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From: Joan Cahalan
Date: 21 Oct 2007
Time: 10:48:34 -0500
Remote Name: 68.13.155.214
Thanks Emily for your very good questions. I am a believer in giving the child as much ownership as possible or within reason. To answer your first question, both the child and I have a copy of the box and it's components. If the child doesn't color in the box layers in spite of attempting the objective, we do it together in the next session. (At this point, the moments come where you can help reshape the child's attitude and perception of "success." A child who attempts a practice assignment in spite of stuttering, in spite of the outcome of using modified speech tools, in my eyes is a success. He/she is building tolerance for stuttering, not avoiding, and perhaps engaging in a good pragmatic communication opportunity.) To address your last question, each child is of course unique. Some you'll have to guide more than others depending on age and maturity. I think the child should self-adjust and be in charge of moving to other levels, and manipulating the "who, what, when or where" in whatever way they need as long as they continue to feel motivated to try, yet challenged as well. Checking in with their therapist (for older kids) before they attempt a task that you haven't discussed in therapy is always a good idea. If they chose a task that produced "failure" in their eyes, we again focus on the positive... that they tried, and the reality that tools don't always work even when we think we're doing everything to ensure "success." As tolerance builds, so does their motivation to create more tasks, or opportunities for transfer. If you work in schools like I do, it's important to assess all elements of educational and social impact that stuttering has at school. A child may not be able to see beyond the box of just the fact that he stutters. A child can develop covert attitudes and behaviors very early on. Timing is important when beginning to speak outside the box. We'll keep the "where" inside the therapy room (and challenge the child to consider a new "who" in the therapy room) until the child is able and willing to choose a new location. Some teachers and parents quite often don't understand stuttering and the therapy process, so in my eyes, this box design intrinsically addresses some of those important "stepping stones" toward reaching the child's goals of improved communication in both academic and social situations at school and home.