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From: Sandra Merlo
Date: 21 Oct 2009
Time: 13:29:41 -0500
Remote Name: 201.95.208.16
Dear Jennifer, thanks for your questions. I think your fluency class is doing a right thing when you spend a lot of time discussing the different attitudes that PWS can show. Negative feelings and behaviors can raise great difficulties for speech improvement. 1) I think the first step for changing is being conscious about the own behavior. The patient has to be conscious about his/her helpless response, about his/her performance goals, and about his/her beliefs that stuttering is unchangeable. Then he/she has to see that fluency can be changed. For example, the patient him/herself probably lives situations where his/her fluency is better; maybe his/her stuttering has changed through time and the speech therapist could use this example. The next step is focusing on learning and not on performance: “what can I learn with these experiences?”. It is also very useful to use situations that the patient is living and interpret them with helpless and mastery-oriented responses. This makes both options clearer. 2) The common characteristic that is shared among PWS who show helpless response is that they don’t believe they can really improve their speech. They understand that they can learn strategies to hide stuttering, but they don’t really believe they can improve. This is very coherent, because things are static for them. Regards, Sandra