owner for giving him that chance.
*Not his real name
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Seeing Brian overcome his stammer filled me with professional pride
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