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From: David Shapiro
Date: 19 Oct 2007
Time: 19:19:04 -0500
Remote Name: 152.30.155.38
Hi Tricia, You are asking a good question. And indeed you are right – there always is more to learn. I would be interested to know what you mean when you say the boys are self-aware. Do you mean that they are aware of when/how they stutter? Or do you mean that they are in touch with and/or accepting of their feelings related to the speaking experience? I would need to know more in order to respond more specifically. However, my approach may be a little different. I find that even when clients are aware of when stuttering occurs, rarely are they aware of what they are doing when they are fluent. Typically, the fluency is more frequent than the disfluency. For these reasons, I do not begin by focusing on the disfluency. I focus first on fluency success, creating opportunities for the client to experience speech without stuttering (e.g., via a fluency shaping exercise, such as choral reading or choral speaking). Then, I identify specifically (i.e., first for, and eventually with, the client) what the client is doing within conversation with me when he is fluent. Typically three patterns are observed - even rate, gentle articulation, and natural inflection. By focusing on those three patterns, the client is addressing what he already is doing that results in fluency and how to do even more often what he already is doing correctly. This is different than directing the client in what not to do. In fact, when demonstrating these three patterns, the client cannot stutter. The client learns that fluency is a consequence of what he is doing (and thinking and feeling); disfluency also is a consequence of what he is doing, but differently. With practice, guidance, and regular home assignments, the client comes to understand and thereby control what he is doing in order to be fluent even more often. By creating opportunities such as this, the client experiences an empowerment that is highly motivating. Nothing is as motivating as directly experiencing fluency success. In other words, success begets success. Both the absolute and relative frequency of fluency increases; typically self-comments reflect increased internal locus of control and the realization of what one can, rather than cannot, do. You might want to review my responses to the people who have reacted to my paper, Being Real, in this conference. In several instances, I explained different aspects of my methods. Also, I elaborated my intervention more thoroughly in the book, Stuttering Intervention: A Collaborative Journey to Fluency Freedom. Feel free to follow up with me outside of the conference if I might provide any clarification. As an SLP and a PWS, thank you for all you are doing to help these two boys. David Shapiro