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From: Kathy Scaler Scott
Date: 16 Oct 2007
Time: 10:30:12 -0500
Remote Name: 24.249.94.37
Kirstin,Excellent point, and I find the lack of awareness interesting as well. In my clinical work, however, I have seen that identifying disfluencies in the moment, especially if they are tension-free repetitions like C3's, also happens with children and sometimes adults who stutter but have no other diagnosis. If you think about how we might say an "um" or "uh" or repeat a word here or there and not even notice it, it makes sense. If there's not the tension of the block they may not notice. Here's what I think happened with the awareness of disfluency in general but no awareness in the moment, at least in C3's case especially: someone pointed out to him that he has repetitions, and so now if you ask him about it, he'll acknowledge it. But that awareness didn't come from him discovering it, it came from what someone told him, and kids are highly suggestible to what we tell them. That's where I think the discrepancy lies. And you're right, lack of awareness can make something difficult to work on and change. Now there can be lack of awareness about many things with the ASD population. So we have to look at the whole picture. If the disfluencies are tension free and we suspect they are more language related, we work on language and don't have to worry about awareness of the disfluency--it's more a byproduct of another issue (of course we are basing this on our best assessments of what we see with the child since more research is needed in this area). If the child is "fighting" stuttering moments with lots of tension and struggle (and that's often a natural reaction to try to push through) and are not aware, we do need to work on increasing their awareness of what they are doing and to talk about what might be more effective so they can get through the word more easily.