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From: John Tetnowski
Date: 16 Oct 2008
Time: 14:15:44 -0500
Remote Name: 74.171.126.240
Dear Jen, Great question and one that I would love to take a shot at. It is a common assumption that spontaneous tasks will be more difficult than reading or repetition tasks. With many PWS this is not the case. As a matter of fact, it may be the complete opposite. I see this as a key factor when evaluating PWS. What I mean is that the difficulty they have in reading (and maybe repetition, as well) could be due to specific word and/or sound fears. That is, they can avoid saying words or sounds when speaking spontaneously (and thus not stutter as much), but they cannot avoid words or sounds that may be problematic when reading (or repeating). This type of client needs to deal with these fears and needs desensitization as part of their therapy regime. Another possibility is that the teen has a reading problem. The reading task may require more cognitive load and thus cause stuttering to be more severe (along with performance anxiety issues). I suggest re-evaluating his stuttering across tasks (spontaneous, reading, and repetition) and make comparisons. Word or sound fear may well be the issue, and this may cause you to alter your therapeutic philosophy, or to rebuild your treatment hierarchy. Great question, John Tetnowski