There are some very painful memories of school experiences recalled and much of that distress might have been prevented if the stammering child had been given speech and language therapy from an early age, and if the teachers had been in a position to play a part in the network of support.

In primary schools where young children have been picked up at an early age and are receiving therapy, as long as the parents agree, the Speech and Language Therapist is sometimes able to visit the school and discuss strategies of support for the teacher. This model of collaboration is the ideal to which we would give our wholehearted support . Progress in these circumstances can be very encouraging.

If the condition has not been identified until the secondary school stage , therapy may be useful and should always be tried but the expectations of success are lower because speech patterns are established and a fear of talking may have been added to the problem, causing emotional difficulties for the child. The helpful collaboration between schools and therapists described above is not always easy to achieve here either as it frequently has resource implications for both the health and education services, and the sheer logistics of arranging meetings between teacher and therapist, particularly in a secondary school with its larger staff and diversity of subject commitments, at a time of stretched resources can pose problems.

Quick Points for every one, from Headteacher to support staff and pupils.

Always give time to the pupil who is having difficulty with speech. This applies in the hidden as well as the formal curriculum. A lot of oral language contacts take place informally in passing conversations. For example, the dinner queue, a common cause of stress for the stammerer will just have to wait for the pupil, after all life requires a lot of queuing and children have to learn about turn taking and waiting. In many ordinary situations, gestures are used to point to items and that is perfectly acceptable, as long it does not become a substitute for the uncomfortable experience of speech.

The tendency may be, particularly at the end of a trying day, for the teacher or other adult to feel irritated by the speech of the stammering child and for that emotion to show in the expression, or in body language. As the child stammers and stumbles over the words, your attitude might make all the difference to the effect which the stammer has on the pupil's whole life. Try to maintain eye contact, and an interested expression and concentrate on what is being said. Do not give an impression of irritability or impatience. These feelings do need to be confronted if, as a teacher you are aware of them in these situations, they are understandable but should be overcome.

If you know that the child has a bad stammer, it is best to avoid any conversation when you have an immediately pressing appointment, break duty or something similar, and indeed all pupils need to be made aware that they should not detain you at such times.

In conversation with the younger child particularly, it might be particularly tempting to finish off words, this is never good practice with any school child who stammers and unless the older pupil or adult stammerer requests that you do that, it is always best to allow the person to finish what they are trying to say, because speech makes such a personal statement about a person that to cut off the flow because of a stutter may be felt to be very demeaning by the stammerer.

As the pupils grow older, it is particularly humiliating to have so little value given to their words and, with the growing sensitivities of adolescence, a cycle of frustration, fear of stammering and inability to express feelings and emotions can be seriously damaging to the personality and the chances of a fulfilling personal and vocational life.

After a period of stammering speech it may be helpful to rephrase what has been said and draw the attention of the class or the group outside the classroom, perhaps at break or wherever, to the comment by repeating its content so that the emphasis is on what has been said rather than the stammer. Then go back to the stammerer in your conversation for a short follow on comment .Gating the conversation at the end of a stammering comment is not good practice, as it smacks a little bit of being grateful that the experience of listening is over and done with.

A forced alternative question can be especially helpful - so do you think that is -----? gives credence to the child's remarks, whether they are said in the classroom context or in informal conversation. It makes a statement to the group and the child with the speech problem that his ideas are worthy of exploration and yet does not require another lengthy bout of talking. The intonation used by the teacher in all these circumstances should be helpful so that interest is obvious..

Even if the pupil needs to make an urgent request it is best to allow him to say it completely before replying. I am thinking of the-"Can I go to the Toilet?" sort of requests , which the school will have some standard of practice in dealing with anyway, as children are prevented from being out of lessons unnecessarily. Even very young children are better completing their request, even if there is a risk of a puddle on the floor. It is not good for a child to begin to see speech as something which can be avoided, we are trying to encourage pupils to use this vital tool of communication, however imperfectly at first. However, I am not sure whether this advice stands in all situations, there may after all be a serious emergency in the school which the stammering pupil has discovered, in these circumstances you must judge for yourself! In this context of an urgent need to communicate, there are schools which allow children with a major speech problem to carry with them a red card, to be shown to a teacher only when the pupil is under great stress and quite unable to speak in a situation where speaking is expected or needed. Having a card which explains the problem, allows the pupil to write down the words for the teacher. Such a procedure may be worth discussing in the individual school and, if it appears to be helpful, with the pupil and the Speech and Language Therapist. We would not as a rule favour such an approach, except in the direst of emergencies, but there may be circumstances where it can be reassuring for the pupil.

As often pupils are asked to go with a message to another teacher, and this is usually done in pairs, do include the child who stammers in such an errand, so that confidence will be built up, younger children could say the message together, older ones will work out their own strategies.

Wherever possible include the child who stammers in all the oral activities of the school, so that it is signalled to all members of the school community that all pupils are valued and accepted for their individual contribution to the life of the school. Such a strategy makes an important point to all pupils about the nature and forms of human individuality and difference.

The observation may have shown a considerable stammering problem generally, but it is important that the individual teacher decides just how much of a problem in this individual class the pupil is having. Stammering is variable, and the interaction of factors may make one class more difficult than another for the pupil. Periods of dysfluency in stammerers of any age do vary and this makes the condition particularly difficult to provide specific approaches which work in all situations. Consequently, if the pupil appears to be quite comfortable with their speech, even though stammering considerably then all you need to do, (not always easy) is to maintain that situation and ensure that you follow some of the simple strategies discussed here.

Be a role model for behaviour generally, and speech in particular.

Iknow that one way to influence another person is to mirror their behaviour, and as pupils generally want to keep the right side of their teacher most of them will react to the teacher's own model of presentation. I know that it is easier said than done to present this model of calm, controlled and reassuring behaviour all the time, and I recall many times myself falling below this high standard with some of our very difficult pupils. But to do that did not assist me in managing the class, it never works to lose control and to raise the emotional temperature unless it is part of an ordered strategy for classroom management.

With any kind of challenging behaviour, even of a passive nature such as the tendency by a stammerer to elect to be mute, it is easier to prevent than to cure.

General Strategies for speaking in typical classroom situations for all teachers

• Registration At registration tell the class that they might give their response either by speaking or raising their hands. This takes off a tremendous amount of pressure for all children as many may be nervous of that moment in the limelight and certainly the pupil who stammers will be.Never go round the class asking for names, not to be able to say your own name is a particularly humiliating experience and another strategy should be found until you are confident that no one in the class has a problem with that. Methods like producing a desk plan with names, are the quickest way of dealing with the problem, and gives the teacher the time to learn the individual names which is vital to good classroom management. Such a list should always be given to a supply teacher who quite unwittingly may cause problems for the speech impaired pupil. Name badges may also be a useful tool.

• Reading: Reading aloud sessions should incorporate more imaginative strategies than just reading round the class , or down the order of the register. Whole class recitation can occasionally be useful as a warm up exercise for this and is a helpful means of observing how a child joins in when given the chance. We would expect that a child who stammers would take the opportunity to join in here because the stammering is not likely to occur and the exercise is a good confidence builder as all the children are encouraged to take part in speaking. Reading aloud should positively reinforce for the pupil an understanding of the text and allow the development of confidence in the sound of his/her own voice. None of this will happen for many children, not just the stammerer, unless there is some preparation for the exercise. This preparation can take place in a situation where each pupil is working with at least one other pupil, and the groupings should be carefully selected to ensure that each member has something to offer the group as a whole.

  Group work where the members work together on the prepared reading of a passage gives all the children the chance to contribute in their own way, and the teacher has the chance to monitor progress and encourage all the pupils to participate. The teacher can offer to the groups different ideas for reading back their work so that the needs of the child with speech and language difficulties are addressed. Strategies such as reading in a small group at the same time, as in choral reading, or reading with at last one other pupil in unison give a pupil who stammers an opportunity to hear his own voice and participate in the class oral activity without fear.

• Paired Reading: a Variation. This technique is very helpful to a child who stammers because although there may not be a reading problem as such there is an articulation problem and regular practice in a supportive environment allows the pupil to hear his own voice and to learn to be comfortable with that. A number of schools use this strategy, in primary schools it is quite common and is often found in the Lower school of the Secondary school for slow readers and children with literacy problems. Essentially, although practice does vary these are common features and used with a pupil up to Year 8, or perhaps year 9 even, it can be very helpful as a tool for familiarising the child with the sound of his own voice and build up confidence.

• Working with volunteers in reading: While we know that in many schools volunteer helpers are involved in reading, with a stammer a little more expertise is required because the purpose of the exercise is not only to hear speaking but to give the pupil the opportunity to discuss fears and anxieties, what helps and what hinders and to feel safe to speak. Therefore, as we do not expect a teacher will have time for this, and there is probably no money for buying in support, a Learning Support Assistant who is ready to develop a little expertise, or the parent is the best way of proceeding. A commitment to 10 or 15 minutes daily usually over a fixed time of about 6 to 8 weeks is allocated. The pupil chooses the reading material and recently schools have been advised to allow boys to choose material which they enjoy reading even if less qualitative than is ideal. The adult and the pupil begin by reading simultaneously, with the helper pointing to the words as they go along. When the pupil is prepared to read aloud separately he does so. The pupil should be encouraged to persevere when the stammer is causing a hesitation but should let the helper know if the word is unknown, and then he should be given that word immediately. The helper needs to allow the pupil to stammer, but if the word is an unknown one the pupil should give a signal and will have it said. The helper then joins in again until the child signals a readiness to read independently. The whole exercise is intended to allow the pupil to become familiar.with the sound of his own voice and to empower him in the reading process, to feel valued for his speech and to begin to recognise some of the feelings connected with stammering. Gentle discussion of the child' stammer can be included and some of the fears which affect him can be discussed. This opportunity to discuss fears, ways of approaching the teacher, how to cope with problems of speaking generally is immensely valuable, and also gives the pupil a member of staff with whom a difficulty can be talked about. Ideally, we would hope that this activity was monitored and used as a support for the child until it was apparent that the pupil was coping without stress with the speech problem in the school. Certainly, by the end of the secondary lower school one would hope that the pupil had come to terms with the stammer if therapy had achieved no long lasting improvement, and was confident enough to take part in school activities to the degree that he was comfortable with, and had the confident to risk talking whenever he had something to say, or was required to do so by examination targets.

• Circle Time: Much is being written about this activity at the moment and many, particularly in teaching younger children, have found the technique helpful in many ways. There is a lot of material of ideas in this and it is certainly helpful in both the primary and lower years of the secondary at least.. The basic principle of having ground rules for speaking and listening within an environment which emphasises pupils working co-operatively are entirely in keeping with our concerns.

• Giving Instructions Teacher Talk: This is fundamental to the art of teaching but nonetheless it is worth reiterating the need for this to be clear and broken down into manageable steps. This is particularly vital in situations where the safety of the group could be put at risk and all teachers are usually aware of this, although in the rush of the classroom practice can be less good. For the child who stammers , particularly the younger one, there may be some difficulties with sequencing and a problem with taking in quite complex information. There is a real skill in phrasing the instructions and it is worth considering these skills occasionally, because we all get rusty. If at all possible, it is helpful to listen to yourself at some time, either by recording your own teacher talk, or having a colleague listen to you and reflect back afterwards. It might be a particularly helpful exercise for the subject specific teacher who may be so curriculum focused that there has been little time for reflection on how the oral instructions are conveyed. Listening to your own teacher talk, and breaking down the sequence of your instructions might show that they are very complex and possibly lack order, as you add points which occur to you. This is particularly hard for the younger child, and probably does not really assist the learning of any pupil. It is an area for colleagues to consider within their own schools, and as a basic teaching tool the giving of verbal instructions is often not revised in inset work , as there is so much else to be done. Methods such as reinforcement with blackboard notes, or work sheets are not always used as often as is needed. Sometimes instructions are given without any follow up on how they have been received.

• Question and Answer Sessions: Question and answer sessions, vital to most subjects should require the pupils to raise their hands. Not only is shouting out likely to lead to disruption , it particularly throws the stammerer who is visibly left behind. Question and answer sessions where the teacher throws out questions at random are very threatening to many children, particularly the stammerer and it is best to avoid that sort of approach. The emphasis is on developing the child's positive experience of hearing his own voice so that fear diminishes and confidence grows. Do talk openly with the child about his stammering if the pupil expresses an interest in doing so, but do not speak in a way that gives the stammer enormous significance. The teacher should judge when asking individual children questions when the child who stammers is most comfortable. Some children get so worked up waiting for their turn that they can hardly speak, and with a younger child it is best to ask the child early on, an older child who talks without embarrassment about the problem should be asked by the teacher which would be most helpful. When the pupil starts to stammer try not to pay more attention to the dysfluency than you would normal speech, this is quite hard to do because it is easy to only hear the stammering and not the content. If you pay more attention to the stammering than the normal speaking, you will be reinforcing the dysfluency. Do rephrase occasionally what has been said and use this as a strategy occasionally for all the class because it focuses on the content of an answer, and not the stammer, as well as being a useful means of valuing the comments of any pupil.

• School activities: Obviously all children should be given the opportunity to participate in school life to the extent that they choose, and this is particularly true of the child who stammers, who may enjoy sctivites in which talking takes place more easily, as in the acting situation for some children. Strengths which can be developed and build self esteem are all tremendously valuable. But occasionally, a stammerer may push themselves forward to join in situations in which they are continually failing, while quite normal with a young child who lacks self consciousness this is a syndrome which in an older child needs careful consideration, and management. Again if the school has been able to give the pupil the support of a particular member of staff who has been working with him in some way these issues can be talked through. Parents should also be involved in any discussion, if they have concerns and do feel strongly about the pupil's involvement in a particular activity. Is it really sensible for the boy to play Macbeth in the school play or the girl its equivalent, Lady Macbeth? Other opportunities to be succeeding might be better found in other areas where the pupil has real ability, and those areas should be developed so that we play to the strengths which are present. While we want to encourage all children who stammer to take part in school activities to the fullest extent they would like, there are limits and in a minority of cases these limits have to be tactfully explored and other opportunities offered.

• Listening to the pupil who stammers: If pupils can be brought to a position where he/she is quite comfortable with their speech, even though the stammer is quite obvious, the teachers are succeeding. Only therapy can really get to grips with the speech problem and unless intervention has been early its impact may not be that considerable. The teacher needs to display signs when listening to stammering speech that the child is accepted just as he is, indeed we would like to see the whole culture of schools being accepting in every way of the needs of each pupil. We anticipate that the inclusive classroom will focus attention on this, and that the promised training will enable teachers to deal more confidently with it. The teacher should maintain eye contact throughout, any evidence of impatience, embarrassment, or pity must be avoided. The way you look to the child as you listen is just as important as what you say, and the pupil will respond to your body language and understand what your real feelings are. The teacher may need to do some work on the "self" to develop these strategies, we do not pretend it is easy. Try not to fill in words when the stammering starts, sometimes a pupil may like you to do this but it is not helpful and gives an impression that the stammer is something which no one can be expected to have the patience to listen to. It is much better to allow the stammer to work its way through, while maintaining an interested expression as would be the case with a fluent pupil. We know of adult stammerers who prefer to have a word said for them but we do not recommend that as a strategy for children.

• Teasing and Bullying: This paper is not about teasing and bullying, but sadly far too many children are teased and bullied and we know from the work which we have sponsored at the University of Sheffield that the child who stammers may suffer from this considerably. The school policy on bullying is hopefully already in place and you will not need me to remind you of the importance of responding immediately to any concerns.

While the aim is always to cure the stammer and early intervention gives the best chance of that, it is difficult to overcome completely and may continue throughout life. The teacher's most helpful role might turn out to be helping the pupil to overcome the fear of stammering which probably does more psychological harm than does the stammering itself. I just want to stress the importance again of a whole school approach which gives all colleagues the information needed for the support of the stammering child. I would like you to consider what steps you are able to take to put speech on the agenda in your school. How will you cascade the information that you have received today in some quick and practical way. Often the busy teacher does not have time to pass on what has been learned. Have you a method for doing this in your school? Reflect on your own practice, ideally with colleagues and consider strategies which you can implement. Next time you are out and about try to imagine how it feels to stammer, particularly for young people and alert others to the problems a stammer may cause.