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For Parents of Stutterers
If the PWS is under age 18, a parent/guardian must email their written consent.
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Stuttering Info
Your age when you first stuttered
Bad Incident
Defining “Bad Incident” as speech where you were deeply humiliated by appearing speech disabled, please answer the following questions:
Of your total conversations in the average day, what % were CLEARLY Bad Incidents?
What PERCENTAGE of your Bad Incidents were one, some or all of the following:
Repeats
Blocks/Silences
Grimaces
Body Contortions
Under pressure, what % of your words do you stutter/block?
When talking to your family/friends?
When talking strangers, authority figures?
When talking on the phone?
When at work or when speaking in class?
In what percentage of your conversations do you appear CLEARLY speech-disabled?
Describe your speech problem:
(Required)
Can you read aloud (alone) without stuttering?
Yes
No
Sometimes
Can you whisper without stuttering?
Yes
No
Sometimes
Can you talk when alone without stuttering?
Yes
No
Sometimes
Are there any other places or situations where you can talk without stuttering?
Yes
No
Sometimes
If yes, where?
Are there other stutterers in your family?
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If so, how many and who are they?
Name and describe any speech therapies you have had:
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Did any of them enable you to stop stuttering?
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Do you have any other impediments that may affect your speech? If so, describe:
Do you have autism, Asperger’s, ADD/ADHD, PANS/OANDAS, Williams Syndrome, or any condition related to any of the foregoing? If so, please describe.
Have you read any of Lee Lovett’s stuttering books? If so, name them:
Are you a Patron Member/Subscriber to World Stop Stuttering Association?
You need to be a member to take advantage of this program and to receive coaching, as you will be asked to use WSSA’s online materials It is very inexpensive.
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Agreement
A few Reminders:
Sign ALL of your EMAILS with your FIRST AND LAST names. Many people have similar names. We must be able to identify you.
Mechanics, Privacy and Caveats.
Coaching is done by Zoom or Skype. WSSA maintains a library of its 2,000+ videos that can be watched by its members only. Your face can be blocked. Last names are never used. Other than what is visible on our website, we do not sell or otherwise share personal data of ANY student with third parties.
WSSA is an IRS-approved charity. Coaching does NOT guarantee any level of success. Coaches heal no one. Students heal themselves by working hard to do what coaches ask them to do.
Most, who finish this program, no longer appear speech disabled and learn to love to speak in all situations.
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