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From: Russ Hicks
Date: 22 Oct 2007
Time: 21:20:05 -0500
Remote Name: 71.123.180.215
Hi Amber HICKS! I like your last name! Are we kin by any chance? Where are you from? I'm from Texas. ..... Anyway you asked "How do you propose one would go about encouraging a young PWS to attain a similar attitude and evaluation of this disfluencies?" That's a very good question. However it's a slow process because it's a "heart" thing, not a "head" thing. The head (the intellect) learns things from books and lectures, etc., and that's fundamentally what you learn in school. (You know about that don't you? <grin>) And "head learning" is relatively quick and easy. You read or hear something and it goes in your brain for you to remember - at least until the next test! Ha, ha, ha! ..... The heart (the emotions) learns things by experience and repetitions. It couldn't care less about logic because it just isn't logical. But "heart learning" is slow and difficult. It requires ten million repetitions for something to sink in and for the heart to BELIEVE. ...... The key to therapy in adults is to teach your client's head first - whether he or she believes you or not. Explain what stuttering is and the various approaches to therapy. You know the drill. We're all different. Fluency is not the goal - despite what they may say - improved communication is what we're after. Explain the stuttering iceberg (see my 2003 ISAD paper called 'The Iceberg Analogy of Stuttering' at http://www.mnsu.edu/comdis/isad6/papers/hicks6.html for more details on this.) Explain that it will be necessary to attack both the top and bottom of the iceberg for any long term results. The top of the iceberg is where the disfluencies are noticeable. The bottom of the iceberg is where the emotions such as fear, shame, embarrassment, isolation, etc., are and those are probably even more important than the fluency aspects of stuttering. ..... That's the easy part. Next on your agenda is to attack the client's heart. And you do that by facilitating LOTS of experiences, the more positive the better. Therapy is not an hour a week event. It's nearly 24/7/365. You can facilitate actions, but the client is going to have to experience them for themselves. For example have them go up to someone in a department store and ask directions to the men's department (or wherever). And STUTTER when they do that. (YOU may have to show them how to do that, so that's why practicing stuttering YOURSELF is so important.) And then notice the listener's reaction to your or your client's stuttering. Did the guy pull out a gun and shoot you? Probably not. Ha, ha, ha! He probably simply gave you the directions you asked for. One experience down, 9,999,999 more to go. Start easy and work up to the more difficult ones. (See a really good paper on this at http://www.mnsu.edu/comdis/isad10/papers/therapy10/dauer10.html ..... I joined the National Stuttering Association many years ago and that ought to be an absolute requirement for anyone who stutters. It was in the NSA that I got the courage to face my fears and join Toastmasters, a public speaking organization. I was scared out of my mind at first. But the continuous and never ending positive feedback I've received from my nearly 20 years in Toastmasters has FINALLY convinced my heart that fluency and communications are two totally different concepts. People really don't care about fluency (within reason), but they DO care about good communication. So I learned how to improve my communication skills in Toastmasters just as surely as you can learn to play the piano. It just takes practice and positive feedback, over and over and over again. Be careful not to practice fluency by itself. That's spinning your wheels. But practice good communication skills such as good eye contact, smiling, firm handshakes, etc. Be positive about yourself and people will inevitably be positive back to you. ..... The key to changing the heart is repeated positive experiences. Toastmasters is one way - and I highly recommend it. There is where I got my real "ah-ha!" moments. But that's not the only way. Learning to say what you want even though you stutter is another way. Being open about your stuttering is another. Attending an annual NSA conference is yet another. (You want to PARTY? Come to an annual NSA conference! <smile>) ..... What you are trying to accomplish in your client is CONFIDENCE in his own ability to lead a happy successful life. He CAN do what he wants! He CAN succeed! He CAN get a date with a pretty girl! He CAN get good grades in school! He CAN do nearly anything he wants if his does NOT let his stuttering stand in his way. Once he has the confidence he needs to succeed, you can chalk him up as a success as a client. Praise, praise, praise... and more praise. (But be careful NOT to praise simple fluency because that sends the message that fluency is good and therefore stuttering is bad.) ..... In children the approach is much the same but simpler. You needn't go overboard on the explanation of stuttering. You can work on standard fluency techniques to reduce his frustration when he gets into trouble with how to, for example, to break a block. Show him how it's done. But keep in mind that the goal still is NOT fluency, but his ability to say what he wants when he wants. And praise him profusely when he does that, especially when he stutters doing it. ..... With children the involvement of the parents is absolutely essential. TEACH the parents about stuttering and maybe even the iceberg. Kids generally don't have much of an iceberg when they start out. And your job as an SLP is keep one from forming. However the iceberg may be with the parents! Show them the importance of continuous positive feedback with their children. And it's not their fault that their child stutters! (That's sooooo important!) And their child can do anything that anyone else can do as long as they don't let their stuttering hold them back. The child will naturally pick up the emotions of the parents. So it's important that the parents feel positive about their child's future too. .... Wow... Had enough for one day? You asked a simple but difficult question and I gave you a much longer answer than I'm sure you expected. This stuff ain't easy, make no doubt about it. If I can answer any other question for you - or if you just want to talk further about this, please feel free to email me at russhicks@mail.com. ..... I wish you the best Amber. And in your journey through life. I hope our paths cross sometime. ..... Russ