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From: Erika Shira
Date: 19 Oct 2008
Time: 13:22:09 -0500
Remote Name: 66.92.76.147
Wow, great questions and ideas here! "(1)(a)How many stuttering clients have you worked with and what percentage would you say expressed a substantial benefit from music therapy?" ~40? If my memory serves me, all but two; one whose mother pulled him from therapy suddenly for reasons unrelated to anything we were working on, and one who turned out to have some serious thought disorders, so we're still focusing there and haven't touched the stuttering. "(b)In what way were they benefited? Meaning, was their stuttering reduced or were they more comfortable with the fact that they stuttered, or both?" Both. I've seen a) folks whose stuttering was reduced, b) some whose speech quality didn't change at all but who were content with their social/emotional gains, c) and some whose stuttering didn't change much in terms of how long it might take them to say a particular phrase but whose speech improved qualitatively in that they presented with thoughtful pauses rather than uncomfortable hesitation. "(c)Do you typically work alone or in conjunction with an SLP?" Both. "I found it interesting that you stated that if a person's stuttering is deemed a "result of social anxiety," then it is okay to work with them individually, without the aid of an SLP. Though SLPs cannot claim to be experts on the subject of stuttering, we can contribute a unique and informed perspective on the subject." Yep, certainly. I love working with SLPs and people of other disciplines for exactly this reason. As I mentioned in a few other threads, I'm a big advocate of making sure my clients know about all the different disciplines and theoretical orientations out there so that they can make informed choices about who to see. A lot of the folks I see have either made a conscious choice that they feel their issues are social/emotional in nature and want to work with someone with a counseling background, or they have cognitive or mental health impairments that make it hard to participate in the more traditional cognitively based approaches that SLPs might use, so their families or guardians have chosen music therapy. "(1) Do you feel that music therapy alone, without speech therapy, is enough for some individuals whose root is supposedly a result of social anxiety?" It depends. I've encountered a lot of people who feel that their issues are entirely social/emotional, and they've expressed that they don't want to work with anyone who doesn't have a counseling background and wouldn't be an appropriate person to also talk to about PTSD or whatever they are identifying as the root of their issues. Other folks will identify as only wanting to see a psych person, often for similar issues, but then I'm pretty sure that I'm also seeing some unusual motoric issues that are out of my area, so I want them to also see a SLP. "It has been my experience, and has been expressed by a number of other people I know who stutter, that a stutterer's anticipation of what they are going to say can have a significant effect on their stuttering. Some suggest that if a stutterer didn't anticipate, they would stutter much less or not at all." Ooh, good way of putting it. Yes, I think this is the case for many folks. "(3)Have your clients made comments regarding their anticipation and whether it has been decreased?" Yes, people have talked about feeling less worried about whether they're going to be able to get something out, and more focused on their ideas than whether they'll be able to make the sounds. Which makes it easier to get the sounds out. This concept probably also applies somewhat to the folks whose actual speech doesn't necessarily come faster, but who present with comfortable/thoughtful pauses instead of the previous hesitation and awkwardness. "Lastly, and this is a comment and not a question,someone in a recent comment also mentioned that the concept of time pressure is altered through the use of music. I'm not sure if there's any evidence for this, but it seems to make sense to me. In music, words are framed differently and there are deliberate pauses and prolongations of words. The flow is completely altered, and language is treated in a unique way in song. It makes complete sense that a sense of urgency is non-existant because the point is to be creative with the rate of flow, not to adhere to a socially accepted rate." Yes! I love the way you and the other commenters are phrasing these concepts. I think this is exactly it. And yes, I do think it's more important that speech flow rather than be produced at a particular rate. In music, silences and slow tempos are acceptable. I definitely play with silence and tempos when I'm improvising with clients. With all clients, actually, because increasing one's flexibility and range of comfort is just a great life skill for, well, everyone. I think this work does help the folks who end up not necessarily having more succinct speech rhythms, but who do end up with a more comfortable-sounding flow. Thanks for the great thought-provoking comments!